To Your Health

Q. After my third baby I didn't lose the weight I gained during pregnancy, and I have even gained some more. What is going on?

A. Obviously pregnancy produces a large number of changes in a woman's body. Some are temporary, but some are long-term and even permanent.

Obstetricians are well aware that calcium reserves are diminished by pregnancy and so routinely advise calcium supplements during the latter stages. Less well known is the need for magnesium to promote healthy bones as well as to maintain balance with calcium. By adding magnesium to the supplement program, the life-threatening condition known as pre-eclampsia can nearly always be prevented. Furthermore, since magnesium is required for energy production, a deficiency may prevent a new mother from returning to a normal activity level. Caring for three children is tiring enough, but probably does not qualify as the aerobic activity needed to lose weight.

Another mineral that mothers donate generously to their offspring is chromium. Chromium is part of a hormone known as "glucose tolerance factor," which works with insulin to transport glucose into cells for burning. The birth of three children is likely to deplete the maternal stores of chromium and result in less efficient performance of glucose regulation. Glucose that is not burned in cells is converted to fat and stored in adipose tissue. Good food sources of chromium are brewer's yeast, whole-grain products including wheat germ, and many vegetables.

The thyroid hormone interacts strongly with female hormones. Following delivery, when female hormones are readjusting, the level of thyroid hormone may fail to return to normal. Thyroid hormone can be thought of as the thermostat that regulates the rate at which energy is used while resting. This "basal" metabolic rate may account for as much as half of our total energy expenditure, thus a small change can greatly affect weight.

One in every 20 women will develop thyroid problems within a few months after delivery of their baby, a problem involving either too much or too little of the hormone. The symptoms may not be easily recognized since they are common among new mothers, and may simply be attributed to lack of sleep, nervousness, or depression. You might want to ask your doctor to order a blood test for thyroid status.

Women who begin pregnancy with a high level of the hormone leptin tend to gain more weight during pregnancy and to retain that weight after delivery. We still have a lot to learn about leptin, but it appears that a high level of this hormone indicates a resistance to its action.

Whatever may be the cause of postpartum excess weight, breastfeeding may assist you in losing weight, at least during the 12 months after giving birth. According to the American College of Obstetricians and Gynecologists, the process of breastfeeding releases a number of hormones that help your body return to its prepregnancy condition.

Because babies (especially their brains) require a considerable amount of various kinds of fat to develop, if you need to reduce calories, reduce sweets and refined carbohydrates and continue to eat foods such as ocean fish and nuts.

Remember that your body has just undergone enormous strain so be sure you eat properly and exercise prudently to maintain your health.