by Jessica Bower, IBCLC, Certified Doula
Disclaimer: I am writing this post based on my journey through gestational diabetes. I am not a nutritionist. I'm a doula and lactation consultant who did my best to make normal sized babies after my first two babies were large. I would say that my journey was successful! So look at this as a case study, check out additional resources, and talk with your healthcare providers about a plan that will work for you if you'd like to try to make a smaller baby.
In 2012, I was pregnant with my first baby. I drank the dreaded glucose drink and I failed the 1 hour test. When I took the 3 hour test, I passed and was thrilled. It didn't look like I had gestational diabetes. I wouldn't say I ate unhealthy at all - I ate a lot of whole foods, lots of fruit, occasional takeout, and of course I did have desserts a few times a week through pregnancy I'm sure. I had an uncomplicated birth and my baby was 9 pounds 5 ounces. He was large, but everything in labor and delivery was smooth. We didn't think I had gestational diabetes since I had passed the test - we just assumed that I made big babies and I was thankful that he came out!
In 2014, I was pregnant with my second baby. I would say that overall, I probably ate even healthier this pregnancy. But again, I did love some Thai takeout, lots of fresh fruit (he was born in September so I had a ton of fresh fruit over the summer - and I'm not going to lie - I ate massive quantities of it!), and I had dessert a few times a week. This time I passed the 1 hour glucose test and so I didn't need to take the 3 hour test. I previously had a great unmedicated birth and I was confident that my body would do what it needed to do again to get my baby out. My baby was measuring on track through my whole pregnancy, but on my due date, the midwife felt that he was measuring 43 weeks rather than 40 weeks which is where he should have been. I had been having signs of labor, so I wasn't too concerned about it. I knew I had birthed a big baby in the past and I felt like he'd be born soon. My labor started later that day. This labor was twice as long as my first labor (24 hours compared to 12 hours). I'll keep the story short to say that when he was born, we experienced a bad shoulder dystocia (his head was born but the rest of his body was stuck in my body for about 3 1/2 minutes). This is an emergent situation, but my care providers took excellent care of us and I'm incredibly thankful that I can say that neither of us had any injuries during the birth. He weighed 11 pounds 8 ounces (and it was a totally unmedicated birth, just in case you're wondering). He. Was. Giant. And his birth was quite scary for me. I lost confidence in my body being able to birth a big baby. I didn't want to have another big baby.
In 2016, I was pregnant with my third baby. I knew this baby had to be smaller. I prayed for an 8 pound baby my whole pregnancy. But I knew I needed to act different too. Even though I had passed the glucose tolerance test in prior pregnancies, I felt like the test had failed me, so I decided that I wouldn't take the test at all during this pregnancy. Instead, I checked my own sugar 3-4 times a day by pricking my finger and keeping a food log and sugar log. This is a very accurate way to see if you have gestational diabetes / insulin resistance. I was able to see that what I ate did in fact impact my numbers - and more importantly, those numbers showed. that what I ate had an impact on my baby. I devoured the book Real Food For Gestational Diabetes. I decided that I needed to go on a very low carb diet. What did this mean for me? Of course it meant that I cut out the obvious things like sugar and breads. But I also cut out grains of any type, potatoes, and almost all fruits. My diet was heavy in vegetables, dairy (cheese, Greek yogurt), meat, and nuts. This may sound like a no carb diet, but it isn't - there are carbs in nuts, veggies, and yogurt. I had 3 desserts in the third trimester - I let myself have one sweet cheat each month in the third trimester. People would tell me that they had no idea how I had that much self control. Let me tell you - living through birthing an 11 pound baby will make you rethink wanting to do it again. My baby in this pregnancy thrived. I also exercised as much as possible - I did 30-60 minutes of exercise 4-6 times each week. It was hard! But I knew it would pay off in labor. For this baby's birth, it was very fast - only about 2 hours of active labor - and my tiny 7 pound 15 ounce baby was born in about 2 pushes and no issues!
In 2018, I was pregnant with my last baby. I felt confident again going into this pregnancy. I knew what to do to make a small baby. Again, my prayer was an 8 pound baby. I checked my sugars and I had my diet and exercise routine down. But this time, my fasting numbers were still high. Despite my diet being perfect, exercising, and being at a healthy weight... the numbers were not right. I knew this would lead to a big baby again. I was frustrated with my body. My midwife and I decided that I should go on insulin to help my numbers. And it worked. Even with the insulin, I stayed committed to my diet. The insulin, diet, and exercise combo worked perfectly and my numbers got back under control. My final birth was a perfect water birth and my last baby was 8 pounds 1 ounce.
The picture on the left is the last picture I have of my bump before my 11 pound baby was born. This was 9 days before his due date. The picture on the right is the day before my 8 pound baby was born. I was wearing the same shirt in both pictures:
People like to ask what I ate. Here are some ideas:
- Eggs - I did a lot of breaskfast casseroles (look for frittata recipes or quiche recipes without crust) with veggies / meat / cheese. These are easy to mix in whatever veggies you have on hand and then you can eat on them for breakfast for a few days.
- Plain Greek yogurt with sliced almonds and berries - Plain Greek yogurt is packed with protein and has limited carbs. It's an acquired taste, so this is where I'd eat my limited amount of fruit for the day - I'd put in blueberries / strawberries / raspberries and sliced almonds to give it some texture and sweetness. Berries have less carbs than fruits like bananas or melons
- Lots of salads - Look on Pinterest and get inspired. I'd buy a rotisserie chicken and pull the meat off of it and eat on it for a few days.
- Leftovers from dinner
- Tacos or fajitas (and use romaine lettuce or a cabbage leaf as a tortilla)
- Thai (I still loved Thai takeout but I'd eat it without rice or eat it over riced cauliflower)
- Italian (and use zucchini noodles rather than pasta).
- Cookout food (hamburgers and hotdogs without the buns - I know it's a little depressing, but it's only short term!)
- Pizza (I experimented with a few low carb pizza crusts that were made out of almond flour, cheese, and eggs) and it was really good!
- Grilled veggies or roasted veggies for sides were incredible
- Cheese sticks
- Nut butters
- Raw Veggies
- Black coffee
- Red Raspberry Leaf tea once I hit 37 weeks (ask your provider about this)
So, will this help *you* make a smaller baby? I hope so?! Maybe!? I just wanted to share my story for inspiration and encourage you to get the book I mentioned. Pinterest was my friend in finding low carb recipes. I never limited my intake of veggies, nuts, or meat. I just ate to hunger. Like I said, talk with your providers about your plan and see how your body and your baby respond to diet modifications. I'll say that my mission to make smaller babies was absolutely worth it both times! Oh - and you might want to know what I ate after my last small, 8 pound baby was born - I ate a peanut butter pie. And it was perfection and everything I dreamed of through the pregnancy!
If you're interested in hearing my full birth stories, I share them on episode #230 of The Birthful Podcast.