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Pregnancy and Bariatric Surgery

Date issued: December 2022

Review date: December 2024

Ref: B-376/Dietetics/RG/Pregnancy and Bariatric Surgery v5

PDF:  Pregnancy Bariatric Surgery final December 2022 v5.pdf [pdf] 222KB

Pregnancy and Bariatric Surgery

You must avoid getting pregnant for at least 12 to 18 months after surgery.  During this period you will be experiencing rapid weight loss and you are most at risk of vitamin and mineral deficiencies which may be harmful to the baby. The effectiveness of the pill may be reduced after surgery so you should seek advice on alternative methods of contraception.

If you do become pregnant after the first 12 to 18 months following surgery, then your vitamin and mineral supplements may need to be adjusted. Pregnant women should undergo nutritional blood screening every trimester.

Planning for Pregnancy

Healthy women, planning for pregnancy, should take an additional 400 mcg/day folic acid prior to conception until the 12th week of pregnancy. However, in women with obesity or diabetes, the recommendation is 5 mg folic acid until the 12th week of pregnancy as there may be an increased risk of neural tube defect affected pregnancy.

Women, as part of preconception care, are advised to avoid vitamin and mineral preparations which contain vitamin A in the retinol form in the first 12 weeks of pregnancy. Supplements containing retinol may be harmful to the fetus especially in the first trimester.

Vitamin and mineral supplements which are safe and specifically aimed at preconception and pregnancy are Pregnacare®, Seven Seas Pregnancy® and Centrum Pregnancy Care®. If in doubt, check with your health care professional that any supplements contain vitamin A in the beta carotene and not retinol form.

Nutritional Screening

Patients who become pregnant following bariatric surgery should undergo nutritional screening every trimester. This should include ferritin, folate, vitamin B12, calcium and fat soluble vitamins A, D, E & K.

A more frequent review with the specialist bariatric dietitian may be required.


Vitamin and mineral supplements after gastric bypass/sleeve gastrectomy in pregnancy

Vitamin and minerals recommended

Multivitamin and mineral supplement

One daily Forceval capsule.  It is safe to continue with Forceval capsules as vitamin A is in beta carotene form. (Forceval soluble tablets are NOT safe in pregnancy as the vitamin A is a retinal form.)

Safe over the counter pregnancy multivitamin and mineral supplements include: Seven Seas Pregnancy®, Pregnacare®, Boots Pregnancy Support®. Take once a day.


45 to 60 mg daily, 200 mg ferrous sulphate, 210 mg ferrous fumarate or 300 mg ferrous gluconate daily.

Folic acid

Encourage intake of folate rich foods such as green vegetables & fortified cereals.   Additional folic acid (5 mg), preconception and first 12 weeks of pregnancy.

Calcium and Vitamin D

Ensure good oral intake of calcium and vitamin D rich foods such as milk, yoghurts and cheese. Continue with maintenance doses of calcium and vitamin D as identified preoperatively. Vitamin D >40mcg and calcium 1200 – 1500mg calcium daily including dietary intake (e.g. Adcal D3 one tablet twice a day Or Theical D3: half a tablet twice a day in pregnancy)

Vitamin B12 

Intramuscular injections of 1mg vitamin B12 three monthly. N.B. sleeve gastrectomy patients may need less frequent injections

Management of gastric bands during pregnancy

There is no international consensus on how to manage gastric bands during pregnancy.  Many women who have had a gastric band are fearful of excessive weight gain during pregnancy and are very reluctant to have their bands defilled.  However, these concerns must be balanced with the potential risks to the baby.  Good nutrition is vital for both the normal development of the foetus and health of the Mother.

If you have a gastric band and become pregnant you should be seen by the Bariatric team as soon as possible after your pregnancy is confirmed.  We will consider each case on an individual basis but it is highly likely we will recommend that your band is completely defilled at this stage.  We will then see you again early in the second trimester to discuss whether some fluid should be reintroduced into the band to limit excessive weight gain. Weight gain is normal during pregnancy and we will not adjust the band to achieve weight loss as this could be harmful to both Mother and baby.

If any fluid has been put into the band during pregnancy, the band should be completely defilled at 36 weeks.  A programme of band adjustment can then be started once breast feeding has been successfully established.

You should have nutritional bloods checked every trimester during your pregnancy and close communication between the Obstetric team and the Bariatric team is required.  

How much weight should I expect to gain through the pregnancy?

You should not try to lose weight while you are pregnant, but it is also important you do not gain too much.

Overweight pregnant women should gain about one stone (6kg)

Normal weight women should gain about two stone (12kg)

If you have concerns, speak to your Dietitian.

Foods to avoid during pregnancy

  • Raw and partially cooked eggs and dishes containing these e.g., homemade mayonnaise, mousses.

  • Raw shellfish; raw and undercooked meats and chicken.

  • Soft ripened cheeses including Brie, Camembert and some goats’ cheeses; blue veined cheeses e.g., Danish Blue; all unpasteurised dairy products; all types of paté including vegetable; soft serve ice cream from vans or kiosks.

  • Shark, marlin, swordfish

  • Fish liver oils containing more than 700mcg/day; liver and liver products e.g., pate, faggots.

  • Alcohol

Foods to take care with during pregnancy:

Oily fish: Eat oily fish such as fresh tuna, salmon, mackerel, sardines no more than twice per week.  Limit canned tuna to four medium cans per week

Caffeine: Limit coffee, tea, cola, high energy drinks and chocolate. Have no more than 200mg caffeine per day (two mugs of coffee or three cups of tea a day).

Who to contact

Claire Woods, Bariatric Nurse Specialist

Rachel Griffin, Bariatric Dietitian. 

Ciara Caleshu, Bariatric Dietitian

Email via the Bariatric Inbox address:


The inbox is checked daily Monday – Friday.

If your query is urgent, phone Derriford Hospital switchboard on 0845 155 8155 and ask them to bleep the Bariatric Nurse.

If your problem is very urgent you will need to attend the Emergency Department (Casualty) at Derriford Hospital

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