Thriving in a Twin Pregnancy: Twin Pregnancy Diet


Excerpted from Double Duty: The Parents’ Guide to Raising Twins, from Pregnancy through the School Years (2nd Edition) by Christina Baglivi Tinglof Copyright © 2009 by Christina Baglivi Tinglof. Excerpted by permission of McGraw-Hill. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Staying Comfortable

A woman carrying twins in Week 30 is carrying the same weight as a woman carrying a singleton at term. For the mom carrying multiples, comfort becomes harder and harder to achieve. Try the following devices to help ease your aches.

  • Flats or sandals. During pregnancy it’s not uncommon for feet to increase a full size (and often they don’t return to their prepregnancy size after birth). To keep your feet comfortable, wear comfy flat shoes, sandals, or a strong pair of flip-flops. But be careful—pregnant woman are not known for their sense of balance.
  • Support hose. It’s not just for the senior set anymore. Wearing support hose (such as Pintoli Women’s Comfy Compression Socks) will help alleviate swelling of the feet and ankles (edema) by forcing the blood back to your heart, and aid in the prevention of varicose veins.
  • Belly support. Toward the end of the second trimester and throughout the third, the weight of twins on a pregnant woman’s back can be intense and painful. Relieve the pressure by wearing a belly support, a minigirdle that wraps around the lower stomach and back. It is available at most maternity stores, through maternity catalogs, and, of course, online. (BellaBand Women’s New Everyday Bellaband is a good choice.)
  • Maternity/nursing bra. A good maternity bra with flaps that open to enable breastfeeding not only gives support to heavy breasts, decreasing the chances for a backache, but it may also help prevent stretch marks.
  • Maternity pillow. Essential to a good night’s sleep, a maternity pillow that comfortably cradles your burgeoning belly should top every pregnant woman’s shopping list. (Leachco Snoogle Total Body Pillow works well.)

Traveling

Usually, the journey itself isn’t harmful to your babies, but with the added chance of preterm labor or other complications that women carrying multiples sometimes experience, most doctors suggest that their patients stay close to home after they reach Week 30.

Diet

Low birth weight (less than 5 pounds, 8 ounces at term) and premature delivery are the two serious complications facing moms expecting twins. Yet expectant mothers who have a proper diet end up with babies who weigh more overall. And since the birth weight of twins is an important indicator in predicting their future mental and physical health, it’s extremely important for you to eat well. A visit to a nutritionist who specializes in high-risk pregnancies can help mothers-to-be with poor eating habits streamline their diets. The first priority of any mom expecting twins should be sound nutrition.

“I was vigilant about eating a lot and eating often. I kept a journal of what I had eaten so that I could make sure my eating was well balanced. For example, when it was time for a snack, I would look to see what I had eaten that day. If, say, I was low on dairy, then I would have some cheese. At the end of the day my goal was to have eaten plenty of protein, dairy, fruits, vegetables, and carbs.” (This mom delivered at Week 38, and her twins weighed 5 pounds 4 ounces and 6 pounds 7 ounces.)

How to Help Avoid Low Birth Weight Through a Proper Diet

Eat up! That’s right, you heard me! After reading page after page of what’s out of your control during these next nine months, diet is finally the one aspect where you have total control. You can greatly improve your chances of delivering plump, healthy babies just by what and how much you eat. And there’s plenty of research these days to back the claim. Reports show that a maternal weight gain of 40 to 45 pounds results in twins averaging 5 pounds 8 ounces (2,500 grams) each. Furthermore, the timing of that weight gain is important, too. Gaining the majority of the pounds early in pregnancy—41 pounds by Week 28—has the strongest impact on babies’ weight at birth. Researchers believe that higher weight gain earlier in pregnancy aids in the development and function of the placenta.

A pregnant mom holding a pear

For most women, packing it on during the first half of pregnancy will come as a treat since they find themselves in a constant state of hunger. (I found myself stopping for a hamburger often while driving home from work at four o’clock!) Once again, it’s Mother Nature’s way of stockpiling all those extra calories and fat to use for your babies in the weeks ahead.

How Much Do You Need to Eat?

While a mother expecting a singleton should consume about 2,300 calories and 80 grams of protein a day, a woman carrying twins needs between 3,000 and 3,500 calories and at least 130 grams of protein (one twin researcher advocates 170 grams of protein a day). You can use a chart like the one provided at the Talk About Twins website to track your intake. While it may seem like an incredible goal to reach, the extra calories and protein required are easily met with just a little more than an additional quart of milk a day!

“I didn’t realize until later in my pregnancy how important it was to gain extra weight with twins. I got that information from Internet research, not from my doctor. I only gained 30 pounds, but I only got to Week 31!”

Types of Food Needed for a Healthy Pregnancy

The following are merely diet highlights. Consult your physician or nutritionist about dietary recommendations.

Protein. The amino acids found in protein are essential in building cells and vital in the growth and development of fetal heart, brain, tissue, and muscle. Lack of adequate protein during pregnancy appears to be strongly connected to low birth weight. Clinical studies found that when a mother consumed 80 grams or more of protein per day, her baby would weigh at least 6 pounds at birth. Conversely, when a woman ate less than 45 grams of protein daily, her baby had a 47 percent chance of weighing less than 5.5 pounds. With every additional 10 grams of protein (up to 100 grams per day), the baby’s weight would increase by one-half pound at birth. (These statistics are for a singleton pregnancy.)

Meat, fish, dairy, nuts, and legumes offer the best sources of complete protein. Choose sources with a high ratio of protein to fat—in other words, eat broiled fish and skinless chicken instead of fatty or fried meat. Strict vegetarians who abstain from meat products should combine protein sources like legumes with whole grains and nuts to obtain complete protein. A protein-rich diet for the vegetarian should also include an abundance of soy products (soy milk, soy yogurt, and tofu).

FOODS HIGH IN PROTEIN

(amounts of protein per serving are averages)

Beef, chicken, liver, pork, turkey . . . . . . . . . . . . 4 oz.: 21 grams

Salmon, trout, shrimp. . . . . . . . . . . . . . . . . . . . . .. 4 oz.: 22 grams

Canned tuna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 oz.: 28 grams

Cheddar cheese . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 oz.: 7 grams

Cottage cheese. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 oz.: 19 grams

Eggs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..1 egg: 6 grams

Whole milk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 oz.: 8 grams

Powdered milk . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup (dry): 25 grams

Yogurt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup: 8 grams

Peanuts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 oz.: 30 grams

Peanut butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1/3 cup: 25 grams

Chickpeas (garbanzo beans). . . . . . . . . . . . . . . . . .3½ oz.: 20 grams

Lima beans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup: 13 grams

Brown rice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 oz.: 14 grams

Oats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 oz.: 12 grams

Spaghetti . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 oz.: 12 grams

Broccoli . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup: 5 grams

Spinach (cooked) . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup: 5 grams

Corn (cooked) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cup: 5 grams

Iron. During pregnancy your need for iron increases dramatically. Iron is essential in building hemoglobin (red blood cells), which transports oxygen in the blood. Toward the end of pregnancy, a baby’s need for iron rises significantly; and if a pregnant mom doesn’t maintain a sufficient level, she will develop anemia, a condition that may lead to pregnancy complications. Iron is also important for a baby’s nutrition immediately following birth, and, therefore, it’s important to build up a supply prior to birth. In addition, it’s important to remember that premature babies are often born anemic—another reason to stock up while you can.

Eating iron-rich foods along with foods high in vitamin C will aid in the absorption of the mineral, raising its efficiency in the body. Most women will find it difficult to meet their daily iron requirement through diet alone, so often a physician will suggest taking iron supplements. Take the supplement between meals with a glass of fruit juice or water (avoid taking it with milk) to aid in its absorption.

FOODS HIGH IN IRON

(amounts of iron per serving are averages)

Beef . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 oz.: 2 mg

Chickpeas (garbanzo beans)

and other legumes (beans and peas) . . . . . . . . . . . . .1 cup: 4 mg

Clams. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 oz.: 10 mg

Dried fruit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 to 12: 5.5 mg

Raisins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ½ cup: 2.7 mg

Pumpkin seeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¼ cup: 3 mg

Soy products (tofu, miso) . . . . . . . . . . . . . . . . . . . . . . .1 cup: 26 mg

Spinach (cooked) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cup: 4 mg

Wheat germ and other whole grains . . . . . . . . . . . . . ½ cup: 3.3 mg

Other foods high in iron:

Sardines

Sea vegetables (seaweed)

Artichokes

Calcium. If the thought of drinking four glasses of milk a day doesn’t turn you on, consider other sources of calcium like cheese, yogurt, almonds, sardines, tuna, salmon, and a variety of green leafy vegetables. Extra calcium is needed in a pregnant woman’s diet to aid in the development of fetal bones, teeth, heart, and nerves and to assist in blood clotting. In addition, some studies indicate that extra calcium reduces the risk of preeclampsia. To aid in its absorption, avoid eating calcium-rich foods with caffeine or fibrous foods such as whole-grain products.

Folic Acid. Folic acid, a B vitamin, is not only needed for baby’s growth and development and liver efficiency, but well-documented studies indicate that a diet deficient in folic acid may contribute to birth defects (such as cleft palate and spina bifida, a condition in which the spinal column doesn’t close completely) and low birth weight. Raw green vegetables (parsley, cilantro, chicory, and dandelion leaves), whole-grain breads, citrus fruits, and legumes all contain high concentrations of folic acid. Many foods rich in iron and protein also contain folic acid.

Salt and Fats. It used to be that a pregnant woman was put on a low-salt diet, but these days a moderate amount of salt is not only considered safe but encouraged. And while a diet for a woman carrying multiples may appear to be high in fat, fat is important in the absorption of vitamins and minerals. Don’t shy away from dairy products because of high fat content—enjoy!

Vitamin Supplements

Taking a prenatal vitamin every day doesn’t mean you can skip a meal—it simply offers insurance that every essential vitamin and mineral requirement is covered. Some women carrying twins will be advised by their physicians to take several kinds of supplements (iron, calcium, and so on).


Tips on Gaining Enough Weight

Pregnancy is no time to start a diet, but for some women, consuming more than 3,500 calories each day is the equivalent to standing on one foot while skateboarding—in short, a real challenge. Take mealtime seriously and consider the following tips to help put on the pounds.

  • Make every meal count. Plan your meals carefully, making sure you eat a wide range of healthy, fresh food with an emphasis on protein. Choose foods that are nutritious, given their calorie and fat content. Sour cream may seem like a delicious way to get a serving of dairy, but check the label—it offers little nutritional value. On the other hand, if you feel your diet is too high in fat, substituting low-fat cottage cheese or 1 percent milk is a better alternative than cutting it out completely.
  • Eat often. Eating several small meals each day instead of three large ones will keep your energy level high, offer a constant fl ow of nutrients to growing babies, and eliminate that uncomfortable “stuffed” feeling often associated with eating a large meal. Shoot for seven small meals a day—breakfast, midmorning snack, lunch, midafternoon snack, dinner, bedtime snack, and, finally, a potty-break-in-the-middle-of-the-night snack. (Have a small snack tray of fruit slices, cheese, or peanut butter and crackers by your bed so that when you get up in the middle of the night to use the bathroom, you can grab a quick bite.)
  • Increase dairy foods. Because they are high in protein, calcium, and calories, dairy foods are a quick answer to fulfilling extra caloric and protein requirements.
  • Drink liquids with calories. Substitute broths, fresh fruit juices, or milk for your eight glasses of water each day.
  • Bag it. Whether it’s a short trip to the supermarket or an afternoon drive in the country, be sure to keep a supply of nutritious snacks in the car, in your handbag, and in your office drawer. Never be without a secret stash of food!
  • Accessorize your food. Grated cheese or chopped roasted peanuts sprinkled on a salad add not only flavor but a nice little protein kick.
  • Disguise foods you dislike. Can’t stand eggs or milk? Hide them in delicious dishes like creamed soups, cream sauces, French toast, or even chocolate milk.

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A copy of the book Double Duty.