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Sunday, March 23, 2008 

Congratulations! And ... congratulations again!

Congratulations! And ... congratulations again!

You're pregnant with twins. And mixed with the joy and wonder comes another emotion -- stark terror. Whether you're an experienced mom or a first-timer, "what to expect when you're expecting twins" involves many unique questions.

Zoeie Kreiner, a mother of six and a lactation consultant in Illinois, already had three children when she gave birth to fraternal twins. But having kids one at a time hadn't prepared her for the challenges of a duo. "I'd already had babies, but there were a lot of specific questions I had that people who'd never had multiples would never know the answer to."

The most critical mission is getting your twins born strong and healthy. Although twins are more likely to be born prematurely and at a low birthweight, it doesn't have to be that way, says Barbara Luke, PhD, ScD, a professor of obstetrics and gynecology at the University of Michigan. "My whole focus is getting babies to grow like they're singletons," she says.

How do you do that? It's all about nutrition -- and weight gain. Steady maternal weight gain, particularly in the first and second trimesters, is "like money in the bank. It's going to earn interest," says Luke, author of When You're Expecting Twins, Triplets, or Quads: A Complete Resource. "Good weight gain before 20 weeks, and between 20 and 28 weeks, really influences fetal growth." An average-weight woman who's pregnant with twins, for example, should try to gain about a pound and a half a week -- 20-30 pounds by 20 weeks, 30-46 pounds by 28 weeks, and 40-56 pounds by 38 weeks.

Here are some suggestions from Luke for achieving that nutritional balance and ideal weight gain:

  • Eat every two to three hours. Pregnancy is "a state of accelerated starvation," Luke says, and twins mean you need even more food.
  • Include protein and carbohydrates together in every meal and every snack: peanut butter on apple slices, cheese with your crackers. Women eat far too many carbohydrates and not enough protein.
  • Eat plenty of red meat. Sorry, vegetarians, says Luke, but red meat is an optimal source of iron.
  • Enjoy those eggs. Cholesterol may be bad for daddy, but it helps keep mommy healthy.

If you are a vegetarian, talk with your doctor about other good sources of iron. Making sure that you get enough calcium and that you take a prenatal vitamin containing folic acid is also a good idea.

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