August 31, 2009

Twins & Triplets — Exercise & Nutrition Tips

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A detour: We received a ques­tion about nutri­tion and exer­cise for mul­ti­ples. So, here is some infor­ma­tion for those with twins and triplets. Add a com­ment if you have a ques­tion or expe­ri­ence to share on this top­ic! Next comes birth, we promise!!

Nutri­tion for Mul­ti­ples:

The pri­ma­ry thing we tell peo­ple with twins or more is that the pro­tein needs rise about 30 grams/baby/day above the 70 — 90 grams/day need­ed for a sin­gle­ton. Water intake also needs to rise. Avoid thirst and as much as pos­si­ble, drink until urine runs clear rather than yel­low (as best as you can).

Mul­ti­ples is con­sid­ered a risk fac­tor, and for each risk fac­tor (mul­ti­ples, under­weight, teenage mom, inter-preg­nan­cy peri­od less than a year) an addi­tion­al 200 calo­ries is often rec­om­mend­ed, with 400 extra calo­ries the upper lim­it.

Exer­cise with Mul­ti­ples:

A crit­i­cal fac­tor in suc­cess­ful implan­ta­tion and growth of the pla­cen­ta appears to be aer­o­bic fit­ness in the six months pri­or to and the first half of preg­nan­cy. Once bio­me­chan­ics become dif­fi­cult in mid-preg­nan­cy, women with mul­ti­ples can con­tin­ue activ­i­ty safe­ly as long as mon­i­tor­ing show the babies are grow­ing appro­pri­ate­ly. A bel­ly sup­port can be extreme­ly help­ful when exer­cis­ing.

Con­traindi­ca­tions for exer­cise include the dis­cov­ery that one fetus is grow­ing at a sig­nif­i­cant­ly slow­er rate than the other(s), that both/all are too small, that the placenta(s) is/are mal­func­tion­ing, or some oth­er con­di­tion occurs, such as an incom­pe­tent cervix or pla­cen­ta pre­via, that would be a fac­tor in any case.

Absolute size dif­fer­ence does not nec­es­sar­i­ly mean that one baby is grow­ing more slow­ly, as some fetus­es may be a cou­ple weeks younger than their uterus-mate(s) if the moth­er ovu­lat­ed twice in the fer­til­i­ty cycle. Or, s/he might be small­er if genet­i­cal­ly des­tined to be a small­er infant at birth. Thus, growth rate is the mea­sur­able fac­tor that helps deter­mine if a fetus is at risk of not receiv­ing ade­quate ener­gy. This can hap­pen when there are two pla­cen­tas and one pla­cen­ta is work­ing more poor­ly than the oth­er, or for some rea­son there is a flaw in the umbil­i­cal cord of an iden­ti­cal. The com­pe­ti­tion for ener­gy places a slow­er grow­ing baby at risk.

Pro­tect­ing Mom and Baby:

The pla­cen­ta is designed to nour­ish the baby and will do so at a cost to the moth­er first if there is inad­e­quate nutri­tion. Thus, activ­i­ty to the lev­el the moth­er can tol­er­ate and fol­low­ing nutri­tion­al guide­lines above — in the absence of med­ical com­pli­ca­tions — pro­duces healthy off­spring. Mul­ti­ples will gar­ner all the same ben­e­fits a sin­gle­ton does.

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