Eating for Three

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Eating for Three

When you are pregnant with twins, it’s an understatement to say your body is working overtime. The extra muscle, tissue and blood needed to create two healthy babies are draining on the mom. It’s not surprising that gestational diabetes, anemia and preeclampsia (caused by elevated blood pressure) are all risks for pregnant moms of multiples, causing many women to deliver under- weight babies prematurely.

Until recently, however, doctors and nutritionists treated all pregnant women the same. But research shows that women creating twins need a different nutritional approach and pattern of weight gain to better take care of themselves and to deliver healthy babies close to term.

Barbara Luke, ScD, M.P.H., R.D., has revolutionized the way doctors around the globe treat pregnant women of multiples. Her research, outlined in her best- selling book When You’re Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy, is now the standard that many obstetricians follow.

The current professor of nursing at the University of Miami has made many discoveries in her thirty years in the field (www.drbarbaraluke.com). For instance, Luke has shown that elevated sugar levels increases a woman’s chances of contracting infections–something women expecting multiples can’t risk.

“Typically at twenty eight weeks (of pregnancy), doctors will test blood sugar levels to see if they are too high. Women pregnant with multiples have a higher risk of getting gestational diabetes and by the twenty eighth week, the doctor’s test confirms (they have) this and then the doctor puts them on a diet. That’s a too-little too-late approach,” says Luke.

Therefore, she recommends a diabetic diet. While good diet is critical, Luke advises women to take additional supplements to address specific issues that women expecting twins typically have.

“I recommend taking extra calcium, magnesium and zinc. Calcium helps with blood pressure (lowering a preeclampsia risk) and bones. Magnesium helps prevent premature labor (by minimizing uterine contractions) and it reduces the risk of cerebral palsy because it protects the developing nervous system. Zinc is vital for the development of the baby’s nervous system. Plus, it reduces the risk of infection as well,” explains Luke.

Supplements and diet are critical during pregnancy, but just as important for women expecting twins, is a specific pattern of weight gain. Luke analyzed over 2,324 pregnancies resulting in 4,684 infants in a study published in 2003 in the Journal of Reproductive Medicine. Her findings conclude that women who delivered twins of good weight at between thirty six and thirty eight weeks gestation followed a specific weight-gain pattern. Therefore, she advises women of normal weight to gain between 1 and 1.5 pounds a week until the twentieth week of pregnancy and between 1.25 and 1.75 pounds a week from the twentieth week until the twenty eighth week.  She also advises to slow back down to gaining 1.25 pounds a week in the final stretch, after the twenty ninth week. This allows for a total weight gain of between forty and fifty four pounds. Women who are underweight or overweight before conception have different goals that Luke outlines in her book.

“We’ve seen wonderful results with this pattern of weight gain allowing women to  deliver at term and at six pounds. Moms with the biggest babies had big weight gain early on,” she explains.

And, as any pregnant woman is excruciatingly aware, you only get one chance to grow healthy babies. See your physician as soon as possible to discuss nutrition, supplements, and weight gain if you are pregnant with twins or suspect that you are. For instance, if you are having fertility treatments, the likelihood of having multiples is much higher, says Luke.  So when you become pregnant, you may want to assume you are having twins and follow a diabetic diet from the beginning.

Interesting Twin Facts: While twins account for only about 3 percent of all live births in the United States, they are disproportionately represented among the premature, low-birth-weight and growth-retarded infant populations. As compared to “singletons”: -Twins are five times more likely to be born premature. -Twins are ten times more likely to have low birth weight. -Twins are seven times more likely to die before their first birthday.   For more information: “Body Mass Index-Specific Weight Gains Associated with Optimal Birth Weights in Twin Pregnancies,” The Journal of Reproductive Medicine, Volume 48, No. 4/April 2003 Barbara Luke, S.D., M.P.H., R.D. Mary L. Hediger, Ph.D., Clark Nugent, M.D., Roger B. Newman, M.D., Jill G. Mauldin, M.D., Frank R. Witter, M.D., and Mary Jo O’Sullivan, M.D.