Double Trouble: Twins and How to Survive Them

The first three months

The most important eating time is the first three months, when the babies are, literally, being created. This is when the nutrient factor is most crucial. Do not fret if you are among the many twin mothers who suffer from morning sickness. Multiple mothers tend to have a higher level of pregnancy hormone in their blood so they experience more nausea and vomiting than their singleton friends.

(#litres_trial_promo) Paradoxically, if you suffer from bad morning sickness and can’t keep the food down for long, this won’t affect the babies’ eventual birth weight. It’s the nutrients they are after, not the fat. And they will take the nutrients from your own body’s supply if you don’t provide them (get used to it, it goes with the territory). Mothers with morning sickness should be heartened by the research showing that sufferers have babies with better overall outcomes. Studies suggest that vomiting may stimulate early placental growth.

If you feel tired and sluggish in the first three months, but not nauseous, remember that your body is making two babies and extra blood volume. For twins you can expect a 75 per cent increase in your blood volume (for triplets there’s a 100 per cent increase).

(#litres_trial_promo) Add to this the fact that a mother pregnant with twins can carry up to 20 pints of water more than a mother of a singleton during her pregnancy, and you can see why you have a perfect excuse to take to your bed at 8pm. Things will ease up in the second trimester, your metabolism will go into high gear, and the weight you gain will all go towards making healthy babies.

Just say ‘no!’ to the calorie counters

Personally, as a poor maths student, the calorie-counting view of the world has never appealed. It turns a sensuous experience, eating, into a tax return. Also, for twin pregnancies, I’ve noticed that the number of calories suggested by ‘experts’ varies wildly. In my own twin book library, the figures range from 2,700 calories to 3,500 per day. However, if calorie counting helps you to feel in control, aim for somewhere in the middle.

My main beef against calorie counting is that it puts you in the frame of mind of dieting, which is the wrong thing to do when pregnant. Also, anything that limits your intake of food (‘I’ve eaten my 3,500 calories today, I should stop now and just drink water’) should be avoided. This is your time for growing the babies, so enjoy it. No other vices are possible in pregnancy (you may get away with lust for a few weeks, but the wolf whistles will disappear by that last trimester), so you may as well indulge in gluttony.

One mother of twins was told by a nurse that she was gaining weight too fast and should stop drinking milk. When she told her husband, he opened the fridge door, took out a two-pint carton and handed it to her. She drank the whole lot on the spot. Don’t listen to any jealous nurses or doctors on the subject. Listen to your body. If you are hungry, it is for a good reason.

Never weigh yourself during pregnancy

Another trick in pregnancy is to never ever weigh yourself. If the midwife wanted to weigh me at the checkup, I asked her to put it in kilos, and my mathematical dyslexia ensured that it stayed a mystery. I found the best place to put my scales was in the loft until the babies’ first birthday. And if you plan to breastfeed for longer, chuck the scales out and buy some new ones when you are ready.

If, however, you are wedded to weight-gain issues, American charts suggest the following:

By the 24th week of a twin pregnancy you should have gained double the number of pounds as a singleton mother – between 24 and 30lb.

By the 37th week you should be around 50lb heavier than your normal weight.

(#litres_trial_promo)

Use these figures only if they help you feel more comfortable about your weight gain.

Why tons of fruit and veg are a good idea

Recent research

(#litres_trial_promo) also suggests that eating plenty of fruit and veg before and during pregnancy may protect against pre-eclampsia. This condition, which is a little more common in twin pregnancies and often appears in the final stages of pregnancy, is characterized by high blood pressure and swelling (my midwife always used to tell me ‘if you can’t get your wedding band off, call me’). Pre-eclampsia is a treatable but serious concern for pregnant mothers, and can sometimes necessitate an early delivery. It has to be monitored because, left untreated, it can eventually affect the function of liver and kidneys. Routine urine tests during pregnancy check for a type of protein which indicates pre-eclampsia.

New research shows that an underlying factor in pre-eclampsia is damage to blood vessels caused by destructive molecules called free radicals. In theory, upping the intake of nutrients that combat free-radical damage – such as vitamin C, found naturally in fruit and veg – may help to reduce the risk of pre-eclampsia. Another reason to gorge yourself at the greengrocers.

Why fish is also good

There is no dispute that well-fed women seem to make healthier babies with higher birth weights. What is news is recent research from Danish scientists reported in the British Medical Journal which suggests that women who eat a diet rich in fish are nearly four times less likely to give birth prematurely. Among 8,700 pregnant women surveyed, 7.1 per cent who never ate fish had a premature delivery, yet only 1.9 per cent of fish-eaters did. This is quite a significant finding for twin mothers, whose babies are usually assumed to be premature. So get baking that fish pie.

What can’t I eat?

Raw fish, such as sushi, is to be avoided. It increases your risk of exposure to salmonella, parasites and hepatitis A infection that can damage your liver. Similarly, you should avoid uncooked eggs and unpasteurized cheeses. Finally, peanuts (which aren’t actually nuts but beans) are still a controversial food item, because some experts believe that including them in your diet sensitizes the baby to peanut allergy. There is no definitive study to show this, but it’s best to avoid them and err on the side of caution.

If you do eat or have already eaten any of the above by mistake, as I have during both my pregnancies, do not panic. Remember that you come from a long line of genetically-fit ancestors, and your pregnant forebears probably feasted happily on Stilton crawling with maggots and boiled boar’s head.

What the experts say

Suzannah Olivier, author of Eating for a Perfect Pregnancy (Simon & Schuster Pocket Books) has the following advice to offer twin mothers:

‘The important thing in any pregnancy, particularly a twin pregnancy, is to eat ‘nutrient dense’ food. Everything provides nutrients, bar sugar, which is empty calories and gives energy without providing nutrients.

‘The other thing is to have more calories than normal. You are going to put on extra weight because of that extra placenta and amniotic fluid. For nutrient-dense food, think of half an avocado rather than extra butter on your bread.

‘Remember, you need these nutrients for yourself as well as the baby in the post-natal stage. To get through those first six months, you need to build up your reserves. You are going to lose a lot of iron, zinc and essential fats in the last trimester and from the birth and the early months of breastfeeding.

‘Food-wise, nuts – tree nuts such as almonds and walnuts – seeds, pulses and oily fish are all good. Zinc is found in any protein-rich food, like red meat.

‘In the third trimester, zinc and essential fats are particularly important for growth. If there’s not enough in the diet the baby will take it from the mother’s reserves (a lot of postnatal depression may be linked in part to the mother’s depletion of zinc and essential fatty acids). Good nutrients also help your own energy levels and stabilize your moods after birth. Often eczema in the mother while breastfeeding is triggered by not having enough essential fats. If you take linseed flax oil, it works very quickly to improve your condition.

‘Two other key nutrients are calcium-rich foods and antioxidant-rich foods, found in fruit and veg. We tend to take a sledgehammer approach to calcium and just drink milk (yoghurt is also good because it is predigested by bacteria), but there are swathes of people who are lactose intolerant. Many people don’t realize that there is plenty of calcium and magnesium in green, leafy veg such as spinach, cabbage, pumpkin seeds, pine nuts and sunflower seeds. Raisins and dried apricots are also unexpected sources of calcium, magnesium, potassium and iron – all needed for bone health.

‘Finally, I would strongly advise every mother pregnant with multiples to take a specially formulated prenatal supplement all through the pregnancy. You can buy them at any chemist, and it’s never too late to start.’

Here is what four triplet (heroine) mothers ate during pregnancy to produce three healthy babies.

‘I ate a lot of toast and Vegemite (my favourite), apples and cheese and lots of red meat (which I found pretty horrible!).’

Susi Gorbey, mother of Abigail, Lucille and Manon, went to 38 weeks with her triplets (‘Don’t let the doctors bully you into delivering early’)

‘I’m a vegetarian, and ate organic food as much as possible during my pregnancy. I ate plenty of fresh foods, but nausea restricted me a lot. I wanted to eat “comfort food”—pies, quiches, potatos, savoury carbohydrates. I avoided caffeine, alcohol, aspartame/phenylalanine as found in fizzy drinks.’

Tracy Alter, mother of Jake, Luke and Daniel

‘I didn’t change much of my diet during pregnancy as we eat a fairly healthy diet in any event. The only change was not drinking alcohol at all and starting every morning with a good breakfast that included flax seed – which I swear kept me extremely well throughout my pregnancy. I didn’t really have a favourite food and didn’t have any cravings.’

Marion Davies, mother of Thomas, Helen and Emma

‘I was either sick or nauseous throughout my entire pregnancy, so ate a lot of whatever didn’t come back up. I steered clear of complex carbohydrates. What I liked best was ice cubes!’

Alex Salmon, mother of Freddy, Lulu and Alexander

Exercise for the permanently tired

There is a lot to be said for keeping fit in pregnancy. Not running around sort of fit, but keeping moving sort of fit, as a preparation for labour. Walking, swimming and yoga are all thoroughly recommended in both the early and late stages, and can be done right up to the day of delivery.

Swimming is the best exercise for twin mothers towards the end, particularly if you are a member of a clean health club (pregnancy makes you notice the plasters on the bottom of the public pool). I loved the feeling of weightlessness as I took to the water, cupping my stomach and the babies as I slowly made my way up and down the pool. I even managed to escape buying a maternity swimming costume by wearing a black Lycra size 20 until the very end. Swimming is also good because it keeps your temperature stable in the water, increases blood flow and urine output, and reduces swelling. At the same time, it puts less stress on other parts of your body, particularly the uterus.

Yoga is also wonderful if you can find a pre-natal class locally, or a yoga teacher who can show you a few simple exercises to do. Pre-natal classes, as opposed to normal classes, also give you the opportunity to sit around chatting to other pregnant women while the yoga teacher reminds you to do your pelvic floor exercises.

Love your pelvic floor

The pelvic floor muscles are what your expanding babies are sitting on. They sit like a hammock supporting your internal organs, and withstand a lot of pressure during pregnancy. Regardless of whether you have elected for a Caesarean and are hoping to escape ‘honeymoon sweet’ (a myth, I’m afraid), you need to learn to love your pelvic floor muscles. It is pregnancy, not birth, that stretches them, so nobody escapes. If you don’t learn to love them now, you may never set foot on a trampoline again, or survive a coughing fit without a dash to the loo. Take those Bangkok girls with ping-pong balls as your role models and ‘squeeeeze!’ (in the words of the heroine of Allison Pearson’s hilarious novel I Don’t Know How She Does It

(#litres_trial_promo))