Pregnancy and birth

Eating for three

Before I got pregnant I knew that the whole ‘eating for two’ thing was a total myth, and that most healthy pregnant women needed no more than an extra 200 calories a day, and even then not until later in their pregnancies. It can actually be quite difficult to find sensible and reliable advice about dietary requirements during pregnancy. I’d thought that something like the Royal College of Obstetricians and Gynaecologists would be a reliable source of evidence-based information, but the only guidelines I can find on its website are clearly aimed at women who are overweight or obese before becoming pregnant. It recommends a maximum pregnancy weight gain of 1o – 12 kgs. Frustratingly, I can’t find information on the Royal College’s website that discusses any possible differences in advice for multiple pregnancy, even though logic would suggest that you might need to tailor your dietary approach if you’re nourishing two foetuses (or more).

However, I’m glad to report that my library book-requesting has already paid dividends in the form of When You’re Expecting Twins, Triplets, or Quads, by Dr Barbara Luke. Luke is an academic who has spent several decades researching maternal nutrition and multiple births, and her book summarises a lot of her findings and offers practical guidance to people like me who have a sense that they may need to take their diets seriously during pregnancy, but don’t really know what to do. What’s reassuring is that everything Luke advises is backed up with substantial research – she’s not just spinning a yarn.

So far I’ve learned that the dietary advice for multiple pregnancy is almost opposite the advice given for singleton pregnancies: instead of just eating normally and adding a few extra calories in the third trimeter, apparently I should focus on gaining healthy levels of pregnancy weight from the start. The aim of it all is to try to ensure that the babies achieve a good birthweight, and to try to prevent (or, at least, mitigate for) premature delivery (which is far more common in twins than I’d realised: it sounds like it’s fairly rare for twins to achieve their 38 week full term). Also, babies that have been well nourished in the womb are more likely to do well if they are born prematurely.

Before I became pregnant my BMI was 22, which put me right in the middle of the healthy range. According to Luke, I should aim to gain around 20 kgs throughout my pregnancy, with a lot of that weight being stacked on by 24 weeks. She really stresses the importance of early weight gain, both because of the high likelihood of not going full term (and therefore not having as much time in the third trimester to gain weight), and because it becomes increasingly difficult to eat much as a multiple pregnancy progresses and the sprogs take up more room.

Twenty flipping kilos! That’s a vast amount of weight. At my heaviest I’ve probably only been four kilos heavier than my normal weight. I’m not worried about ending up enormous – I know that it’s all for a good cause, and I’ll just have to join Weightwatchers and become a crazed boot camp person afterwards – but I can’t imagine how I’ll actually eat enough to be that much bigger. Of course, quality of food is just as important as quantity, so it’s not simply a case of eating lollies and junk food (which is just as well, given that I don’t feel like eating either). I still have very little appetite, and although I’m eating really healthily, with far more cheese and dairy products that usual, it’s a bit odd that I haven’t gained anything at all so far.

You may recall that lovely Dr Di was totally unconcerned about my lack of appetite, which puts her squarely in opposition to Dr Luke’s ‘eat eat eat’ philosophy. This isn’t the first time that we’ve experienced a well-meaning GP dishing out generic information instead of tailored advice, and it makes me so thankful that I live in an age where a) patients are empowered to be their own advocates, and b) it’s incredibly easy to access information.

Of course, I’m not going to base my diet solely on the advice given in one book: I’ll do some more research into recommended weight gain, and I’ll also bring it up at my first Shore Birth appointment tomorrow. I’ve just done some googling and have found a local nutritionist who specialises in pregnancy, so I might pay them a visit as well.

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6 thoughts on “Eating for three

  1. To be honest, I would just eat when, what and as you feel like it. I can say I never ever gave a second thought to how much I was eating with the twins – when you’re pregnant I think most often you’re guided by what your body tells you to eat. I gained about 18 kgs with the twins, they got to 38 weeks (and I’m sure would have been full term if it hadn’t been for their positions – hence the c-section) and were both big enough not to need neonatal care. We’ve got a family history of pretty good, healthy sized babies, so that’s always a good thing. 🙂

  2. As someone who started out with a BMI if idontevenwanttoknow I am resigned to putting all the weight I lost to qualify for ivf back on and more. It’s a really really upsetting thought but basically when you’re pregnant your body is just not your own anymore and thats all there is to it. It’s sole purpose is to grow a person – or people. I don’t know about further on but don’t stress too much in the first trimester – if it’s a case of eating what you can stomach rather than what you ‘should’ then so be it. Rather something that stays down than healthy food that comes back up. Just keep up the dairy and definitely some elevit right through.

    1. Thanks Steph – will do! I am really loving dairy at the moment and seem to have something dairy with pretty much every snack or meal, so if nothing else these kids should have healthy bones! And I do agree with you that your body is really not your own when you’re pregnant, and you just have to do what you need to do in order to get through it and produce a healthy baby (or babies) at the end.

  3. I agree with the previous person – eat whatever you feel like, it doesn’t have to be strictly healthy. Generally pregnant women have a particular type of food that they feel like and so that’s what your body is telling you to eat – my advice is to listen to your body, don’t worry about making sure everything you eat is healthy, just make sure you eat a good mix of dairy, protein, fruit and veges, and you’ll be fine. I lost 3kg then put on 23kg, and I wasn’t even huge – it’s easily gained. It may seem like a lot of weight now, but don’t stress, you’ll be over this nausea soon in a few weeks and will feel like eating whatever your body decides it needs.

    1. Vickie, I’m so looking forward to having an appetite again! As somebody who has always been a bit of a piglet, it’s so weird to really not fancy any particular food. I can’t wait for some decent cravings!

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