Saturday, June 1, 2013

Triplet pregnancy vs singleton pregnancy: Nutrition, Exercise, and Weight Gain

I've never been pregnant before so I wasn't 100% sure what to expect with a singleton pregnancy, let alone a triplet pregnancy!  I had bought a pregnancy book as soon as I knew I was pregnant, but that was only somewhat helpful as most pregnancy books only have a paragraph or two on being pregnant with multiples.  The book I found very helpful at the beginning of this pregnancy was, "When You're Expecting Twins, Triplets, or Quads" by Dr. Barbara Luke.  I started reading this when I was about eight weeks pregnant and I feel like it helped me understand the nutritional needs, weight gain goals, and the possible complications (since a multiples pregnancy is considered high-risk). 

NUTRITION: The book recommends 4,000 calories a day for triplets, which includes at least 200 grams of protein.  For about a month I was very careful to write down everything I ate so that I knew I was getting enough calories and (close to) enough protein (that is a lot of protein!).  In my opinion, the nutritional guidelines outlined in the book are a bit impossible to meet as it recommends you get 14 servings of dairy, 16 servings of lean meat, poultry, fish, and eggs, 8 servings of vegetables, 8 servings of fruit, and 14 servings of grains.  I was extremely fortunate that, for the most part, I did not have morning sickness, but there were definitely some foods that sounded more appetizing than others and if I tried to eat something that didn't sound good on a particular day I did feel a bit sick. I had my first appointment with my OB around week 13 and I picked her because she has twins.  From her own experience, she strongly recommended that I didn't get so caught up in how much I ate as long as I ate a balanced diet and gained weight, and I think that was the best advice she could have given me as I tend to get a bit obsessive.  Also, even though I'm sure I didn't get 4,000 calories most days, I still gained a VERY sufficient amount of weight, and my weight doesn't usually fluctuate so I was surprised that it was so easy to pack on the pounds.

Until around week 20 of the pregnancy, it was imperative that I ate between 700-800 calories within the first couple of hours of waking up, otherwise I would feel very sick.  Anytime I felt at all nauseous during this time period the solution was to eat!  This was a bit annoying as it meant I couldn't make any early morning plans as I had to take my mornings slow and get sufficient calories, but I was very fortunate that I was not working so I could make my own schedule.  Although I have quite the sweet tooth, besides eating ice cream which is recommended in the book as it counts as dairy :), I tried to limit my sweets so that I wasn't getting empty calories.  Somehow I didn't really start craving sweets until the third trimester either, and at that point I gave into my cravings more as I was so uncomfortable and it was comforting (I am not saying this is something everyone should do - it was just a way for me to cope with being super pregnant!).

As far as what I ate, I really didn't change my diet from what I normally eat except that I just ate a bit more of it.  I tried to eat eggs several times a week for breakfast (I don't love eggs, but they are a good source of protein).  Somehow I started to really like milk during the pregnancy, which is good because I needed the calcium, but funny because I normally hate plain milk.  I ate a lot of cheese (crackers and cheese, chips and cheese, cheese sandwiches, string cheese, etc).  I also ate apples with peanut butter almost every day.  I ate Greek yogurt daily because it has a ton of protein, until I got so tired of it around week 20-something that I could hardly choke it down.  I tried to drink Ensure and smoothies with protein powder, but they never sat well with me and honestly I'd just rather eat real foods.

For the first 20-25 weeks I truly had to eat every two hours or so, otherwise I would be starving.  As the pregnancy went on my heartburn was so bad and the babies took up so much room that I just didn't feel as hungry.

WATER: Another important thing during any pregnancy is drinking a sufficient amount of water, and the book recommends drinking a gallon of water a day for a multiples pregnancy.  I found the best way for me to make sure I was drinking enough was to fill up a gallon pitcher every morning so that I had a visual of the amount of water I needed to drink.  Drinking enough water really was not a problem as I usually drink a lot throughout the day since I'm normally pretty active.

EXERCISE: One thing I found difficult was that I wasn't supposed to do any more exercise than a 30 minute walk or swim each day, and I'm usually a runner.  Looking back I realize that I probably could have done more exercise early on in the pregnancy as long as I listened to my body, but I was nervous about being pregnant with triplets and I didn't want to do anything to mess it up.  I was also sooooo tired during the first 15 weeks that I really didn't have any motivation to do more than a walk anyway.  I really wish I would have swam more throughout the pregnancy as that is a great way to get in a decent workout without putting strain on your body, but I didn't feel like paying to go to a public pool.  Around week 23 I swam for the first time and realized how great it felt, but I really couldn't do many laps anymore since my belly was a bit large and I had terrible heartburn whenever I was horizontal.  So in addition to swimming some laps, I would walk / jog around the pool just to get my heart rate up a bit and get my body moving.

Around week 17 I started realizing that my stomach would contract whenever I would walk, which made me nervous because of the high risk of pre-term labor so I bought a belly support band which really helped.  As the pregnancy progressed, my walks got shorter and I went on fewer each week.  Right now I'm 30 weeks in and I'm pretty much done walking as my lower back aches if I walk around the house for 10-15 minutes.  My doctor has told me that I can hang out in a pool to get the weight off for a little bit, but she said no more lap swimming at this point.  Right now the goal is to hang on for another 4-6 weeks, so although a part of me feels like I should be exercising, I'm going to follow her advice and take it easy.

WEIGHT GAIN: Dr. Luke's book recommends gaining 58-75 pounds by week 34 of a triplet pregnancy.  I'm not sure why she only goes through week 34 since I believe most doctors will let women carry triplets to week 36 if possible.  I thought this was a daunting task when I first read it as I'm usually around 120 pounds and I couldn't imagine packing on that much weight, but as I mentioned earlier, it was NOT a problem for me.  I passed 30 weeks this week and I've gained 61 pounds!  I was hoping to gain 60 during the entire pregnancy, and I'm starting to get worried that I might even surpass the recommended maximum of 75 pounds if I make it all the way to 36 weeks (although I guess according to Dr. Luke 80 is probably the max for 36 weeks).  The weight gain has been one of the hardest things for me to wrap my head around as the recommendation for a singleton pregnancy is 25-35 pounds, and if I were to gain that I would still weigh less than my husband.  The week I passed his weight was tough, but now when I step on the scale we both just laugh at how large the number has gotten.  Although I do worry about how difficult it will be to lose the weight, for now I'm just trying to be okay with gaining the weight as I know this is best for the babies.

One thing I found interesting about the weight gain goals for a multiples pregnancy is that, according to Dr. Luke's book, there is a true correlation between weight gain and the size of the babies when they are born.  From what I understand, this is not necessarily true in a singleton pregnancy as I had a friend gain 60 pounds and have a 6 pound baby and another friend that gained 25 pounds and had an 8 pound baby!  Part of it might have to do with the source of the calories during those pregnancies, which would also be true for multiples pregnancies then but, regardless, the weight gain was stressed in the book so that the babies have a better chance at being bigger when they are born as all triplets are born premature.  So far our triplets are gaining sufficient weight as at week 28 two of them were estimated to weigh 2 lbs 10 oz and one was estimated to weigh 2 lbs 9 oz.

1 comment:

  1. Thanks for sharing such a good article with us. This is very helpful for me.
    Pregnancy nutrition

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