Dr. Luke (and others) -vs- Your OB

I learned about Dr. Luke from TS and started to look into and even follow some of her recommendations. However, as I started to ask my OB questions I noticed that their answers were often very different. One main way seems to be in the weight gain. I put on weight very fast and early on in the pregnancy, which Dr. Luke endorses (so do others) and says is good and my Ob told me to slow down, cutout carbs, and juice and go to skim milk. I was not eating junk food, just the opposite but I was hungry all the time and when I would get nauseous it made my stomach better to eat something. My Ob says 35-45 pounds for twins, Dr Luke (and others) say more than that. One says 3600 calories a day my OB says no way that is way to many. I read that by 28 weeks a good weight gain for twins is up to 46 pounds, I have gained 43 and my OB says its not bad, but a little high although I have "slowed down" I don't know what to believe anymore. I hear of women on here who are put on strict bed rest if their cervix shortens and my Dr says that bed rest wont necessarily stop labor from happening but It can help reduce contractions (which is why I am on Procardia daily) So he has not put me on bed rest even with a cervix at 22 and beginning to funnel (no dilating yet). Sometimes I feel like I should put myself on bed rest. I have another Ffn test this week and if it is pos I will put myself on bedrest even if he doesn't because that is what my old OB did with my single preg when I was pos at 29 weeks and I went to 37 weeks, so it seems to work so why does he say there is no real evidence? :headbang: so much conflicting information out there. I feel like I pick and choose from it all but in the end I want to do what is best for these babies. This is not my first rodeo (although with twins it is) so I do have experience but it seems like everywhere I read and turn and every Dr. or Specialist or TS story says something different. Maybe I am just hormonal today but I feel overwhelmed. How do/did you ladies sort all the information to get to the right answer and decision for you?

 

I'm Asian & petite (only 5'). My height is off Dr Luke's guide for weight gain lol, so I personally took it with a pinch of salt.

I believe that it's more important to listen to what your body wants. If you're craving for fries & burger, then go for it. I have to say though that during my pregnancy I've not been following a well-balanced diet. I just ate whatever I felt like, whenever I felt like it. I feel that cravings are the body's way of telling you that it needs some calories/vitamins/minerals from the food you're craving for. There was a period when I was craving for beef all the time. My weight gain has been quite steady & at my u/s the twins have been gaining weight well too, which I think is more important?

:hug: to you for feeling overwhelmed. There's loads of information online and in books.

I think the best advice would be to ignore them and follow the ones you get on TS!

 

personally I never liked Dr. Luke's book...to me it was so gloom and doom - as in "if you don't follow my advice you'll have sickly babies"...I'm also a regular diabetic (not gestational) and I'm heavy so her weight recommendations were off the charts for me...

 

I personally believe in dr luke's book and have seen many success stories from it. I look at it as a goal. Do I get 3500 calories? No, but the goal. Do I eat enough protein? no, but try to. I think with all the stats and what she has seen, how can it be wrong. I think most OB's have so little experience with twins, they can't be experts and I believe a twin pregnancy is very different from a singleton. Just my 2 cents. LOL.

 

I really liked Dr. Luke's diet portion of the book. I didn't follow it exactly but with the general sense of protein, protein, protein and water. I did gain 130 lbs with the twins but I also had the twins at 41w5d and they were typical singleton sizes (8lb3 and 6lb11). I never saw an OB during the pregnancy and my MW never commented on my weight so I didn't feel like I had to pick ideas to follow. I was slightly underweight before conception and am 6'2" so 130 wasn't really as bad as it seems.

If your diet is mostly healthy then I say gain all the weight you want. When they are two you can deal with whatever is left over! :laughing:

 

I would have to say that if you don't have faith in YOUR OB, why not find someone else? If you are going by a book that you have read, and NEVER met the Doctor in person, how can that advice be worth listening to? Each pregnancy is different even with the same set of parents (I have 9 children, so I am speaking from experience here....hubby and I are the parents to all of them).

I hold what my personal doctors say and think as what they think is the best for me and my baby or babies. They are the ones that went to medical school and have the ability to refer you to a different doctor (specialist) if need be. I have never second guessed my doctor (don't get me wrong, I ask A LOT of questions).

I lost weight during every single one of my pregnancies (without having morning sickness), the doctors watched me, but didn't stress over it, they just made sure that the baby was growing and such.......no pregnancy is textbook.

Just my 2¢

 

My OB also didn't believe that bed rest can prevent PTL. She advised me to listen to my body and rest whenever I felt tired. Even my peri didn't advise bedrest - just to get off my feet when tired.

As for the calories and weight gain, I gained only 40 lbs or so. I do agree with eating as much healthy protein as possible. But as for calories for calories sake, it seems overboard. Fetuses are truly parasites. They will take what they need from you. I just went to vitamins, protein and tried to eat healthy.

But to echo another poster, you seem to second-guess your doctor. Maybe it's time to switch to someone you trust more.

 

With each of your pregnancies you weighed less while giving birth than you did when you conceived? That's so weird! I'm curious to hear more! opcorn: (Not to look at you like a freak but I gained between 60 and 130 with each of mine!)

 

No I trust my Dr. actually very much and we love him, I am just trying to sort out all the different ways of thinking because I think that just 1 way may not be the best way. If my Dr. says get in bed and lay flat, I will... If he says just be reasonable, I will... but there are soooo many schools of thoughts, just getting other perspectives!!

 

Yep, that is true.....weighed less at the time that I birthed my babies, than I did during my first OB appointment.

For example, with my twins, I weighed 27 less the day after giving birth, than I did at my first OB appointment (with no morning sickness to speak of).

I just had a singleton 2 weeks ago, and at my last appointment before her birth, I weighed 7 pounds less than I did at my first OB appointment (I have not weighed myself since giving birth).....she weighed 5 pounds, not counting all of the fluid and extra weight that the pregnancy adds.

I could go on and on about the weight losses, but I will spare you the details..........what my point was is that weight gain is only relative to what your doctor makes it be.

 

I had docs who were pretty laid back but I followed the Dr. Luke book. I'm a fan. ardon: Firstly, she addresses that most OBs do not specialize in multiple births. While peris do have more experience, they can be lackadaisical as well. What sold me on her book was the scientific analysis of how her babies were significantly bigger with less problems verses other babies at the same gestation. I figured if she was the head of a Multiples Clinic, I was basically getting the best care for multiples in the country.

Yes, 3,600 calories are the goal. I wasn't able to do it every day, but was able to work up to an average of 3,300 calories which were not primarily junk. There is a recommendation for ice cream every day- which does give you calories and calcium. I credit calcium and magnesium supplements in helping me not have as much as a contraction before my water broke at 37w 5d.

There are recommendations for preventative eating, too. Lots of protein/red meat which helps keep anemia at bay... certain fruits and veggies at various times in the pregnancy as the baby develops. Of course babies will take what they need, but we all do know that multiples are a different ball of wax and take a toll on a body.

I gained 70 lbs with the boys- 50 or so which were gone by the time my swelling went down. I am currently 10 lbs or so over my pre-pregnant weight but am still nursing and not actively trying to get rid of it. :ibiggrin:

All in all I have no regrets about following the Dr. Luke plan, although I think I'm going to have re-train my brain as far as how much I need to eat once I'm done nursing. My boys were 6 lbs 2 oz and 5 lbs 7 oz. Still smallish, big enough to go home, not go to the NICU and nurse from the get-go.

 

I always follow my OB first... as he's the one in charge of my care and responsible for me and the babies, should anything go awry. So if you are doing something that he's not suggesting, then he can't do his job correctly.
I listen to him and if I'm unsure of think that he might not be "correct", then I question him on it and ask him to explain WHY he's sending me for that test, or why not, etc.

 

Dr Luke just frustrated me and convinced me I would have early small babies. Well, they were 5 and 6 pounds at 37 weeks. I couldn't imagine three servings a day of red meat, Or four naps a day! Maybe f I had a maid and a cook and no job, but it just wasnt realistic for me.

 

Just a different way of thinking. For me, *I* was the only "one in charge of my care and responsible for me and the babies." I've never actually seen an OB during any of my pregnancies so it might just be semantics but I would never feel comfortable handing over any major decisions to anyone else.

My financial advisor doesn't make the final decisions; the contractor building my house doesn't get a say in decision making. Clearly we trust their advise and consider the information they present, but like any individual they have their biases. I'm biased toward Luke's plan because I *think* it worked for me. (42 weeks, 8#3,6#11) but leaudemiel *thinks* not following it worked for her because she didn't follow it (37 w, 5#, 6#). We are both correct in our thinking. So just as we have our biases so does every OB out there, and not every bias is in MY best interest.


And leaudemiel- I could still go for 4 naps a day, and a maid, a cook and no job. Could you even imagine?? :laughing: Dreaming......

 

I definitely think that we (my DH and I) tend toward your thinking. However, no OB? Did you have a midwife? We tend to take what all Dr's say with a grain of salt, take the advice then educate ourselves and come to our own conclusion. We use Chiropractors and natural medicine above traditional medicine and don't vaccinate for example. I guess my "fear" is that if my Ob says to do something and we decide that a different approach is best and something goes wrong that I would live with guilt. That is why I try to get many different opinions and mix and match! And 4 naps? In what world? But it is worth dreaming about during the 1 nap I get!!

 

I too am a big fan of the Dr. Luke book. I took it all with many grains of salt, though, and didn't let the idea of small, early babies get to me. I knew it was a possibility, but I also knew that big, healthy babies were a definitely possibility as well! I didn't get the full calories recommended very often, but I did focus on lots of protein and healthy fats. I gained most of my weight during the 2nd trimester, and by the end I think I lost a lb in the last week as I just had no room left to eat anything! I had a c-section at 38 weeks and 2 days with no real PTL issues to speak of other than continuous contractions from about 30 weeks on, but they did not provoke any cervical changes whatsoever. On the day of my delivery I had gained 60 lbs total, and I gave birth to a baby A weighing 7 lbs 6 oz, and baby B weighing 8 lbs 2 oz! The staff in the OR were pretty shocked, and my OB was impressed! He too never fully agreed with Dr. Luke's recommendations and said that I could gain 30 lbs and have very healthy babies, but I did what felt right and seemed right (based on research) to me. PPs are right that most OBs are not specialists in multiples births, and I trusted the info coming from someone who specializes in the field. Just like most pediatricians seem to know VERY little about breast feeding even though it's the way babies are born to be fed. We have to go to lactation consultants to get specialized info for that.

I trusted Dr. Luke's book, but didn't do every single thing she recommended, nor was I crazy about it. It was a rough guideline for my pregnancy, it gave me some goals and an idea of how to eat best for my babies, and I would say that we are a great example of how it can work well.

 

I would be wary of following a book. Those calorie recommendations are not appropriate to everyone. I gained 38 pounds with my twin pregnancy--mostly water (I lost 65 in the three weeks after they were born). My twins were 7.13 and 6.2 at 37.5 weeks. No bedrest. No peri. Worked to 35 weeks and then stopped voluntarily due to the commute. I just don't buy that all twin pregnancies are the same and need bedrest, tons of weight gain, a peri, etc. Find a doctor or doctors you trust and listen to them--not a book written by someone who doesn't know your situation.

 

I haven't read Dr. Luke's book yet - and I'm not sure I'm going to. My OB, who has 5-month old twins herself, said she wants to see me gain 35-40 lbs. I lost 5 the first trimester, then have gained 15 since then, for a net of 10 lbs. I'm a little worried about how fast the 15 came on...at this rate, I'll gain much more than 35 lbs. But really I'm just trying to listen to my body. I've essentially been the same weight since I was 15 (well, in the past 5 years, I've put on about 5 lbs), and I just follow my body's lead and keep in mind three principles: fresh is better, moderation is usually (though not always) to be preferred over excess, and meat consumption should be limited (no red meat, occasional fish and chicken - though I'm definitely having more of the latter two these days). I'm hoping these will work for pregnancy, too, with some modification, of course. Figuring out what moderation means for pregnancy has been tricky, but I think I've got the hang of it - I allow myself to get a little fuller than I usually do, but still try to intuit when the next bite will make me uncomfortably full. I have to admit, though, that I have been indulging my chocolate cravings a more often while pregnant

We'll see how it goes.

 

I was concerned at first at how fast mine came on as well. I gained 29 pounds in 18 weeks but I was eating when hungry, eating protein and lots of veggies with little to no junk. I have now slowed to a pound a week and sometimes no weight gain in a week. I think the babies are taking what they need. I have now gained 43 pounds in 29 weeks. So I will be above the 35-45 pounds my Ob had originally wanted but the babies are both big for their gestation so I guess the weight gain has been good! I am only putting on baby weight.. nothing in my face or arms and am not swelling at all. I guess I am just going to take bits and pieces from all the experts including what I think is right and go for it!!

 

I think you need to approach any advice book in this fashion- take what might work for you and disregard the rest. I mean, I've never done cry it out but I love the first section of Ferber's book that lists the generally advised sleep needs at different ages. I often joke that we don't actually look for advice books for the information they give, but we look for advice books that already recommend what we believe. Like we somehow need an "expert" to back up our instinct.

Mama knows best when society doesn't get in the way!

 

I was more on the Dr. Luke train, but mostly because I felt compelled to eat that way anyway. I was never super-nauseous, but spent nearly my whole pregnancy feeling like I might collapse if I wasn't eating constantly. I gained 75 lbs. It all came off (in the first year or so) and now I'm probably healthier than I've ever been in my life. And my babies were born 6 lbs each at 37 weeks -- which may have had nothing whatsoever to do with Dr. Luke, but given the generally positive outcome, I'm not sorry.

Plus, as I said, I was going to eat constantly anyway -- so at least I could justify it with a book. :laughing:

I do think she is overly alarmist (for me) about the need for a peri and lots of special treatment. I had a peri do the all-important 19w ultrasound, and my regular OB did the rest.