Your opinion on weight goals in When You're Expecting Twins, Triplets or Quads

Hi Ladies,

So ... after it was determined that we really were going to be having twins, I read When You're Expecting Twins, Triplets or Quads (by Barbara Luke and Tamara Eberlein) and I imagine some of you must have read this also. I was in a mode where I was really extremely concerned (and still am, but now I have other concerns too) about the possibility of pre-term labor and delivering the twins too early to survive. My cousin had a singleton pregnancy that delivered at 27 weeks and her little guy was in NICU for a couple of months and still has three different specialists that he is seeing for his range of developmental challenges and physical issues. I was terrified that since the average delivery point for twin moms is 35 weeks that I needed to really follow the advice in this book, which, in a nutshell, is gain 1-1 1/4 pounds per week (for my body mass index, which is slightly overweight). I was determined to gain weight early in case I didn't have room later or in case the twins came too early.

As time passed, I tried to do this, but it was actually a lot harder than I thought. I had some vomiting issues, still do now due to acid reflux more than nausea. And, I don't know, it just seemed like I was maintaining weight rather than gaining, although my belly popped early and I look like I am 7 months rather than 5 months. I am 24 weeks today, actually. And I've gained 17 pounds. THat would be 7-13 pounds less than recommended by the book.

However, while I think the book made a lot of sense, my OBGYN wasn't particularly convinced. She says big babies don't necessarily mean that they have good lungs, that that is the key thing. I am aiming for 6 pounds for my little beans. Well, that makes sense too. And she is sure that I will put on a lot of weight in the end weeks, that I will definitely be gaining 40+ pounds total, and that is in synch with the book's recommendation of 40-56 pounds total weight gain.

At 23 weeks, the growth ultrasound registered Baby A at 1 lb 1 oz and Baby B at 1 lb 3 ozs, and that seems right ... so, since (a) the babies seem on track and (b) I was throwing up more when I was trying to eat more; I've sort of thrown in the towel on managing my weight and just winging it.

What do you guys think about this? Did you read and agree with the book? Any followers? As I have started reading twin mom forums during my sleepless nights, I noticed that there is a big range on baby weights even between moms delivering at the same time, 35-36 weeks. Some are under 5 pounds. One mom had two babies that were 7 1/2 pounds each (she was close to term though) but still! Yay for her!

By the way, the chart on gestational weight gain that appears in this forum was all garbled for my view, but it seems others could read it. Can anyone post it as an image?

If you're getting close to delivery, is it true that a ton of weight piles on at the end? Thanks ladies!

 

I think the weight guidelines are just guidelines and do not apply to everyone. I think some women are more prone or less prone to put on weight when pregnant and there's not a whole lot we can do about it. I've worked pretty much my whole life to stay in shape/ not overweight, and when I'm pregnant I don't worry about it and really gain a lot (unintentionally). I think between 8 and 12 weeks alone with the twins I put on 13 lbs, my OB told me I was gaining too much and I was crushed. I never had morning sickness and felt ravenously hungry all the time. There wasn't a whole lot I was willing to do, I felt ravenous without protein.

In the end I wound up gaining way too much and having a lot to lose on my own after delivery, but I had two 6 lb girls at almost 37 weeks, and I was walking around right up until my delivery.

You're not trying to "not gain weight", you can't help it if you have nausea, sometimes weight gain during pregnancy is just not easily controlled. I'd try not to worry about it.

 

I did the book. Who can say whether I would have had bigger or smaller babies if I hadn't? My mindset at the time was that I felt privileged to access info from a premier multiples specialist and followed the advice accordingly. Would I do it again the same way? I'm honestly not sure.

I will say it got easier to eat all that food as time went on. When I first started the book it was overwhelming. Also, I think it was worth the heartburn help- the calcium/magnesium supplement took my heartburn away completely.

 

I refused to buy Dr. Luke's book personally. I had just found out I pregnant with twins and was still very much in my nausea period (for me that's the whole first trimester plus some no matter how many babies are in there). I picked up her book in the store and turned to a random page to see what it was about. The first paragraph I read made me feel incredibly guilty about not eating more. I immediately put it back and never read another page. I am sure she has very good information in there but a guilt trip about not being able to eat was NOT what I needed (I have my own family and ILs to provide that, thank you very much).

I followed my doctor's weight gain guidelines. My weight/BMI was in the normal range pre-pregnancy. I gained just over 30 lbs. My girls were born at 39 weeks 1 day at 6 lbs 8 oz and 6 lbs 3 oz. (Please note, my doctor is a little more old-school than many. She also had me stick to lower weight gain goals with my singleton and, perhaps most importantly, was not going to induce me before I/the babies were ready unless it was medically necessary.)

Also, my weight gain was not a flat line. There was no pound a week or whatever. I only gained a bit before 15 weeks and very little after 32 weeks. The girls were gaining and growing through that whole time but I was not. In the early weeks, I had a great deal of nausea that was only contained with medication. In the later weeks, my stomach felt like it was the size of a bean and the reflux didn't help either. There was actually a time in my second trimester where she told me to slow down on the weight gain (I had a huge surge in there where I could actually eat and I took full advantage of it :lol: ).

I guess the long and short of it is that I know many twin moms that swear by Dr. Luke's book and love it. It was also highly recommended by the multiples class at the hospital I delivered at. However, her book was just not a good fit for me.

 

I actually lost weight until the precursor to preeclampsia started settling in. By thirty weeks I had caught up with my prepregnancy weight. Then I put on about thirty pounds in a month and delivered at 34+5. I didn't follow the book. I just ate what I could when I could. But I had morning sickness throughout the whole pregnancy. My two did no NICU time, even though they were small babies. 4-14 and 5-4.

 

I gained 25 lbs by 35 weeks (and I was a little overweight, too). The last 2 weeks I gained another 25 lbs!!! But it was mostly water. My ankles were like tree trunks and even my nose swelled. Yeah, sexy. My girls were born at 37 w 5 days. Sydney was 7# 9oz, Sabrina was 5# 3oz. At 7, she's still tiny, and has never even been on the charts... She's the height of an average 5 year old and weight of an average 4 year old, and has a genetically inherited visual impairment. But otherwise, they're both happy an healthy!

I think if you're eating healthy and gaining some, you're doing great!

 

I refused to buy the book. Honestly, I think the weight recommendations are nuts, but I'm not a doctor or a multiples specialist. I was overweight starting my pregnancy. I gained 38 pounds, which was a LOT of water weight. My babies came at 37.5 weeks and were 7.13 and 6.2. No NICU time. I then lost 65 pounds in the three weeks post-delivery, which is why I say it was a LOT of water. I don't think I gained any real weight--just babies and fluid.

 

It is interesting to see the different perspectives on this book. I too have tried to follow the principles of the book but there is no way I could possibly eat as much food/calories as she specifies. I have tried to significantly up my protein and while I don't usually achieve the crazy high 150-175 grams of protein she specifies I definitely get more than I did before I was pregnant with these guys. Right now my little guys are measuring a bit ahead and weighing in a 1 lb 8 oz and 1 lb 10 oz at just before 24 weeks so they are growing well regardless. IT will be very interesting to see how things continue to go from here. I am sure that her guidelines have validity and she seems to have the stats to prove it but if you can't eat that much without throwing up then I think it is pointless to force feed yourself. So many moms have healthy twins and don't follow those guidelines that you have take all this with a grain of salt I think. Stressing about every morsel that you put into your mouth isn't good either I think and the level of stress that could create would seem to be detrimental if anything.

 

I was beginning to think I was the only one because everywhere I turn people speak so highly of it.

This is my feeling on the weight gain recommendations of the book, just stated much more succinctly and eloquently.

 

I read the book and found it a bit extreme and unrealistic. I think it makes sense to try to eat more protein and obviously you need to gain more than a pregnancy with a singleton. My high risk OB had said as long as the babies were growing well on ultrasound, she was not overly concerned about my weight gain. Good luck!

 

I read the book at around 22 weeks and went into a BIG panic because I had not gained nearly enough weight by then. And no way was I going to be able to consume the amount of protein needed. But my weight and my babies' weight was never a concern for my doctor. I did, however, go into preterm labor and had my twins at 31 weeks, but I doubt is was because of my weight... but I guess I'll never know for sure why it happened. I gained a total of 35 lbs and my babies were very big for 31 weekers... 4lb 3oz and 4lb 7oz.

I did skip the chapter on Preterm Labor and the NICU... boy I wish I hadn't

 

I decided not to read any books and just followed my dr. I'm a worrier, so sometimes the books are more harm than help.

 

I think Futurebuckeyefansx3 said pretty well exactly what I was thinking, especially "I am sure that her guidelines have validity and she seems to have the stats to prove it but if you can't eat that much without throwing up then I think it is pointless to force feed yourself. So many moms have healthy twins and don't follow those guidelines that you have take all this with a grain of salt I think. Stressing about every morsel that you put into your mouth isn't good either I think and the level of stress that could create would seem to be detrimental if anything."

For me personally, I was super excited to go to 37 weeks and have a 6 lb. girl and 5 lb 13 oz. boy. I attribute this length and their weights to this book. I tried very hard to meet the basic principal of the book: early and appropriate weight gain.

When I got the book at 15 weeks, I hadn't gained hardly any weight and really wasn't aware of the ways in which a twin pregnancy is different than a singleton pregnancy. I really hate reading medical stuff/pregnancy stuff that tells you all the dangers of things, but boy was I glad to be alerted to research that showed correlations between women who met certain weight gain goals and longer pregnancy and heavier babies.

The emphasis on early weight gain made so much sense to me because average twin pregnancies go 35 or 36 weeks (I've heard both numbers). In a singleton pregnancy, the baby and mother tend to put on the most weight in the last month or so of the pregnancy. If you go average length with twins, you don't have those extra weeks to put on weight for the babies. My babies put on a lot of weight starting around 30 weeks (we were astounded to go into appointments every 2 weeks and hear how much they had grown!).

Here are the things I did from the book:
- Drink a lot of water! (I bought a Poland Spring 3 quart jug and tried to finish it each day).
- Aim for the amount of calories recommended for your BMI. I didn't formally count calories and I really had a hard time meeting this calorie amount. I didn't get stressed about not meeting the guidelines, but it did give me something to shoot for. Protein bars, milkshakes, and greek yogurt were good foods to up my calories.
- Eating every 2-3 hours. I had lots of nausea and food aversions, so it was easy for me to not eat food (the first time in my life I didn't want to eat!). Trying to pay attention to eating smaller amounts very frequently made it seem more manageable.
- I had terrible acid reflux and took tums for while and then switched to zantac. I really tried to avoid taking anything for a few weeks, but both really improved my comfort level.
- I tried as much as possible to meet the weight gain goals up to 28 weeks. I was 5 pounds short at 20 weeks, but kept at it. At 28 weeks, I was just shy of the weight gain goal but then I let up on trying to gain weight with such insistence. It was really fun to reach 28 weeks and relax and let up on trying to gain so much weight.
- I had a lot of sleepless nights...I often ate once or twice during the night to squeeze in a few more calories.

I was excited to see your post because I really think this book changed the trajectory of my pregnancy for the better. I was not militant about it, but I did feel empowered--there was something I could at least shoot for a good outcome at the end of the pregnancy. That said, I am very quick to say if it doesn't work for you, don't worry about it and do what works. Good luck with everything!!

 

I read some of the suggestions from that book ( on here I thinks). However, I had hyperemesis so my reality was nooooo where close to the desired weight gain. I was about 5 pounds over my ideal when I got prego, lost 23 pounds in 3 weeks, gained the 23 back by 24 weeks gestation ( with the help of IV nutrition and feeding tubes). Delivered at 38 weeks with a grand total 7 pound gain from per- pregnancy weight. Babies were 5.3 & 5.13 and heathy. They are very good parasites and take what they need. The doctors where never really worried about the babies, more concerned about how my body was being impacted.

So do your best, make good food choices and don't stress about it.

 

I really appreciate all of your responses. I've been checking in and reading the new ones frequently -- and already made some changes.

1) started that calcium/magnesium/zinc supplement. There's one by NatureMade that has the exact mgs of each just as recommended, which makes it really easy. And I will try anything that will ease the reflux.

2) I'm making a point of eating almonds and Greek yogurt every day.

3) I'm going to try some protein shakes. What a good idea! Never thought of that.

4) I think my reflux worsened when I relaxed my "many small meals" routine and ate like a full-size dinner because I was over hungry from having nothing since lunch. It really does seem like my body is digesting way more slowly -- and a full-size meal, even as early as 6, is causing me huge discomfort and a bad night. So ... Trying to refocus on small meals and really be careful at night without simply skipping dinner. Tonight I had celery with peanut butter and raisins, almonds and some mango, which made me a little nervous(acidic?) but it just sounded so good.

I do find it reassuring that many of you take the book with a grain of salt and don't stress much over it (if at all). I agree the babies (little parasites!) take what they need ... But I hope the book is right that if you give them plenty and do so early, maybe it will help avoid preterm labor. It can't hurt to try at any rate.

The remarks of those who have already delivered are particularly interesting because you get the final data. I am no longer stressed exactly about whether or not to strive to follow the book -- my stress now is how bad I'm going to feel in 2 months and if its awful horrible how will I possibly keep my babies in long enough for them to be totally good!

I had a particularly bad 36 hours where I was just so weak, overtired, emotional, feeling huge, trouble with food, felt like I ought to be on bed rest, ugh! Just kept bursting into tears worrying that I simply wasn't going to make it to 30 weeks, let alone 34 (isn't that safety?) or 38 (ideal).

I feel better today. Got some sleep last night and protein today. Just got to take each week 1 day at a time, I suppose. Thank you all for bring there and for the great dialogue on the book. I'll keep checking back.

 

Wow, you did have big babies for 31 weekers! Mine were born at 31 weeks and were 3lb4oz and 3lb8oz.

I read the book and tried to do the best I could, but there is no way I could eat that much. At first due to morning sickness, and later because I was just too full of babies and I had indigestion all the time. I just tried to up my protein and eat protein snacks. I was of normal weight pre-pregnancy, and very fit. I landed on bedrest at 16 weeks, so after 15 weeks of bedrest I ended up gaining 42 pounds and losing my metabolism. It took me a long time to get rid of those 42 pounds (even though I pumped). I didn't really get back to exercising until they were 9 months old, sleep was more important.

 

I read the book and found it helpful, but I did not think it was the 'end all be all'.

My high risk Dr. said to eat a lot of protein, drink, and to eat small low-acid meals (I had fairly painful reflux). Though I did not eat the large amount of food--the high protein helped calm my nausea and added good fats. She said to not second guess every little thing-- that is too stressful!! Do I what I can, stay on bedrest, and try to enjoy being pregnant!

I ate a TON of peanut butter since I could not stomach much meat. I was likely underweight when I got pregnant and my DR was happy with the babies size- I did not gain 24 lbs by 24 weeks.


My girls were premature and I felt better prepared (you are never fully prepared!) having done research on preemies and what to expect. BUT they were a good weight for their gestational age. I gained a lot of water weight the last few days, but that is not 'true' weight that is helping baby weight gain! I did 11 weeks of bedrest and tried not to obsess over every little thing.

FWIW- my 'bigger' baby has more health issues even now. She came home later from the NICU as well. My smaller twin was more 'stressed' in utero and they think that helped mature her lungs a bit faster. I also got steriod shots before they were born and that seemed to make a difference.

 

I didn't read the book, I heard about it here on Twinstuff and it sounded weird to me. I discussed the book and the weight gain expectations with my OB and my Perinatal Dr - both of them said it doesn't really matter how much weight you gain, as long as you stay hydrated and make sure you eat healthy. I really didn't gain any weight until week 12-14. I was really sick and I was barely able to eat the whole time so I ate small portions here and there, and I made sure I drank a lot of water and I made it. I gained a total of 37 pounds, I made it to my scheduled C-Section of 37 weeks and 5 days and my kids were 6 pounds 5 oz each and they didn't have any NICU. My kids are 2 and 4 months and they are both very healthy.

Good luck with the rest of your pregnancy.

 

I honestly think your body knows how much weight you need to gain. Some women gain more and some gain less. And yes, big babies don't necessarily mean healthy babies. While my babies were in the NICU I saw full term 9 lb babies come into the NICU and some of them were worse off than my 2 lb babies...it depends on lung development when they are born. Do what you can, eat healthy and get plenty of protein and drink lots of water. :good:

 

Personally I don't think that as long as you are eating and keeping yourself as healthy as possible you should not concentrate on your weight gain.

With my first set of twins I gained 28 pounds and delivered at 28 weeks. Lucas was 2lb 12 oz and Adam was 2lb 9oz

The second set I gained only 32 pounds and delivered at 35 weeks. Allsion weighed 4lb 7oz and Tori 4lb 5oz. NO nicu time.

I hated the misconception that "wow, your having twins, you should be bigger!"

Follow how you are feeling! Good luck!