Thursday, November 26, 2009

Stepping on the scale, putting on the pounds

After reading Citysaur's last post, I feel somewhat guilty for what I'm about to write. But here it goes: thus far this pregnancy, I've gained about 8.8lbs. This is bad. I know what you're probably thinking - 9lbs (give or take a few ounces) is a pretty hefty gain for 17 weeks. But not for twins.

At this stage, I need to explain that instead of relying on my doctors, I've gotten most of my health and nutrition information from this book:

Choosing a book over your physician might seem odd, but there's a very good reason behind my decision: my doctors aren't very well informed about multiples pregnancies. This isn't saying anything bad about them - I live in a small town, and there simply aren't a lot of twin births here. So although the doctors are lovely people, they don't really know the ins and outs of a multiple pregnancy. Dr Luke, on the other hand, does. For years, she ran a specialist clinic for women expecting multiples at the University of Michigan, part of the University Consortium on Multiple Births. Her book is the Bible of anyone expecting more than one baby - unlike most pregnancy books, which tend to treat multiples as just being a little extra pregnant, WYETTQ is full of highly specific information for women carrying more than one baby, including dietary recommendations.

When I first began this pregnancy, my doctor recommended that for my height and weight, I should gain around 15lbs (it probably would have been a bit higher if I was in the USA, but Aussie docs are a little more conservative). The problem is, this recommendation is based on the weight gain needed to sustain a single pregnancy. WYETTQ's recommendation, on the other hand, is that I gain somewhere between 31-36lbs. That's more than twice the amount recommended for a single pregnancy. And not only that, but Dr Luke recommends gaining most of that weight in the first 28 weeks.

The idea of gaining this much weight (especially in such a short period of time) made me feel a bit nervous - I've battled my weight my entire life and was firmly in the 'overweight' category when I conceived. The idea of intentionally putting on 35lbs frightened me until I read the reasons behind the recommendation.

As most people probably know, twins often have lower birthweights than single babies. This isn't just due to being born earlier or space constraints in the womb, but often because they're simply getting less nutrition - after all, they're forced to share the energy the mother's body provides. Twins with higher birthweights are healthier than those who weigh less, and evidence suggests that good in utero growth may reduce the likelihood of a premature birth - and even if they are born earlier, preemie twins who have had plenty of nourishment before birth have fewer illnesses and quicker recovery times than those who didn't. All excellent reasons for wanting a higher birthweight!

The reason that most of this weight needs to be gained in the first 28 weeks is simple: the more babies you're carrying, the less time you'll have to put on the needed weight. Twins are usually born at about 36 weeks - that's a full four weeks less of in utero growth time than a singleton, so they need all the energy they can get, as fast as they can get it.


Bun in the oven scale from here

Ideally, for my height and weight, I should gain:
15-20lbs by week 20
23-28lbs by week 28
31-36lbs by week 38 (if I make it that long)

With a current weight gain of approximately 9 pounds by week 17, this means I need to pack on another 1.5lbs per week for the rest of my pregnancy to hit my targets - in fact, I'd need to gain more than 2lbs per week in the next three weeks to reach the low end of my week 20 goal!

This is harder than you might think, even for someone who is habitually overweight (such as yours truly)! I've actually found it quite challenging to consume enough calories to put on the pounds - good calories, that is. Sure, I could eat a box of brownies every day, but that's not an especially healthy strategy. I've increased my portion sizes, eating extra protein and carbohydrates at every meal for the last several weeks, and faithfully eating three full meals plus two (sometimes three!) generous snacks per day, but even that doesn't seem to be doing it - these twins are consuming far more energy from my body than I expected.

I've never faced this kind of weight battle before - in fact, I never even dreamed it would be an issue! WYETTQ recommends upping your servings of full fat dairy, protein, grains, eggs and good oils/fats to help put on the pounds, and I thought I'd done that...but clearly not well enough.

So I'm putting out a call for help: what's your favorite hearty, protein-based (not low fat!) meal?

2 comments:

  1. I don't like a lot of meat or high-protein meals, so I squeeze protein in throughout the day.

    I like to keep a bowl of hard boiled eggs and chocolate soy milk boxed drinks in my fridge - easy grab and go, or "I don't know what to eat" items. I also drink milk with meals and add it to my cooking, whether it's in oatmeal, soups, or in the rice or mashed potatoes I make. And I add sliced cheese or peanut butter every time I eat snacks like crackers, bagels or apple slices.

    Honestly, I've only upped my protein since about week 16... didn't realize baby needed so much until then! Good luck to you and the babies!

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  2. Good for you! I can relate...as an obese (according to the BMI index at least) mama-to-be gaining weight has been an issue for me too. I am up 10 lbs. which is good at nearly 31 weeks pg with a singleton.

    That said, with the GD dx I am not eating more carbs than I typically would. About twice a many in a day. So it's weird to "allow" myself more than one serving of bread or to add milk to my main meals, etc.

    I am pretty good about getting protein in...my goal was 80-100 grams/day and I am usually over that, most days. I imagine for a multiple pregnancy it would be more. For me, I try to take that 100-120 grams and spread it out over the course of the day...at last in 5 of my 6 meals. So I am only looking at 20-30 g/protein per meal or snack.

    Good sources of protein are, of course, meat...so I do try to have at least 3-4 oz. of lean chicken, turkey, beef or pork with dinner.

    For lunch I'll add some shrimp or grilled chicken to a salad or quinoa pasta.

    For breakfasts I like two eggs scrambled with an oz. of shredded cheese in two small low-carb tortillas or english muffins.

    Hardboiled eggs are good for on the run and egg salad sandwiches are tasty at lunch. I try to have 2-3 eggs/day. Sometimes I'll still 2 egg whites into a 1/2 c. of oatmeal (while it's still cooking) to add some protein to my first meal of the day (if I am not eating scrambled eggs).

    Cottage cheese packs a lot of protein in a 1/2 c. serving (14 g.)...I eat the 2% small curd kind and have about a cup with a slice of high fiber toast, butter and low-sugar jam.

    Almongs make a good snack and have some protein, as do mozzarella cheese sticks (7 g/stick). I usually eat these with a small apple or pear.

    Plain yogurt has good protein, but not as much as cottage cheese and it's higher in carbs, which for my I have to watch.

    Milk has 1 g/protein per ounce so you can have 8-12 ounces with a meal and pack in some protein that way too. I drink 8 oz. of 1% milk 2-3/day which is also good for added calcium for the babies.

    I get frozen lean turkey meatballs...3 of them have 18 grams of protein and I eat 6 of them for dinner with some steamed veggies and 3 oz. of sweet potato oven fries.

    I also have craved salmon lox this entire pregnancy and have 2 oz. on 2 slices of high fiber toast (used to be a yummy bagel once a week before GD) with 2 tbpn. of cream cheese. There's a good amount of protein there. I eat this about 1x week.

    For a treat, ice cream is the way to go...it's packed with protein compared to other options (like cake, pie, cookies, etc.)

    Good luck! You can do it! And those 35 lbs. will drop off...no worries...you'll have two babies to expend all of that energy on and if you breast feed or pump, that will help too.

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