Congratulations! And ... congratulations again!
You're pregnant with twins. And mixed with the joy and wonder comes another emotion -- stark terror. Whether you're an experienced mom or a first-timer, "what to expect when you're expecting twins" involves many unique questions.
Zoeie Kreiner, a mother of six and a lactation consultant in Illinois, already had three children when she gave birth to fraternal twins. But having kids one at a time hadn't prepared her for the challenges of a duo. "I'd already had babies, but there were a lot of specific questions I had that people who'd never had multiples would never know the answer to."
The most critical mission is getting your twins born strong and healthy. Although twins are more likely to be born prematurely and at a low birthweight, it doesn't have to be that way, says Barbara Luke, PhD, ScD, a professor of obstetrics and gynecology at the University of Michigan. "My whole focus is getting babies to grow like they're singletons," she says.
How do you do that? It's all about nutrition -- and weight gain. Steady maternal weight gain, particularly in the first and second trimesters, is "like money in the bank. It's going to earn interest," says Luke, author of When You're Expecting Twins, Triplets, or Quads: A Complete Resource. "Good weight gain before 20 weeks, and between 20 and 28 weeks, really influences fetal growth." An average-weight woman who's pregnant with twins, for example, should try to gain about a pound and a half a week -- 20-30 pounds by 20 weeks, 30-46 pounds by 28 weeks, and 40-56 pounds by 38 weeks.
Here are some suggestions from Luke for achieving that nutritional balance and ideal weight gain:
- Eat every two to three hours. Pregnancy is "a state of accelerated starvation," Luke says, and twins mean you need even more food.
- Include protein and carbohydrates together in every meal and every snack: peanut butter on apple slices, cheese with your crackers. Women eat far too many carbohydrates and not enough protein.
- Eat plenty of red meat. Sorry, vegetarians, says Luke, but red meat is an optimal source of iron.
- Enjoy those eggs. Cholesterol may be bad for daddy, but it helps keep mommy healthy.
If you are a vegetarian, talk with your doctor about other good sources of iron. Making sure that you get enough calcium and that you take a prenatal vitamin containing folic acid is also a good idea.
Two Breasts, Two Babies?
Most mothers of twins wonder about two main things, says Julie Morreale, leader of the DeKalb, Ill., La Leche League: "Will I be able to make enough milk, and will I ever sleep?" Morreale, herself a mother of five including 3-year-old twin girls, reassures mothers that their bodies can, indeed, supply the nutritional needs of two babies at the same time. "Your body will produce enough milk for twins, as long as you're feeding on demand. Some people try to set up a schedule: That's a fine thing if it works for you once they're 4 to 6 months old, but newborns and breastfeeding babies are made to nurse more often, and twins nurse more often yet," she says.
"Nurse early, nurse often," agrees Zoeie Kreiner, who's worked with hundreds of mothers of twins on breastfeeding issues. "The more you nurse, the more your body produces."
Nursing your twins at the same time, if you can, will help you get a little more rest at a time when you can expect to feel like a zombie. How do you accomplish this feat of coordination? Kreiner suggests trying a few positions. First, sit down on the couch with a baby on either side, perpendicular to you. First pick up whichever baby is the stronger nurser at the time -- since she'll pull the milk down for her twin. Then try the "double football hold" -- with each baby's head on one breast and her bottom resting on whatever you're sitting on, with your hands supporting her head. Or the cradle position, with one baby cradled in the crook of your arm and second baby's head almost in the other baby's lap. Kreiner notes that many twins like that posture because they're used to being so close.
For the most hands-on advice you can find, get involved with a local mothers-of-twins-and-multiples group, which will be easy to find with the help of the National Organization of Mothers of Twins Clubs (www.nomotc.org). Many groups have a "stork mom" program, pairing experienced twin mothers with nervous newbies to answer questions like, "How do you get through the grocery store?" and "How do you handle all those car seats?"
Support Is Vital
Support from other moms of twins is vital during your pregnancy, when everyone thinks your body is community property and has a tale to tell of twins they know. "All of a sudden you'll know that Aunt Ida's third cousin's ex-husband's fifth wife had twins and this is what went wrong with her delivery," says Kreiner. It's even more important during that rough first year, when sleep becomes a stranger.
"Use whatever pairs of hands you can find," says Gila Reiter, MD, a New York ob-gyn and mother of 12-year-old twins. "I tell my patients, 'You're going to be out of commission for a year. Tell your friends, tell your relatives, you won't be decorating the Christmas tree this year or hosting the parties.'"