Obstetrics >> Pregnancy: Twins!


Drink water — lots of water. 8-10 glasses a day is 64-80 ounces. Your pregnancy requires lots of water to create the fluid-filled environment in which the babies float. You also need adequate water to metabolize calories, maintain a normal blood pressure and avoid dehydration that can lead to headache, fatigue, urinary tract infections, premature labor and so much more.

Drink your milk. Your babies and your bones need 7 glasses/56 oz. of milk a day or 2000 mg. of calcium. 8oz. of milk or yogurt or cottage cheese contains 300mg.

Drinking 3 glasses of milk a day is difficult for anyone, but 7 glasses is nearly impossible. If you are not able to drink that much milk, that is okay. Try sneaking in yogurt and cheese anytime you can.  You can substitute a calcium supplement for milk: try Tums Ultra, Caltrate, Oscal, Citracal, and Viactiv.

If you can eat three servings of dairy a day, then you need only 6 Tums Ultra to make up the remainder of your daily needs. Take two Tums at a time. Do not take Tums with your vitamin or iron supplement.

Babies are made out of water, calcium and protein. Your protein goal: 12 oz. of meat daily from 20 weeks to your delivery. You can eat chicken, beef, turkey, fish (tuna and salmon are the best), eggs, soy. Snack on protein throughout out the day: cheese sticks, peanut butter, nuts, hard-boiled eggs, protein bars and protein drinks. Adequate protein intake is essential to build healthy proteins to make your babies, maintain your blood pressure and keep the ankle swelling away.

Although you may eat fish when you are pregnant, you should limit you fish intake to 12 ounces a week (like two cans of tuna). Do not eat shark or swordfish: they tend to contain more mercury than may be safe during pregnancy. All fish that you eat must be cooked. Shellfish is okay.

A daily prenatal vitamin prevents some birth defects and corrects anemia. Do not take your vitamin with milk or Tums or an antacid.

An iron supplement is necessary to make blood for the second twin. Try Slo-Fe just once a day. Take your prenatal vitamin and your iron supplement at either end of the day without milk or antacids.  Consider an Omega-3 (fish oil or DHA) supplement. This oil is essential for your baby’s brain growth and may help keep your blood pressure normal. One for each baby. Take one with your prenatal vitamin and one with your iron supplement.

Get more fiber in your diet to avoid constipation. Raisin bran, apples, raw vegetables. Products that help: Metamucil, Citracel, Fibercon.

10 oz. of caffeine (less than 100 mg.) a day from coffee or tea is okay. Avoid soda pop which may contain an acceptable amount of caffeine, but has too much salt and sugar for your healthy pregnancy. 

Smoking damages your baby’s brain development by significantly diminishing blood and oxygen flow to the uterus for an hour after every cigarette. Cut down and quit. Nicotine lozenges or gum may be helpful. Do not use nicotine patches.

A healthy weight gain is 25-40 pounds, depending on your starting weight. Ideally you will gain:

  • 4-5 pounds in the first three months (150 calories a day)
  • 10-15 pounds in the second three months (500 calories a day)
  • 1-2 pounds a week in the third trimester (500-750 calories a day)

Sleep 8 hours at night. Wind down an hour before bed. Take a warm bath. Try hot tea, meditation, and reading. Avoid caffeine after noon. On your day off sleep til you wake up. Listen to your body. Most pregnant women would benefit from an afternoon nap. Rest revives you, boosts your immune system and gives your body the energy to grow a healthy pregnancy.

Exercise for 20 minutes, three times a week. Exercise that raises your heart rate will burn calories, strengthen your muscles, make your bowels work better, improve your sleep and sense of well-being.

Try a brisk walk, bicycle, and swim. There is no need to do high impact exercise such as jogging during pregnancy. Don’t forget to warm up, cool off and drink lots of water. Keep your heart rate under 140.

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