A detour: We received a question about nutrition and exercise for multiples. So, here is some information for those with twins and triplets. Add a comment if you have a question or experience to share on this topic! Next comes birth, we promise!!
Nutrition for Multiples:
The primary thing we tell people with twins or more is that the protein needs rise about 30 grams/baby/day above the 70 — 90 grams/day needed for a singleton. Water intake also needs to rise. Avoid thirst and as much as possible, drink until urine runs clear rather than yellow (as best as you can).
Multiples is considered a risk factor, and for each risk factor (multiples, underweight, teenage mom, inter-pregnancy period less than a year) an additional 200 calories is often recommended, with 400 extra calories the upper limit.
Exercise with Multiples:
A critical factor in successful implantation and growth of the placenta appears to be aerobic fitness in the six months prior to and the first half of pregnancy. Once biomechanics become difficult in mid-pregnancy, women with multiples can continue activity safely as long as monitoring show the babies are growing appropriately. A belly support can be extremely helpful when exercising.
Contraindications for exercise include the discovery that one fetus is growing at a significantly slower rate than the other(s), that both/all are too small, that the placenta(s) is/are malfunctioning, or some other condition occurs, such as an incompetent cervix or placenta previa, that would be a factor in any case.
Absolute size difference does not necessarily mean that one baby is growing more slowly, as some fetuses may be a couple weeks younger than their uterus-mate(s) if the mother ovulated twice in the fertility cycle. Or, s/he might be smaller if genetically destined to be a smaller infant at birth. Thus, growth rate is the measurable factor that helps determine if a fetus is at risk of not receiving adequate energy. This can happen when there are two placentas and one placenta is working more poorly than the other, or for some reason there is a flaw in the umbilical cord of an identical. The competition for energy places a slower growing baby at risk.
Protecting Mom and Baby:
The placenta is designed to nourish the baby and will do so at a cost to the mother first if there is inadequate nutrition. Thus, activity to the level the mother can tolerate and following nutritional guidelines above — in the absence of medical complications — produces healthy offspring. Multiples will garner all the same benefits a singleton does.
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