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Ages & Stages

Having Twins? How to Stay Healthy

The fact that you are carrying more than one baby does place you in a special category in the eyes of obstetricians. Many would call a twin pregnancy a high-riskpregnancy, but don’t be scared by this categorization. High risk does not automatically translate into your pregnancy having problems. Rather, high risk can be translated as, “We will need to follow this pregnancy more closely.” Also in the high-risk category are mothers with diabetes, those with a history of preterm labor with prior pregnancies, or those who have other major health issues themselves. The majority of twin pregnancies progress smoothly, and the odds of a healthy pregnancy increase if you take better care of yourself.

The most important step to care for your pregnancy is proper nutrition. Ideally, pregnant mothers should take a prenatal vitamin with folic acid starting from 3 months prior to conception. Folic acid has definitively been proven to reduce the chances of neural tube defects such as spina bifida. If you haven’t started taking the vitamin daily yet, don’t fret about the missed time—but do start now. Take the vitamin with food to reduce nausea, and applaud yourself for taking yet another step to keep your babies as healthy as possible. Moms of twins don’t need 2 prenatal vitamins a day—one is enough.

Eating the proper foods and the right amount of calories is critical in a twin pregnancy.

Whereas single-born pregnancies require 300 extra calories a day, most experts agree that twin pregnancies need around 1,000 extra calories a day. Frequent and healthy snacks can help you reach your caloric goals each day. Morning sickness—or in most women's cases, all-day sickness—can be eased by eating small snacks frequently. Keeping a little something in your stomach at all times can help take the edge off of the nausea. Low-fat yogurt, fruit, smoothies, crackers, and protein shakes are all good snack options.

In addition to the extra calories, it is important to sip on water throughout the day. Keeping well hydrated may drive you crazy in later months when it seems like you’re running to the bathroom every 5 minutes; however, your babies’ extra blood flow and removal of wastes depends on it! It may help to drink more water earlier in the day and then stop after 8:00 pm so that you can sleep longer stretches at night between bathroom breaks.

Proper nutrition and hydration is important for your twin pregnancy, as is listening to your body. Any new pregnancy symptoms you notice must be brought to your obstetrician’s attention.

Seemingly minor things could be a sign of something more serious.

​Because twins have an increased chance of being born early, any symptoms or concerns must be addressed for the safety of your babies. Bleeding or vaginal discharge, contractions that are becoming more frequent, pressure in the pelvis or lower back, or even diarrhea can all be signs of preterm labor. And while early bleeding in the first trimester could be the normal phenomenon of the twins implanting in the uterine wall, you should call your obstetrician if you experience bleeding at any point.

Twin pregnancies can also increase the chances of preeclampsia, a condition in which the mother has increased blood pressure, protein in the urine (detectable by urinalysis), and more swelling than is normal in pregnancy. If you notice rapid weight gain or headaches, alert your obstetrician so you may be examined as soon as possible. Depending on the severity of the situation, treatment may range from bed rest, to hospital-administered medications, to immediate delivery of the babies (the only “cure” for preeclampsia).

An optimistic yet careful attitude during your pregnancy will help your mental state and hence help your babies thrive during pregnancy as long as possible. Take things one day at a time and one week at a time. Eat well and pay attention to what your body and your twins are telling you. Every extra day that your babies spend inside the womb will help them once delivery day arrives. The bigger your belly gets, the bigger your smile should be, since you’re creating 2 miracles!

Last Updated
Raising Twins: From Pregnancy to Preschool (Copyright © 2010 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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