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Breastfeeding Multiples:
Good Nutrition Means Healthy Twins

Joanie Randle
Athens, Georgia, USA
From: NEW BEGINNINGS, Vol. 11 No. 5, September-October 1994, pp. 147-9

We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.

When I discovered I was pregnant with my third child, I told my doctor that his suggestion that I might be carrying twins was ridiculous. There was no family history of twins. To me, having twins was as likely as winning a million dollar sweepstakes. It was something that happened to other people, not me.

But by my twelfth week of pregnancy I needed maternity clothes, and an ultrasound revealed that, indeed, there were two babies. What a shock! Suddenly, my hopes for a third uneventful, low-tech birth disappeared, along with my self-confidence. Could I carry twins to term? What about breastfeeding?

I drove home in a state of denial and disbelief. My doctor's parting words rang in my ears: "High risk...bed rest...probability of premature labor and delivery...50% chance of a cesarean...don't forget to take two prenatal vitamins a day from now on...."

I knew that good nutrition was basic to a healthy pregnancy. It seemed especially important in the case of a multiple pregnancy, so immediately I bought a book entitled Having Twins by Elizabeth Noble. It was the most informative book I read on multiple pregnancy and birth. Two sentences struck me as especially important. The first was "studies show that caloric intake in the presence of high protein, more than any other factor, helps avoid low-birth weight babies and infant death." The other said "Daily intake of 4,000 calories and 140-150 grams of protein for a twin pregnancy...has generally resulted in term babies weighing at least seven pounds."

At first it seemed that eating 4,000 calories a day would be easy. Visions of banana splits, hot fudge sundaes, and plates of fettucini alfredo filled my head. Eating 4,000 nutritious calories, however, was a challenge. I learned to make every bite count and to eat many small meals instead of three big ones. I experienced tremendous nausea during the first six months of my pregnancy. It was worse when I didn't eat enough on a regular basis and subsided when I ate before I really got hungry.

I began each day with a large glass of water, a bowl of whole-grain cereal with milk, and a glass of orange juice. Later that morning I had two scrambled eggs with grated cheese, toast, and a yogurt milk shake. Lunch was light: soup or sandwich, cottage cheese and pineapple, orange juice, and fruit. Split pea soup was a favorite lunchtime meal because it contains lots of vegetables and is easy to prepare. I often froze the soup in small ziplock sandwich bags for lunches.

Drinking plenty of water throughout the day is another very important component of good prenatal nutrition. With two amniotic sacs demanding fluid, I needed a lot of water. Keeping a sports bottle of water with me at all times was helpful. I made it a habit to drink a large glass of water after every trip to the bathroom to ensure that I was getting enough to drink.

Every day at about 3:00 PM, I had a high-protein shake, a peanut butter sandwich, or an apple with cheese. This was a consistent source of 50 g of high quality protein. Just blend one cup of whole milk, 1/3 cup nonfat dry milk powder, 4 tablespoons soy powder, 1 banana, honey to taste, and some frozen fruit. If I was low on protein at the end of the day, I often had another of these shakes at bedtime.

I tried to keep dinner simple: grilled meat or fish, green salad and steamed vegetables, rice, pasta, or potatoes. Striving for variety kept our meals interesting as well as nutritious. I also had a snack before bed and another in the middle of the night, otherwise I woke up nauseated and very hungry. My snacks were often a high protein bar I found at my local health food store, and a glass of orange juice.

It was too hard to keep track of my protein and calorie intake without writing down everything I ate in a food diary. A weekly chart with the days of the week across the top and food items down the left-hand side was also useful. Cookbooks such as WHOLE FOODS FOR THE WHOLE FAMILY provided calorie and protein information at the end of each recipe.* Many health food stores carry charts which break down food items into the calorie, fat, carbohydrate, and protein content of each.

Keeping track of my food intake during my twin pregnancy became a hobby; what I ate seemed to be the only thing I had any control over during a time when I felt very vulnerable. I knew that if I ate well, I could give my babies the best chance of being born full-term with normal birthweights. As a result, my health was excellent. I was never confined to bed and never experienced anemia, high blood pressure, toxemia, gestational diabetes, or premature labor. My babies were born by a scheduled cesarean section (one was breech and the other transverse) at 38 weeks.

Lilyanne was born first and weighed a breathtaking 9 lbs. 2 oz. Henry Thomas was delivered second and was a very respectable 8 lbs. 4 oz. We set a birth weight record for twins in Athens, Georgia! My doctor was shocked; he had never seen such large twins.

After worrying all those months about carrying the babies to term, breastfeeding them was a welcome relief. Unfortunately, I stopped paying as much attention to what I ate. When I began feeling lightheaded and dizzy, I discussed my symptoms with a friend who is a lactation consultant. She suggested that I was not eating enough: exclusively nursing twins is a nutritionally demanding job! Such a mother often produces two liters of milk a day or more! When I went back to the diet I followed so carefully when I was pregnant, the dizzy spells went away. I have continued to follow my "twin diet," including the two prenatal vitamins a day. Lilyanne and Henry Thomas are now fourteen months old and are very busy nursing toddlers. I have lost all 65 pounds I gained when I was pregnant, plus a few more.

I feel so incredibly fortunate. I had an uneventful multiple pregnancy that resulted in a term delivery of above average weight twins. I exclusively breastfed for seven months. I look forward to nursing them until they wean themselves. I never would have believed that I could have twins. Maybe I should find that million dollar sweepstakes entry....


Brewer, Gail Sforza and Tom Brewer. What Every Pregnant Woman Should Know: The Truth about Diet and Drugs in Pregnancy. Revised Ed. Penguin Books. Baltimore, MD. 1985.

The Brewer Medical Diet for Normal and High Risk Pregnancy: a Leading Obstetrician's Guide to Every Stage of Pregnancy. Fireside. New York, NY. 1983.

Brewer, Thomas, MD. Metabolic Toxemia of Late Pregnancy: a Disease of Malnutrition. Keats. New Canaan, CT. 1982.

Kitzinger, Sheila. The Complete Book of Pregnancy and Childbirth. Knopf. New York, NY. 1988.

Noble, Elizabeth. Having Twins. Houghton Mifflin. Boston, MA. 1991.

Riordan, Jan and Kathleen G. Auerbach. Breastfeeding and Human Lactation. Jones and Bartlett. Boston, MA. 1993.

*The revised edition of WHOLE FOODS FOR THE WHOLE FAMILY provides a more complete nutritional analysis of each recipe.

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