Expecting the Unexpected rings true again. Never in my life did I think I would have the excuse to say "I am eating for three" & never in my life did I think I would have some of my cravings squashed by the diagnosis of gestational diabetes partway through my hungriest pregnancy yet!
So let's start at the beginning of pregnancy number three. I felt hungry before I even knew I was pregnant. I stayed in starvation mode even throughout the awful nausea & vomiting. I could & can still eat a feast at every meal with more than a few snacks in between. Sound familiar? I thought I was hungry when I was pregnant with Eloise, see Eating for two, but this pregnancy has made that one look like I was on a diet
; )
I was really interested to know what was recommended for growing multiples as opposed to a singleton. A friend of mine that has twins recommended a book called When You're Expecting Twins, Triplets, or Quads. She followed the recommendations as well as she could & delivered around 30-31 weeks with great sized babies for that gestational age. I also have another friend that followed the recommendations & carried triplets to 35 weeks with two weighing over 5 pounds & one just under.That is awesome! I was really excited to read it since I fall more on the "knowledge is power" side of the fence & of course hope for the best outcome with my little ones.
It is written by Dr. Barbara Luke, a professor of obstetrics & gynecology who has taught at two different medical schools, researcher & nutritionist along with another woman who is a professional writer & has twins herself. Dr. Luke founded and ran a multiples clinic in Michigan that counseled women throughout pregnancy with the goal of improving pregnancy outcomes. The outcomes she mentions are quite impressive such as lower incidence of preterm labor, high blood pressure, preeclampsia & premature rupture of membranes, all things mamas of multiples are at a higher risk for. For the infants born to these moms, the outcomes are fantastic. Results have been triplets weigh 35% more on average while twins weigh 20% more than others born nationwide at the same gestational age. She also mentions that 60% of twins deliver at 36 weeks or later compared to only 40% nationwide.
This blog post is not all about this book but I have to share a bit about how it has shaped my eating plan. Another important chapter is titled Weight-Gain Goals & Nutrition Know-How. It starts with talking about the importance of the weight gain pattern. It states:
- "Your weight gain up to 28 weeks has the greatest influence on the babies' rate of growth. recent research on twin pregnancies has shown that the amount you gain before 28 weeks gestation significantly influences your babies' growth rates before & after 28 weeks - and all the way up to their delivery date."
- For triplets & quadruplets, the weight gained prior to 24 weeks makes the most difference. "For instance, triplets whose moms gain at least 36 pounds by week 24 generally are born nearly a half a pound heavier than triplets whose moms did not hit this early weight gain goal." A half a pound doesn't sound like much on our bodies but on a preemie it makes a big difference!
- Anyone remember what it feels like to try & consume a large amount of food when 38-40 weeks pregnant? If you forgot, it feels like your stomach is only about 6 inches from your chin & is the size of a ping pong ball. That is at least how I feel : ) "The bigger your babies grow, the less room there is for your stomach to expand. With multiples, that 40 week size arrives much sooner- at around 32 weeks for twins, 28 weeks for triplets, and 24 weeks for quads." With my appointment at 29 weeks yesterday, I am already measuring 41 weeks due to my short stature so I am definitely feeling the the squeeze between the top of my belly bump & my chin.
- For twins with a mom starting at a normal weight which I was just under, she recommends 20 pounds by 20 weeks, 38 pounds by 28 weeks with a total of 45-60 pounds. I hit the 28 week goal of 38 pounds last week. Wahoo!
All that to say, when I read that I should eat that many calories a day, I was stoked! It was everything I had ever dreamed of in a pregnancy ; ) I did run this by my doctor & he thought the total weight gain was about right but thought sticking closer to 2800-3000 calories was a better idea. Honestly, I haven't really kept track of exact calories throughout but have eaten often & a lot.
Onto the cravings of this hungry mama:
1. RED MEAT
- This is hands down the one thing I cannot get enough of!!! I have eaten more steak, steak fajitas & roast beef sandwiches than any person should ever consume. My favorite place to get a roast beef sandwich from is Publix, our neighborhood grocery store (for those of you who don't live around here). I get it with Boar's Head meat & cheese & can consume in record breaking time. I have been known to get a 12 inch & eat it in one sitting. We have gotten hooked on Cantina Laredo Mexican Restaurant which happens to be close by my doctors office. It think we have eaten there weekly & one week twice for the past month. Two times ago we got the lunch portion of steak fajitas & we called the waiter over to ask how much more it was to get the dinner portion, he took one look at me & said "oh, eating for two" to which Robby replied "actually she is eating for three." He swiftly delivered a dinner sized portion to our table on top of what we already had. We ate it all up & he was so kind to not even charge us for it : ) Thanks Owen & Anson for making me look so hungry!
- As I mentioned in a previous post , we added a smoker to our collection of items on the back porch so I have enjoyed my fair share of brisket that tastes better than any BBQ I ever had in Texas
-I went through a week span of eating a sausage, egg & cheese breakfast sandwich from Panera more days than not.
2. NUTS
- I am like a little squirrel having a constant supply of a bag of assorted nuts in my purse at all times. My current favs are almonds & walnuts.
-Sunday mornings as soon as the sermon starts I sneak my bag out & start snackin'!
3. ICECREAM
- We went through more than a couple tubs of Blue Bell (is there any other ice cream out there?) Cookies & Cream. It was the nightly treat right before bed for awhile. I have slowed down on my ice cream consumption lately but was just informed by a diabetic friend that eating a small portion of premium ice cream was still a possibility for gestational diabetes due to its high protein & high fat that slows the absorption of sugar. Yee-haw! These growing cowboys love when I eat ice cream ; )
Living on the thin side of life, I have never worried too much about portion control, calories or carbohydrates. Along with my OB doctor I was shocked to be diagnosed with gestational diabetes, I actually laughed out loud. Thinking back to what I have eaten over the course of this pregnancy, I don't think I have been completely out of control but I did stick to three protein drinks a day for awhile that were high in sugar. Of course as a mom or just as a woman, I am frequently analyzing myself or the situation to see if I did things right or wrong. I will say that I ate probably 100 donuts during my last pregnancy by the time Eloise made her debut but I passed my glucose tolerance test. I know I went on a Rainbow Chip icing binge for a few days somewhere around 20 weeks this time around & I enjoyed some Halloween candy but overall, I felt like I was eating a wide variety of healthy foods along with some sweet treats. So, can you really know if you caused it to happen? I don't know. My doctor said I was the skinniest twin mama to be diagnosed with gestational diabetes he has ever seen in his 20+ years of practice. He said as I was leaving the office yesterday "Thanks for throwing me a curve ball!" I replied "Just trying to keep you on your toes!"
His best guess is that I ended up with this diagnosis this time around because of the twins. Basically what happens in any pregnancy is once the placenta takes over providing nourishment for the baby, hormones are secreted that can interfere with how the body usually responds to insulin. These hormones can cause insulin resistance to occur making the blood glucose level rise. So imagine a placenta large enough to support the growth of two babies & the excessive amount of hormones secreted. My pancreas apparently could not keep up! Generally one of the greatest risks is a baby who grows to large & then experiences birth trauma in a vaginal delivery. This is not really a concern at all with twins who will be delivered via cesarean. One risk we are up against is the boys becoming hypoglycemic after birth. They will be monitored closely following delivery & treated as necessary. For me, this will go away at delivery! I am at a greater risk for developing Type II Diabetes later in life though. May sound nerdy but I am looking forward to meeting with the diabetic educator this coming week & learning all about what is happening inside my growing body & getting some tips on what to read to be even more educated. For now I have started on a diabetic diet & will get my glucose monitor this week when I see the educator. I will do a weeks worth of monitoring (4 times/day) while just changing my diet & if it is under control I will continue with that plan. If I am getting abnormally high results, I may be started on insulin. Hopefully diet change is all this girl needs!
This pregnancy has taught me a ridiculous amount of information that I will have in my mind for the rest of my life. It is SO different to experience it all first hand rather than care for patient after patient dealing with high risk pregnancies. For that I am thankful as I know I will understand more deeply what these families have struggled through to make it to Labor & Delivery. I am thankful also for living where we do, just a mere 25 minutes from such a high acuity hospital that is able to provide excellent care for me & the little guys. I am thankful for the resources we have been graciously given to cover the necessary expenses.
I am thankful that I am still pregnant at 29 weeks with 2 wiggly boys inside as I write these words. God has shown us mercy week after week. Join us in praying that my body would respond well to my change in diet & provide these babies with exactly what they need to keep growing.
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