The Baby Designers

Sure, you’re more tired, more nauseated, just about more everything since you’re carrying multiples, but there is at least one upside: You’ve got a license to eat! Multiple moms get to indulge in an extra 600 calories a day — doctor’s orders. But before you take that as a free pass to Burritoville (extra guacamole for Baby A; refried beans for Baby B), think again. The quality of what you eat will be just as important as the quantity. In fact, good nutrition during a multiple pregnancy has an even greater impact on baby birth weight than it does during a singleton’s pregnancy.
 
Even with the best intentions, however, there will definitely be challenges to eating right. As your pregnancy progresses, there will be less and less room in your belly for food. And that’s not metaphorically speaking: Your babies will literally take up space usually inhabited by your stomach and esophagus (hence the heartburn many moms of multiples experience). Since you’ll still have to do your best to eat the foods you and your babies need most, you’ll require a good strategy: Eat several smaller meals a day (petite platefuls take up less room going down but deliver the same nutritional punch at the end of the day). And common sense requires that you choose foods that pack plenty of nutrients into small servings. So how do you get the biggest nutritional charge for the calories you consume? Consider the following:
 
Calories count. Most practitioners recommend taking in an additional 300 calories per day, per fetus. That translates to 600 calories if you’re carrying twins, 900 calories for triplets, and so on (so on?!!). Given that the average nonpregnant woman eats about 1,800 calories a day, that 600 extra is a significant amount of food (about a 33 percent increase!). Again, you’ll need to make sure those extra calories come from nutritious foods that best nourish your babies and your pregnancy. In fact, studies show that a high-calorie diet that’s also high in nutrients significantly improves your chances of having healthy, robust, full-term babies. How best to accomplish this? Follow The Pregnancy Diet and add one extra serving daily of protein, calcium, and whole grains for each baby you’re carrying.
 
Protein power. Protein is a mom-to-be’s best friend, especially for those carrying multiples. Eating ample amounts may help prevent preeclampsia, gestational diabetes, and preterm labor (all more common in multiple pregnancies). Protein is also essential for building uterine muscle fiber and for fueling the increased blood volume required to nourish two or more babies. How much is enough? The four servings of protein and four servings of dairy that The Daily Dozen prescribes for multiple moms-to-be will get you the 80 to 100 grams of protein per day that nutritionists recommend. Think of yourself as a body-builder bulking up for a big competition. (After all, what are you doing if not building new little bodies?)
 
What are your best protein choices? Go for lean meats, including beef, pork, turkey, and chicken, which will earn you the most bang for your protein buck (seven grams of protein per ounce!). Nuts, yogurt, milk, cheese, cottage cheese, and tofu are other good sources. You can rev up the protein content of your milk by adding a spoonful or two of powdered milk. This portable protein booster (stash some in a resealable plastic bag in your purse) is also a great addition to oatmeal or a yogurt-and-fruit smoothie. (Wow, you get calcium, vitamins, fiber, and protein all at once!)
 
Go green. Another food group that deserves some precious abdominal real estate is fruit and vegetables. Your developing babies need their micronutrients (folic acid, iron, and vitamins, to name a few) and you need the fiber. Pregnancy slows down your gastrointestinal goings-on, but you can minimize or avoid constipation (and that delightful side effect, hemorrhoids), if you save room every day for fresh fruits and vegetables.
 
The challenge, of course, is that fruits and veggies are bulky — and you’ve got plenty of bulk in your belly already (thank you very much). What to do? Instead of indulging in huge salads (like you used to when it was just you in there), stock your fridge (and purse) with small, easy-to-eat goodies like berries, grapes, baby carrots, and grape tomatoes. Graze all day. Dried fruit is another good option because it retains all the nutrients and fiber in a smaller package. (But don’t go overboard: dried fruits can cause gas) 
 
Pump up the iron. There are a few more nutrients that are especially important when you’re carrying more than one baby. One is iron, which helps your body manufacture red blood cells (you’ll need lots of those for the increased blood you’ll be pumping) and prevents maternal anemia, a common problem in multiple pregnancies. Anemia (which occurs when the number of red blood cells falls below normal) can cause your appetite to decrease and your fatigue to increase (yes, it’s possible for you to be even more tired) as well as reduce the amount of oxygen that reaches your organs and your developing babies. Your practitioner will probably recommend foods such as red meat and dried fruit, which are great sources of iron (and other powerful nutrients). Your goal is to get between 30 and 60 milligrams of iron daily throughout your pregnancy, so make sure your prenatal vitamin contains enough, or talk to your practitioner about taking a separate supplement. 
 
Keep in mind that iron supplements can cause constipation and/or nausea, so try to take them with meals. Iron is most easily absorbed when eaten with foods containing protein or vitamin C (like orange juice) and foods that are high in acid, such as yogurt. Coffee, tea, and soda drinkers should know that consuming caffeinated beverages with high-iron foods will reduce the amount of iron that your body absorbs (one more reason to kick the caffeine habit, at least for a while). If the supplements give you tummy trouble, try taking several small doses a day, instead of one large one or look for a slow-release supplement. This may not only help relieve your digestive problems but also help your body absorb and utilize the iron most effectively.
 
Water works. Drink up, ladies — dehydration can lead to preterm labor and that’s something moms-to-be of multiples are already at risk for. Down at least eight glasses of water a day and don’t wait for mealtime. Drinking between meals rather than with them will keep fluids from competing with solids for precious space in your ever-more crowded belly. One sign that you’re well-hydrated is constant trips to the bathroom (take a peek in the potty — urine should be pale in color when your fluid intake is sufficient).
 
Get extra magnesium. When you’re pregnant, magnesium helps manufacture and repair your body tissue, regulate insulin and blood sugar levels, and build your babies’ strong bones and teeth. Just as important, research indicates that maintaining adequate levels of magnesium during pregnancy can help keep the uterus from contracting too soon, a definite factor when you’re carrying more than one. The best food sources are whole grains, green leafy vegetables, nuts, meat, and milk. Think pumpkin and sunflower seeds; wheat germ; spinach pasta; unblanched almonds; tofu and yogurt; and talk to your practitioner about supplements if necessary.

So much goes into planning and choosing a practitioner who is experienced and well versed in the challenges of carrying twins and a hospital that is well equipped for the bundles of joy.

 
Check out these tips below:
      
Choosing your practitioner. 
In today’s time moms-to-be have many options to choose from. If you have a regular practitioner in mind, stick to him/her. He or she will likely treat your pregnancy with added attention. Other moms-to-be who have significant needs such as advanced age, history of miscarriage, or a chronic health conditions may want to consider a maternal-fetal medicine specialist. Many OBGYN practices send patients who are pregnant with multiples to a specialist.
 

When choosing your practitioner, here are some questions to ask and factors to consider:
 

• Does your doctor practice solo or as part of a group? There are pros and cons to each scenario. Chances are you’ll get plenty of personal attention in a private practice, but if your doctor is delivering someone else’s babies, you may find your appointment canceled. Worse, he or she could be basking in the sun on a beach in Fiji when you go into labor, leaving you in the hands of someone you’ve never met. If you choose a group practice, you won’t see your primary doctor at every visit (and maybe not in the delivery room), but everyone in the office will be thoroughly familiar with your medical history. 
• Does your doctor perform sonograms in the office? You’re going to have several, so if there’s no ultrasound equipment on site, get ready for lots of trips to another facility.
• Find out which hospital your doctor is affiliated with (see more below). Ideally, you want a facility with the ability to care for premature babies (one with a neonatal intensive care unit).
• Some doctors induce at 38 weeks as a matter of course. Ask what the policy is — it’d be good to know if you have the option of carrying beyond that time frame if all is well. 
• What about delivery? Is a vaginal birth possible, or does your doctor routinely delivery multiples via C-section? What about pain relief? If you were hoping for natural childbirth experience, you might have to reconsider: In most cases, routine epidurals are strongly recommended, just in case you need an emergency C-section for one or both babies.
•  

Choosing your hospital. In most cases, moms give birth in the hospital at which their doctor has admitting privileges. That means you’re probably choosing your hospital when you pick your doctor. (Some doctors deliver at more than one facility, so ask where you’re likely to actually give birth.) Beyond that, here are tips on researching a hospital’s capabilities and approach to delivering and caring for multiples. 

• The single most important factor may be the presence of a neonatal intensive care unit, or NICU. Multiples arrive before term more often than do singletons, which means they might need some personal attention right away. 
• Find out where you will actually give birth. In most cases, multiples are delivered in an OR as a precautionary measure.
• Ask about fetal monitoring and intravenous hydration. Some hospitals have rules about procedures you’d rather have your doctor request and monitor. 
•  Find out if an anesthesiologist is on duty at all hours — you may not be too happy about waiting for his or her arrival if not.
• Ask about the ratio of labor nurses to moms. Obviously, the lower, the better.
• You’ll want to know who can be in the room when you give birth. Is there a limit on the number of people? Are siblings allowed?
• Find out the policy on videotaping and photographing the birth. These days, some facilities allow both (some veto video altogether), but because you’re likely to be in the OR, that might not be possible.

Here are some much needed advice to sail through your pregnancy!!

Okay Deep Breathe. So you tell me that there is more than one baby, in my belly? Are you kidding me? This might be your first response once you are told that you are carrying more than one bub. Disbelief I know! You will get proof from the ultrasound your MD will take. Even if you have been hoping for multiplies, reality is that you are carrying more than one can somewhat come across as SHOCKING. There might be tears of joy, excitement, fear, worry among you and your partner. You might wonder ” Will they be healthy?”, Do we have enough room?” Things of that nature.   

 
Carrying twins can be far more challenging. There cna be physical transformations on top of emotional changes. Will my regular practitioner suffice or will I have to see a specialist? How much food am I supposed to eat (and how much weight do I have to gain)? Is exercising safe with babies on board? And speaking of safety, what are the risks associated with multiple pregnancy? Here are some smart strategies for enjoying a multiple pregnancy — at the best time ever for having a healthy, happy set of little ones.  

Edema ( Swelling of the ankles and legs)

What causes fluid retention and the ways to eliminate it:
 

What is Edema: Mild swelling in your lower extrimities that is noticable in the feet and ankles.
 
What causes edema: Bodily fluids that are increased during preganancy which nuture you and baby. As your body tissues accumulate and retain fluids, you may experience this oh-so-necessary increase as oh-so-annoying swelling.
 
What you need to know about edema : Mild edema is harmless and normal. it is also normal not to experience swelling during pregnancy.

  What you can do about edema: 
Avoid long periods of standing or sitting. If you’re on your feet a lot, take breaks and have a seat. If you’re on your butt a lot, take a five-minute stroll at least once an hour, and try to keep your legs elevated when you’re back in your chair.
Wear comfy shoes while you’re out (those sexy slingbacks don’t fit now, anyway), and once you get home, switch to a pair of soft slippers. 
Avoid tight elastic-top socks or stockings. Your goal is to let blood and fluids flow as freely as possible.
Try support hose — opt for full pantyhose (with extra tummy room) or knee- or thigh-highs (a better choice if you’re perpetually warm) that aren’t tight on top. Whichever type of support hose you choose, put them on in the morning before the daily swelling starts so they can do their job more effectively. 
Drink water early and often. It may seem illogical to try to flush out fluids with fluids, but drinking eight to ten glasses of water a day will help rid your system of excess sodium and other waste products, minimizing swelling.
If your hands and/or face become puffy, or if swelling persists for more than a day at a time (it doesn’t improve overnight), call your practitioner. (Excessive edema can be a sign of preeclampsia, especially when accompanied by rapid weight gain, a rise in blood pressure, and protein in the urine.)

Diarrhea in Pregnancy

So you have found yourself going to the bathroom alot more than usual.. Below there are some tips on everything you need to know the next time you go.
 
What it is: Diarrhea is defined as loose or watery that is frequent. Okay so maybe you know the definition but hey, it a start. 
 
What causes it: Diarrhea maybe a result of somethings that you are now eating like the foods and the extra water you are drinking. Prenatal Vitamins can be another cause for loose stools as well. 
  
There are things that can cause diarrhea during pregnancy that have nothing to do with hormones or lifestyle changes. Food poisoning, intestinal parasites, or a simple stomach flu may be behind a nasty bout. If you suspect any of these might be the case, call your practitioner ASAP so you can be tested and treated, when possible.
 
What you need to know about it: Diarrhea tends to be much less common than constipation during pregnancy and generally doesn’t last as long. In fact, diarrhea that persists for more than a couple of days, no matter how mild, is worth a call to your practitioner. Diarrhea can not only be a pain in the rear but can quickly lead to dehydration, a major risk factor for premature labor. For that reason alone, if you’ve got it, take it seriously.
 
What to do about diarrhea during pregnancy: Keep away from foods that will only make the problem worse: dried fruits (consider prunes your enemy); fatty or spicy foods; and milk, especially if you’re lactose intolerant. The so-called BRAT diet (bananas, rice, applesauce, toast) has been recommended for years but the newest thinking expands on those options to include important vitamins and minerals (especially zinc) that are not provided by the BRAT diet. While BRAT foods are indeed gentle on your digestive track, try adding the following:   

• other starchy foods like potatoes, unsweetened cereals, crackers, and toast 
• vegetables, such as cooked carrots, and non-milk-based soups with noodles, rice, and/or vegetables 
•  lean meats
• yogurt, especially with live, active cultures of lactobacillus acidophilus

Avoid “simple” high-sugar drinks (apple and grape juice, gelatin, regular colas, and other soft drinks), which can draw water into your tummy, making diarrhea last even longer. Sports drinks (like the electrolyte-replacement favorite, Gatorade) and water are much better options. And, as always (but particularly now), avoid fatty and fried foods.
 
Remember, while a mild case isn’t anything to really worry about, severe diarrhea (more than three stools a day), or stools that are bloody, have mucus, or are purely liquid are a sign to give your practitioner a call (today).

Clumsiness

Oh man, I just trip again… Wonder why this happens during pregnancy, read the tips below to find out.

What is clumsiness during pregnancy: Pregnant women definitely have a tendency to slip, trip, drop, and plop. In short, they’re clumsy.
 
What causes clumsiness during pregnancy: Your unintentional slapstick act is a temporary side effect caused by several factors: the retention of water and loosening of joints, both of which can make your grip less firm; a loss of concentration; a change in your center of gravity (and later, the fact that you can’t see past your belly to your feet); and a lack of dexterity due to carpal tunnel syndrome, which is common during pregnancy.
 
What you need to know about clumsiness during pregnancy: Your expanding girth and shifting posture may put you a bit off-kilter, sometimes making the simplest balancing act as tough as a Balanchine leap. Add that to the hormonal changes that make you drop everything, and you’ve got quite the challenge just staying on two feet and hanging on to your plate on the way to the dishwasher. Most pregnancy clumsiness is just annoying — repeatedly retrieving the car keys from the floor, for instance, is merely an ongoing pain in the neck (as well as a pain in the back if you don’t remember to bend from the knees). Falls, however, can be a more serious matter — which is why “caution” should be your middle name when you’re expecting.
 
What you can do about clumsiness during pregnancy:

• Proceed with care. Slow down, use extra caution in the tub or shower, steer clear of fancy footwork, don’t wear slippery soles or socks without shoes, make sure your area rugs aren’t slippery, keep hallways and stairs clear of objects that might trip you up, and don’t stand on any chairs (no matter what you need to reach).
• Don’t pick up what you don’t want to drop. The clumsiness will be with you for a while, so leave your favorite crystal on the shelf for the duration and let someone else load and unload the dishwasher (especially when the good china’s involved).

Chloasma (“Mask of Pregnancy”)

What causes that blotchy discoloration on your face, and what you can do about it?

What it is chloasma (mask of pregnancy): Chloasma is splashes of darkened skin that may appear on the forehead, nose, and cheeks in a mask-like configuration on some pregnant women — more often in dark-skinned women.
 
What causes chloasma (mask of pregnancy): Those mischievous pregnancy hormones are toying with you again, causing hyperpigmentation on many parts of your body. You might have noticed your freckles and moles are darker now, there’s probably a dark line down the center of your abdomen (the linea nigra), and your areolas are probably a deeper shade as well. (You might as well decide this is sexy.) Dark-skinned women usually notice such hyperpigmentation more, but light-skinned women aren’t off the hook completely — they too will get their fair share of darkening skin, though it may not be as noticeable.
 
What you need to know about chloasma: Rest assured, the age of darkness doesn’t last forever, though you might find a few new freckles that are here to stay. Most skin discolorations — including chloasma — fade within a few months after you give birth; you’ll still have a pale line, though, and let’s face it — your vulva’s never the same.
 
What you can do about chloasma:

• Eat foods that contain folic acid (you’ll also get plenty in your prenatal supplement), since studies have shown that a folate deficiency can be related to hyperpigmentation. Good choices include green leafy vegetables, oranges, whole-wheat bread, and whole-grain cereal.
• Stay out of the sun as much as possible and wear a sunscreen of at least SPF 15 (sunlight can also intensify hyperpigmentation). A hat and long sleeves are a good idea if you’re fair-skinned, headed to the beach, or have a historically sensitive complexion.
• If you like, use a good concealer to cover particularly pesky spots, but skip bleaches or other chemically based lightening treatments until after you give birth. No peels or lasers, either.

To bumper or not to bumper? This is the question many moms ask when outfitting their newborn’s crib. You’ve heard that cushier bedding is linked to SIDS (so that fluffy quilt is already out) but a bumper completes the room decor so perfectly. Can you have a cozy-cute bed for your baby without worrying yourself sick? Here’s a new idea: Babylicious Crib Fringe.

The cool “fringe” (which looks like a string of mini flags) ties to the top of your crib rails, adding a hip, unexpected design element. Available in several color themes, the fringe is reversible and washable. Go old-school classic with the white embroidered, scallop-edge “Snow” fringe, or super mod with the stripes and circles of their “Islands” print. The two strings of fringe tie to just the long rails, so they don’t interfere with a drop side. Just be sure to remove the fringe on your crib once junior can crawl, pull up, or stand.

Products from Babylicious, a Canadian company and celeb-favorite (hot daddy Hugh Jackman’s a fan), are sold all over the U.S.

http://www.parents.com/baby/nursery/design/crib-bumper-alternative/

By Janna Johnson