The Hemp Connection [Search results for triplets] 

We had a really interesting inquiry from a lactation consultant, who had been trying to find information to give her new mothers of multiple births, regarding how much they need to eat to maintain their own nutrition AND produce enough milk for multiple babies.

We have a great resource for that, inCYSTer Chris Wittmer, in Dayton, Ohio. Chris works for a medical practice that manages high-risk pregnancies. Chris' great answer is posted below. I wanted to share it with our readers, so that others looking for this information don't have to work so hard to find it. Enough of you are undergoing procedures that increase the chances of multiple birth, I wanted to be sure that from beginning to end, mother and babies are well fed!

I linked to the book in case anyone wanted to find it without an inordinate amount of hunting.

Thanks so much, Chris, and I hope this helps!

There are very few"official" recommendations for nutrition for mom while breastfeeding multiples, but Barbara Luke, who is the"guru" of nutrition for pregnancy with multiples has extrapolated some numbers/recommendations for a singleton mom to multiples. They are included in her book:"When You are Expecting Twins, Triplets, or Quads", 2nd edition, chapter 10.

The overall caloric recommendations are
--1000-1200 calories additional for twins (500-600 calories per baby),
--1500-1800 additional calories for triplets and
--2000 to 2400 additional calories for quads.

For twins her recommendation is 3200 calories/day and 160 g protein/day, keeping the distribution of calories approximately 40% carbohydrate, 20% protein, and 40% fat. Elizabeth Noble recommends about 3000 calories/day for twins (400 extra per baby The calcium needs are the greatest-increasing by 50%, so that would be in the range of 3000 mg/day.

Other important nutrients include Omega 3 fatty acids, Zinc, and Iodine. It is extremely important for mom to eat adequately or her milk supply will be diminished. Eat nutrient dense foods frequently to help get in the needed calories and nutrients and continue to drink adequate fluids-preferably milk, juice or water. I don't know if any of this will be helpful, but as has been said before, it is a subject that has not been addressed adequately in the literature. There is a need since the incidence of multiples is rising.

Multiple gestation pregnancies are increasing dramatically in the United States. This often leads to increasing frequency of low birth weight infants, preterm labor and other conditions associated with high risk pregnancies. Nutrition is a key element to reducing the risk of birth defects, suboptimal fetal growth and development and chronic health problems for both mother and child. Nutritional intervention has been proven consistently to improve outcomes in multiples.

Weight gain recommendations are based on pre -pregnancy Body Mass Index ( BMI ) whether for singleton pregnancies or multiple gestations. Twins and higher multiples do require both more calories and increased weight gain (over a singleton pregnancy). The following are guidelines that I have gathered from the literature:
Singleton: Twins: Triplets: Quadruplets:
Underweight (< 18.5 BMI) 28-40 lbs. No guidelines established
Normal weight (18.5-24.9 BMI) 25-35 lbs. 37-54 lbs. 50-60 lbs. 65-80 lbs.
Overweight (25-29.9 BMI) 15-25 lbs. 31-50 lbs.
Obese (> 30 BMI ) 11-20 lbs. 25-42 lbs.

Some additional things to consider:
Multiple gestation in a woman's first pregnancy: Gain an additional 5-7 lbs as quickly as possible
Multiples as a result of infertility treatments: Gain an additional 4-6 lbs. during the first half of the pregnancy
(This has been shown to decrease the liklihood of miscarriage-reason unknown)
Smokers or those who have recently quit smoking should gain an additional 5-7 lbs. to help replace nutrients lost through smoking and to replenish lost nutrients.

The pattern of weight gain is also important when having multiples. This is because often multiples do not go to term, so early weight gain is important. Weight gain in the first 24 weeks has the most influence on
weight gain after 24 weeks.
The recommendation is as follows: Before 24 weeks After 24 weeks
Goal weight gain/week Goal weight gain/week
Singleton 1/2 lb. 1 lb.
Twins 1 lb. 2 lbs.
Triplets 1 1/2 lbs. 2 1/2 lbs.
Quadruplets 2 lbs. 3 lbs.

How many calories are needed for appropriate weight gain?
The following guidelines (based on pre -pregnancy weight) can be used to estimate individual needs:
Singleton:
Normal pre -pregnancy weight: 30 calories/kilogram(kg.) (1 kg = 2.2 lbs.) Your weight/2.2=weight in kg.
Overweight: 24 calories/kg.
Underweight: 36-40 calories/kg.

Twins: Add 500 calories per day to the above recommendations as soon as the multiple pregnancy
is diagnosed.

If you need assistance with determining or reaching goals, seek out a nutrition professional/Registered Dietitian who works with high risk pregnancies.