On this episode, we tackle the problem of hyperemesis in multiple pregnancies and explain how to maximise your nutrition when you’re too ill to keep anything down, or there’s simply no room left for food.

Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell explains what happens to your body when you’re supplying nutrients to more than one baby at a time, and what supplements are required to ensure your vitamin and mineral needs are catered for.

Pregnancy Dietician and Nutritionist Jessica Ruescher offers some practical advice on the types and amounts of foods you’ll need to eat, to maintain adequate weight gain during your pregnancy.

Also, twin mum Elyse Jamieson and I talk about our experiences with hyperemesis, while mum of quadruplets Jannelle Snaddon shares her struggle with nutrition towards the end of her pregnancy when she was running out of room for food.

Vitamin supplements

As a woman carrying more than one baby, your energy and protein requirements are dramatically increased. This is because your resting energy expenditure is much greater than that of a woman carrying a singleton. What this means is that due to the increased maternal tissue you’re carrying you’ll burn more calories at rest.

And, this, of course, affects your vitamin and mineral levels, which have a significant impact on the growth and development of your babies.

Maternal-Fetal Medicine Specialist Professor Craig Pennell explains that vitamin supplementation is a lot more important in twins than in singletons, and it’s actually not for the baby it’s more for the mother. He says the babies will take what they need from the mother almost always, which leads to the mother losing calcium from her bones. She will also lose iron because she’s making an extra litre-and-a-half to two-litres of maternal blood, plus two placentas, plus two baby blood volumes, all of which uses up iron.

Associate Professor Pennell advises all women carrying multiples to take a good pregnancy multivitamin, more folate than normal, iron, and calcium in a preventable manner at the very beginning of their pregnancy.

“When the vast majority of women become iron deficient in pregnancy, and when we know it’s going to happen to all twins, the best thing to do is to start supplementing early,”

“That way if you get side effects from the iron, missing a few days here and there isn’t an issue when you’re looking at it over a seven-or-eight-month period,”

“Whereas if you’re trying to cram all of your iron in at 30-weeks to have it fixed before your delivery then it becomes a much bigger problem,” he says.

Hyperemesis

It’s no secret that vomiting and hyperemesis are much more common in multiple pregnancies because you have two, three, or even four times the pregnancy hormones.

Associate Professor Craig Pennell tells us that the first trimester is usually the most challenging and the best advice, if this is the case, is to keep down whatever you can and not be too worried about it, with water being the most important thing.

Hypnobirthing Practitioner and Birthing Doula Elyse Jamieson was hospitalised with hyperemesis in her first trimester and struggled to eat anything substantial for the first 18 weeks of her twin pregnancy. She even had a short stay in the hospital to get some intravenous fluids in.

“The main thing for me was managing my life with the hyperemesis,”

“I was fairly well bedridden for a large chunk of my pregnancy,” admits Elyse.

Elyse says that simply keeping hydrated and trying to eat any food was a struggle and there was a period where she couldn’t even keep water down.

“I’m the kind of person who eats organic food and eats the rainbow of vegetables and things but I couldn’t stomach most things for weeks at a time,” says Elyse.

Despite being quite a small person Elyse didn’t lose any weight during the height of her hyperemesis.