I'm Going to Gain 70-80 Pounds?!

I'm a dietitian. So right after I came to grips with having quadruplets, I started wondering what my weight gain goal would be for carrying these 4 kiddos to fruition.

Having taught undergraduate and graduate level nutrition courses for about 10 years now, I was familiar with the 2009 Institute of Medicine's Weight Gain Guidelines for Pregnancy. These guidelines basically say that for optimal birth outcomes, a woman who is at a healthy body mass index (BMI) prior to pregnancy should expect to gain:

  • 25-35 pounds by the end of pregnancy with one baby
  • 37-54 pounds by the end of pregnancy with twins

But what about triplets, quadruplets or quintuplets? Turns out, there's not enough data to set good guidelines, which, as a data-driven person, I found super frustrating.

The thing that cured my weight gain quandary was from the one resource that I routinely turned to during my quadruplet pregnancy: Dr. Barbara Luke's book When You're Expecting Twins, Triplets, or Quads. I love that Dr. Luke is also a dietitian and that she weaves real life anecdotal stories of multiple pregnancies with decades of her own team's research in her writings. 

Dr. Luke contributed to the 2009 IOM guidelines, so her recs are legit, and they say that healthy weighted women should expect to gain:

  • 40-56 pounds by the end of pregnancy with twins
  • 58-75 pounds by the end of pregnancy with triplets
  • 70-80 pounds by the end of pregnancy with quadruplets

So, there you have it: 70-80 pounds was my weight gain goal. I've spent so much of my career talking about the dangers of excessive weight gain during pregnancy, and here I was having to deal with the other end - making sure I gained enough. 

And the key is, you've got to get it in early. Dr. Luke's book stressed that early pregnancy weight gain is essential, since:

  • Your weight gain up to 28 weeks has the most influence on the babies' rate of growth
  • Changes in hormones associated with pregnancy promote mom's weight gain long before fetuses themselves gain weight
  • It gets way harder to gain weight as your pregnancy progresses and you're not going to get that full 40 weeks to do it

I am 5'10" and had gained 25 pounds with my first daughter, so the thought of tripling that for quadruplets was kind of mind-boggling. Here I am at 31 weeks when I broke the 200 mark. I'm smiling since I had gained 60 of those 70-80 pounds I needed to, but I really hope I never see this side of 200 again!

  Breaking 200 pounds at 31 weeks; the smile is fake.

 

Breaking 200 pounds at 31 weeks; the smile is fake.