MULTIPLE PREGNANCIES

The phenomenon where more than one fetus results from a single pregnancy is termed as Twin Pregnancy or Multiple Pregnancy. It is caused due to the spontaneous competition between the sperms. These types of pregnancies are either natural or due to infertility treatments.

The chances of multiple pregnancies increase:

  • Through fertility treatments.
  • When the age of the mother is above 30.
  • With a personal or family history of fraternal (non-identical) twins.

How can complications be addressed?

Various complications occur during twin or multiple pregnancies due to high competition between the embryos. The most common one is ‘Pre-term Labour’. Apart from this, other complications that may arise are Anemia, Miscarriage and Vanishing twin, Preeclampsia, Intrauterine growth restriction (IUGR), Gestational diabetes and Post-partum hemorrhage. However, the good news is that twin or multiple pregnancies can lead to successful outcomes by ensuring Frequent antenatal visits, Frequent fetal assessment, Attention to nutritional needs, Assessment of cervix, Restricted physical activity and Neonatal care.

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Nutrition 

The mother has to pay close attention to her nutrition levels when expecting twins or multiples. A diet rich in good quality protein, iron, folic acid and calcium with optimum calories is recommended for better pregnancy outcomes.

Including wholesome nutritious foods like whole grains, fruits, milk and sprouts to the diet, rather than processed food, helps in giving the mother a balanced diet.

Special Clinics

Special clinics are dedicated to mothers experiencing multiple pregnancies. It helps them keep a track of the fetal growth by offering close monitoring and counseling thereby reducing complications or risks that may arise. Visiting these clinics is beneficial to parents and babies.

Fernandez Hospital started a specialized Twins Clinic in 2006, the only one of its kind in Telangana and Andhra Pradesh. This is a fully functional, multidisciplinary clinic comprising a dedicated obstetrician, fetal medicine specialist, nutritionist, lactation consultant and an excellent neonatal team that provides round the clock service. The Clinic deals with about 250 twin and 10 triplet pregnancies per year.

Mothers monitored by specialized clinics tend to give birth closer to term, reducing the risk of pre-term labour. More importantly, these clinics give an opportunity for parents in similar situations to meet, discuss and feel more at ease.

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THE IMPORTANCE OF BREASTFEEDING

Breastfeeding is a natural, safe and healthy way to provide nutrition for your baby. The overall composition, temperature and cleanliness of breast milk makes it an ideal food source for a newborn. Breastfeeding is beneficial not only to the baby but to the mother as well. All healthy newborns should receive exclusive breastfeeds for the first six months and mothers should continue to breastfeed their infants for two years or beyond.

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The benefits of breastfeeding:

  • It strengthens the bond between the mother and the newborn.
  • It supplies the required nutrients for the appropriate growth of the baby and builds the baby’s immune system.
  • It protects the baby from diseases like obesity and cancer.
  • It keeps common allergies, infections and sickness at bay.
  • It is easily digested, avoiding constipation, diarrhea or an upset stomach.

Breastfeeding Counseling at Fernandez Hospital

Fernandez Hospital provides counseling on breastfeeding to expectant mothers before delivery. This includes a general discussion about pregnancy and breastfeeding counseling sessions by our in-house Neonatologist, Dr. Hemashree.

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Dr. Hemashree

 Dr. Hemashree has been associated with Fernandez Hospital since 2011. In every counseling session, she highlights the advantages of breastfeeding to the mother and baby. Some of the common topics covered in the sessions include composition of breast milk, correct position of the baby, latching onto the breast, common breast and nipple problems, storage of the milk and the role of mother’s diet in breastfeeding.

According to Dr. Hemashree, “Breastfeeding is not given importance in this modern era.” She stresses on this natural phenomenon, recommending exclusive breastfeeding for all newborns for the first six months and to continue breastfeeding with complementary nutrition after six months till two years and beyond. The mother should use every opportunity to ensure skin to skin contact immediately after birth (breast crawl) and provide colostrum (first milk) to her newborn.

Your questions answered

Q: How often should a mother breastfeed?

Dr. Hema:  Breastfeeding should be on demand. Watch for hunger cues. Crying is a late sign of hunger. On an average the newborn feeds 8 to 10 times a day.

Q: How do we know when the baby is hungry?

Dr. Hema: When the baby cries, it is its last signal of hunger and should be breastfed immediately. The early clues to a baby’s hunger are moving its head from side to side, mouthing movements, sucking movements, puckering of lips and rooting for any object nearby.

Q: Is it safe if the mother continues to feed the baby when she has flu or cold?

Dr. Hema: Yes, it is safe and the mother must continue to feed the baby. In fact breastfeeding at this time will boost the baby’s immunity.

Q: How can a mother increase her milk supply?

Dr. Hema: The more frequently the baby suckles from the mother’s breast the more will be the milk supply. Emptying of the breasts by the baby is the best stimulus for more milk.

Q: Is there any special diet for feeding mothers?

Dr. Hema: They need to maintain a balanced diet. Concentrating more on small meals and keeping themselves hydrated with water and juices will improve lactation.  Natural galactagogues (substances that promote lactation) such as garlic and methi seeds may be used.

Q: How will we know if the baby is getting adequate milk or not?

Dr. Hema: Weight gain is the best way to know that the baby is receiving adequate milk. 6 to 8 wet diapers per day, sleep for 45 minutes to 1 hour after a feed are the other indications of adequate milk.

Q: What is the progressive weight of the baby?

Dr. Hema: The baby might lose weight initially, but it should regain birthweight by two weeks after birth. After that a newborn puts on nearly 800 grams per month in the first six months of life.

Breastfeeding for the Working Mother

Though difficult, it is possible to nurse your baby while working. If you live near work or have a day care within the premises, you can always take short breaks to feed your baby.

Your milk supply can be kept at an optimum by using a high-quality electric breast pump to express milk during workdays. The babysitter can feed your baby this expressed milk. Expressed milk can be stored at room temperature for 4 to 6 hours and in the refrigerator for 24 to 48 hours.

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Even with alternatives available, make sure to nurse your baby in the mornings and at night. Remember that if you do not nurse or pump during the day, your milk supply will decline.

Even with alternatives available, make sure to nurse your baby in the mornings and at night. Remember that if you do not nurse or pump during the day, your milk supply will decline.

Milk Bank

The Milk Bank is used to store donor mother’s milk which is pasteurized and made available to fragile infants when their birth mother is unable to produce enough milk. It helps the baby receive enough calories and nutrients for its development.

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The myth that donor milk causes unknown infections is not true.

By donating milk to the milk bank, donors have satisfaction of helping sick and premature babies to survive; it is a service to humanity.

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Mothers Speak

Michelle Valdez, who delivered her baby at Fernandez Hospital, states: “Donor milk meant the difference between life and death for my baby.”

Another mother, Mary Jane Pfuetze shares, “My child might not have lived if it were not for breast milk donations. She is adopted and I could not provide her with mother’s milk. People do not realize that some children cannot survive on formula and some mothers cannot provide their own breast milk.