> So I guess from my perspective, I think that this belief that it is
> "normal"
> for twins to not make it full term and be small is questionable and a
> self-forfilling prophecy.
>
I heartily agree that this is a risk that is very real. However, the
research I was discussing suggests not that twins are small, but they
are smaller than singletons, and progressively more so with gestation.
It compared the average size of twins cf. singletons when born at
various points in gestation. 32 week old singletons are only slightly
bigger than twin premies born at 32 weeks, while 38 week old twins are
much smaller, on average, than singletons. This is what I meant by the
disparity increasing with gestational length.
Another inaccurate perception is that twins are born early because there
is no more room for intrauterine growth, which leads some mothers to eat
less to keep them small and keep them in longer, when, in fact, larger
babies are less often pre-term. At our local twins' club, the
coordinator and I encourage mothers to eat well and amply thoughout
their pregnancy, and have noticed a real tendency for those who do to
have large babies close to term. My twins were born at 39 and 39.5 weeks
respectively, and weighed between 7#2oz. (both girls, different sets)
and 8#4oz. I have noticed, with great relief, that there are more and
more large multiples born close to term. I admit I was a bit sorry to
lose my title of mother of the largest multiple in our club... at least
I'm still the only member with two sets to compare. So, yes, my babies'
birth weights and terms would have led me to assume that it was only
because twins are born early that they are small, and both of these
things were due to a self-fulfilling prophecy I managed to avoid (my
appetite displacing that idea, probably, or because I was a natural
rebel...) However, my singletons were probably a bit larger for
gestation -- the one born at 39 weeks was 8#3 and the ones born at 40.5
and 41.5 weeks were 9#1oz and 9#8oz. respectively.
In the paper on multiples I am discussing now, I presented a review of
the literature in this respect and concluded exactly what you said: that
mothers were told by hcps and by the literature that it was normal, and
even beneficial ("there is no negative outcome in waiting to deliver
twins until 38 weeks rather than at 36 weeks," was how one study put it;
I wonder what the researcher was *expecting* to find?) to deliver
multiples early. In my opinion, the monitoring is best done by a
clinician who thinks it is normal for twins to be at least as large and
as happy to remain inside as mine were.
I am so glad to hear that you are working hard to educate women on
nutrition during their pregnancy, as well as their infant's nutrition
after the birth. I wish there were more people doing such a great job!
:-)
Jo-Anne, reading backwards again, so more on this soon.
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