Welcome to the latest series of Fertility Foundations, where we speak in depth with expert guests about how to prepare the foundations for healthy pregnancy. This week Sandra Greenbank is talking to Kirsten Mooring about nutrition for twin pregnancies. 

Kirsten struggled for years with fertility issues and pregnancy loss in her 30s and wondered if she would ever be able to have a baby. Looking for ways to support her and her partner’s bodies and help their fertility, Kirsten’s personal research led her to nutrition, and much to her surprise, two little boys arrived. 

Having seen for herself the benefit of individualised nutrition and adjustments to lifestyle, she decided to retrain and now she’s a nutritional therapist specialising in fertility. Kirsten has a particular interest in cases of unexplained infertility and pregnancy loss, helping clients take back control over their fertility. 

Listen to this episode of the Fertility Foundations podcast with Kirsten Mooring here.

Find Kirsten here: https://kirstenmooring.com
www.instagram.com/kirstenmooringnutrition

Our sponsors for this episode of Fertility Foundations are NeoVos, a UK-based lab that provide at-home health tests and cutting edge analysis. Knowledge is power and in my opinion, you need to always check not guess your levels of Omega 3 and vitamin D so that you can supplement correctly if you need it. I found the novice test really easy to use and affordable. The team at NeoVos have kindly offered Fertility Foundations listeners a 10% discount by using the code FERTILITY at the checkout. Visit the NeoVos website for more information.

Podcast transcript

Sandra 0:04 

Hello and welcome to the Fertility Foundation’s podcast where we go into detail about how to prepare the foundations for healthy pregnancy. We dive deep into the underlying root causes for fertility issues and natural solutions. I want you to know that you’re not alone and you’re not broken. I hope that by sharing these episodes, they will help you move from feeling overwhelmed and lost to feeling hopeful and empowered to take charge of your own path to parenthood, because there are actually lots of things that you can do to help rewrite your own story. 

I’m Sandra Greenbank nutritional therapist, functional medicine practitioner, coach and educator, specialising in fertility, pregnancy and postpartum health. I’m also the founder of the Fertility Nutrition Centre, where you can find fully trained experts in nutrition, lifestyle and functional approaches to healthy fertility and pregnancy. You can find more information over at www.fertilitynutritioncentre.org and also book a free strategy call with one of our experts. 

Today I’m speaking to Kirsten Mooring about nutrition for twin pregnancies because this really does add a different dimension to looking after both mothers and babies. Kirsten struggled for years with fertility issues and pregnancy loss in her 30s and wondered if she would ever have a be able to have a baby. Looking for ways to support her and her partner’s bodies and help their fertility. Kirsten’s personal research brought her to nutrition, and much to her surprise, two little boys arrived. Having seen for herself the benefit to fertility of individualised nutrition and adjustments to lifestyle, she decided to retrain and now she’s a nutritional therapist specialising in fertility. Kirsten has a particular interest in cases of unexplained infertility and pregnancy loss helping clients take back control over their fertility. 

But before we get into the interview, I wanted to talk a little bit about our podcast sponsors, Neovos. They’re a UK lab that provide at home health tests and cutting edge analysis. I personally like the vitamin D and Omega three tests, which are absolutely crucial to get right for anyone trying for a baby. Knowledge is power. In my opinion, you need to always check not guess your levels of Omega three and vitamin D so that you can supplement correctly if you need it. I found the novice test really easy to use and affordable so the Neovos team have kindly offered our listeners a 10% discount on their website using the code FERTILITY at the checkout. Their website is simply www.neovos.com. All of these details are also in the show notes for you. 

Now let’s get into today’s interview with Kirsten. So hi, Kirsten, thanks so much for joining me on the podcast. 

Kirsten 2:41 It’s so lovely to be here. 

Sandra 2:43 We’re going to be talking about twin pregnancies today and the nutritional things, we have to keep it keep in mind. And obviously it’s not one of those things you can sort of really prepare for us such you know, we prepare for pregnancy if you don’t necessarily prepare to get have twins, you just sort of ended up pregnant with trying to find out. But firstly, because you are a twin mom, I’d love to hear about your story. How, you know, just 

Kirsten 3:13 absolutely. Yeah, I am a twin mum, we’ve got two boys, they are seven and a half. And we did have quite a difficult journey to pregnancy. We met in our 30s. So we we sort of met later in life, which probably, you know, lots of people will say, Well, you know, you’re old and therefore you can’t get pregnant. And I absolutely don’t believe that now, but then put a lot of fear in. And, you know, the after the usual tests through the GP because we’ve been trying for the, I guess a year and a half nothing. And they just sort of labelled us unexplained. So there’s nothing wrong with you, you know, all your labs come back. Okay. So just go away and keep doing what you’re doing. It’s probably just because you’re older. 

Sandra 4:07 How old were you at this point? 

Kirsten 4:10 So at this point where I was probably about 37. Okay, that’s yeah, so not like super old. But yeah, and then it was probably about 38. Then we carried on trying, nothing happened. We then decided that we would try IVF and we had random IVF in our local clinic, which was just awful. I had quite high ma Hmh. And they did manage to get quite a lot of eggs. I think we had 30 eggs, which is masses. But we only actually managed to fertilise two. Okay. And when it got to day five there was only one I have those lab. So we had that one transferred. And I got ovarian hyperstimulation syndrome as well. 

Sandra 5:10 Okay, so did you have some PCOS? 

Kirsten 5:14 Now, I think that I did have PCOS without all of the without all of the syndromes. So I think I definitely was polycystic, but have never been sort of overweight or any of the other things on the on the Rotterdam’s scale. But yeah, I think there definitely was something and Oh, HSS is just dreadful. Anybody who’s experienced that will know it’s excruciating, was crawling around on the floor. And in a lot of pain, and unfortunately, though, by the 14 days passed, I wasn’t pregnant, that one embryo hadn’t taken. And I think that that experience just well, and truly put us off going through it again. So we sort of thought, well, we’re not going to go through that again, because that’s just, I don’t want to go through that for my body. Again, we’ll just keep going. And I’d always been interested in nutrition. So I guess I probably started reading around about that about then. We then did fall pregnant, naturally. But I had a miscarriage at about 10 weeks, which was obviously devastating. Anybody who’s been there knows what that’s like, 

Sandra 6:37 you’d be so true to so much already. Yeah. And 

Kirsten 6:41 then when you’re sort of, and also, you’ve still got this sort of feeling that you’re too old, and that, you know, it’s never going to happen. And you know, there’s no reason for it and all of this kind of stuff, and then you have a miscarriage and the whole of the miscarriage experiences just appalling. I went through medical management, and that didn’t work, but had to go through surgical management, which was wonderful as well. So just a horrible experience. And then we kept on trying, I probably got pregnant again about five months later, and had another miscarriage at about eight weeks. So by this point, I’m sort of starting to believe the hype, I’m starting to believe that it’s not possible. Yeah. But I’ve still been doing a lot of reading around about nutrition and trying to look after both of us trying to look after Alex, my, my partner, and sort of his, you know, his body as well as mine and feeding us well. But feeling anxious that obviously it’s not going to happen. And then I did fall pregnant again. And this time it stuck. And when we went for a scan, no matter how old they were to blew my mind. We do have twins in my family. But it occurred to me that it would be twins. 

Sandra 8:14 Because you’re just so focused on the one child. Yeah. 

Kirsten 8:18 And then there’s just sort of all the anxiety about you know, now now you’re pregnant risk. And it’s 20, you’re high risk, and now you’re old, because when I was 39, you know, and so now you’re old and having twins. And so you’re being, you know, reviewed all the times in the consultant, which I guess is a good thing. But yeah, just I can remember feeling intensely worried throughout throughout pregnancy and constantly worried that I was going to lose the pregnancy. Yeah. I think it was probably about I was probably about 24 weeks by time I, I sort of thought, Well, maybe it’s going to be okay. 

Sandra 8:59 And that’s really normal when you’ve had problems. 

Kirsten 9:03 It’s very common. And I concealed it from people even though I was huge. Build it from people to 20 weeks, because I just didn’t want to tell anybody and then have to say that I had a miscarriage. I know. S

Sandra 9:17 Yeah, I can I can totally understand that. Because I did the same. So I was told that my son had a heart problem and they said, Oh, well you know, next time next scan, we’ll see if it’s you know, and I had to wait till the 20 week scan to see if he was going to be okay, you know, and then there is that thing of like, I don’t want anyone to know and then I think psychologically hiding it away is it’s quite kind of gets you down, doesn’t it? You’re sort of hiding it from yourself. You don’t want to hope you don’t want to think about it. And 

Kirsten 9:48 you’re not experiencing the joy of it either. So you’re having this pregnancy which is miraculous anyway as all pregnancies are but here you are and you’re actually having a you know, a twin or a multiple pregnancy and You can’t enjoy it because you’re too busy worrying about the fact that you might lose it or that you know, something might be wrong with the baby or whatever. But lots of testing, and I did have harmony tests, which was really good for tackling some of the nerves. So I recommend having that I think that’s a good idea. But yeah, and then went through pregnancy. And I have to say, I think I was reasonably well, actually, I did get big quite quickly. But I didn’t have any health problems as such. I did have a bad back. But you know, that’s common in pregnancy. And I have suffered with back problems anyway. So that’s not a big deal. But then at 36 weeks, I think I’d had another scan. And they said that the babies had stopped growing. And that they wanted to basically get them out straightaway. Which, again, was all very frightening. I think the way sometimes the bedside manner sometimes of how these things are about us to is terrifying. You know, the first time that we we’d been through it. So you know, we didn’t really know how to advocate for ourselves, and just found ourselves getting pushed through this sort of rush you through getting the babies out. So we did end up having a C section, which wasn’t really what we had wanted. But you know, the most important thing is the babies got here safely. And they were fine. They were little, but they didn’t have to go into the NICU. So that was good. 

Sandra 11:38 Yeah. So you just got to take them straight home? Well, 

Kirsten 11:40 no, because I was really ill. I was really ill. I didn’t react to the weather, it was the anaesthetic or the actual process of having a C section I’ll never really know. But I was very sick, couldn’t hold food down for 48 hours. And was in a lot of pain. And had quite a difficult time for some time off. So I think I stayed in hospital for a week. One of the babies went in the NICU for one day, because but apart from that they were fine. And then came out and then I had a lot of postpartum bleeding is obviously common. It’s part of, you know, the process, but mine went on and on and on for months. And turned out that I had retained placenta. And these are things that you know, and I kept saying to the doctor, right, you know, this isn’t normal. I don’t feel like it’s normal. But it took three months for them to actually agree that perhaps it wasn’t normal, and take me in, have a look, and then discover that I had retained placenta. So yeah, so that side of things wasn’t great. But you know, the babies were perfect. There was nothing wrong with them. So that was great. Two little boys. 

Sandra 13:03 Are they identical, I can see a picture behind you know, S

Kirsten 13:06 they’re not identical, identical, although they did look very identical. I have to say, even now, when I look at some of their newborn pictures, I really struggle I used to put them down right and left. 

Sandra 13:19 Which I used to work with ants. And so it was like, they always stand like that. And two decks like the people know which one isn’t that they look anything like each other. 

Kirsten 13:29 But just so people know, because there’s so synonymous, aren’t they? I mean, now now, they don’t look that alike at all. But when they were babies, they really did. But yeah, and that’s, you know, postpartum as a whole, a whole new ballgame. Yeah, 

Sandra 13:45 I can imagine. And so obviously, you sort of, you know, you’re saying you’ve got to about 24 weeks, and then you maybe start to dare to hope and I guess at that point, started to connect with the babies, and you know, all of this that you’re going through, but you kind of only had 10 weeks of that, because they came out so soon. So and I think that this kind of disassociation from your pregnant body or from the baby can be a very natural defence mechanism when you’ve been through problems. And I believe that this can then have an impact potentially on your own mental health and your risk of person at postnatal depression. 

Kirsten 14:21 Absolutely. 

Sandra 14:22 So how did you find all of that 

Kirsten 1 14:25 totally agree with that, and I think that it’s actually very common in twin pregnancies. And I think the whole it’s not just postpartum depression, it’s actually postpartum depletion, as well, that sort of actually your body being completely devoid of, you know, all resources and how that can affect you mentally and physically. And, and for me, mentally, I was actually okay, very exhausted, because obviously when you’re feeding through the night, and you’re feeding two babies isn’t changing to babies by the time you’ve done that on a two hour cycle, you’re doing it well ever again, there isn’t much time to sleep. But by about three months postpartum, with the combination of probably this sort of retained placenta plus the exhaustion plus having had a twin pregnancy, I was wholly depleted. And physically, my body showed me that I was by having a huge eczema flare up, which I hadn’t had for a very long time, which probably took me the best part of two years to heal. So it was a very real thing where my body was going in, you know, we don’t have the resources to deal with all the different things that you’re doing. You need to do more looking after of your own health. And I just hadn’t been prepared for that at all, I guess I just thought you’d get your babies and you’ve sailed through. And yes, you’d be a bit tired, and we’d go, and it was just wasn’t like that at all. And I think I was just physically, you know, rock bottom, really. And I think, I think if I knew now, what I or if I, if I knew then what I knew know, now, I think I would have made much more effort to be more concise about how I had prepared my body for postpartum, not just for pregnancy. So don’t think I took that into account. And I also, although I tried to understand what a twin pregnancy might need, I don’t think I had enough information to really give my body the resources to, you know, develop, grow, feed two babies, as well as maintain my health. And so whilst I’d been healthy before, was healthy through pregnancy, by the end of the pregnancy, and a short period postpartum, there was just nothing left. So I think that that, for me is something I’m very passionate about with all my ladies who get pregnant, but particularly with twin pregnancies, because it is so demanding on on the body. 

Sandra 17:12 Yeah, cuz I mean, because you talked about how you actually focus quite a lot on nutrition beforehand. And also on to task, how did you keep motivated, because that’s tough, as well, to sort of just keep going and you were like, you know, reading up and doing everything you could for both of you, but how do you how do you keep going when you’re just sort of coming up against sort of miscarriage and other miscarriage. And 

Kirsten 17:37 I think what I was really lucky, I mean, Alex, my partner is a very optimistic person. And he was just very positive about the fact that he believed that we would have a family. And I think that, you know, while I don’t believe that it’s just positive mental attitude will get you pregnant, I do think it’s supportive, you know, definitely not sort of looking after how you feel about things mentally, and being able to talk about it. And you know, perhaps have counselling definitely helps. But I was, I felt like, if I could get hold of something, like the nutritional side of things, which are just more I read, the more I felt like it was going to help, then the more I could take control of the situation, I just didn’t want to have that feeling of being unempowered by being told you’re unexplained, because I just wanted to be able to put a solution to it. And obviously, I never found out what, what the solution was because I wasn’t a qualified individual. But obviously, eating in a particular way, eating better, must have helped in some way. And now I would probably be able to identify which of those elements were, you know, were the deciding factors, you know, was it the fact that we ate more protein? Was it the supplements that we took, you know, all those sorts of things, but it is difficult to keep going. When you’ve had a couple of miscarriages? You know, it’s you just you question whether it’s worth it and you question whether it’ll just be another miscarriage if you do get pregnant again. And unfortunately, you know, if you, if you do Dr. Google, then Dr. Google will tell you that the more miscarriages you have, the more you’re likely to have, which isn’t very helpful. So you just have to kind of steer away from those sorts of things and try not to read that kind of stuff, read more positive stories and, you know, literature that makes you feel better about hopeful about the future. 

Sandra 19:50 So a bit of positivity, but also the right support or the right people around you who are going to keep you kind of a flow to suppose And that is, you know, the whole thing about, you know, yes, you are more at risk of a miscarriage if you’ve already had one, but not if you identify the root cause of it. And you know, there’s so many things we can do salutely. 

Kirsten 20:15 And that’s the whole point, I think, you know, I guess we might have got pregnant and kept the pregnancy sooner had I known some of those things, then, you know, it’s possible, but you know, I could have had different lab work different tests, and come to some conclusions sooner that would have helped us to not have a second loss, for example, that nutrition on its own was just supportive, but perhaps not directional enough, soon enough, without the help of the labs. So 

Sandra 20:51 what is the kind of what is the thought that because I know, the twin pregnancy research is just really kind of it’s not, there’s not a lot out there with it. Certainly, when you were having your babies, it was even less. So. What do we know now about the needs, for example of unit duty or nutritional needs during a twin twin pregnancy? 

Kirsten 21:11 Well, and that’s, that’s the difficult thing, because there aren’t that many studies on twin pregnancies. And the ones that there are tend to be more reviews. So it’s quite speculative. But logic, kind of, if you use the data that is out there and then apply some logic to it, it does sort of make sense that if you’re growing, not one, but two, or possibly more babies, then you will have more nutrient needs, and that your resources will be depleted more quickly than that of a mother of a singleton. So, yeah, there is there is definitely a need for more nutrient dense diet, I would say. And having a focus on that is more important. It’s 

Sandra 22:01 even more important, even. I mean, we know that, you know, as the mom, or you know, if you’re hoping to get pregnant, there are certain nutrients that are laid down in the run up to pregnancy, and the baby actually gets their nutrients to us from what you’ve stored, rather than what’s in your diet at the point of pregnancy. We also know that your body adapts, and actually so your digestion and absorption changes to absorb more from the food that is in your diet. But there’s obviously, you know, the rate limiting step there is kind of how much you’re getting in because your body can only absorb as much as you’re getting in regard, you know, it’s not going in, it’s not going to get absorbed, however good your your digestion and absorption. So that’s where it really begins to make a difference, isn’t it? And it’s not necessarily about eating so much more. Absolutely. 

Kirsten 22:54 And it’s about, you know, what are your personal levels, and I always recommend testing. Because, you know, if we’re talking about even if we’re talking about folic acid or folate, then you know, some of the some of the studies suggest that you need a higher dose in twin pregnancy than the recommended dose. But it’s very much dependent on the mother’s levels already in her her blood. So I would recommend testing that always, rather than just supplementing. And we know that we can get some from the diet. So if you’re eating a diet that’s, you know, heavy and you know, dark green leafy vegetables and grains, and you’ll be getting a good amount from that as well. So it isn’t just a sort of cookie cutter approach of yet definitely take twice as much, I wouldn’t recommend that. It has to be on an individual basis. And, you know, folic acid is so important because it’s for your tube development and retinal development. And I’ve I’ve definitely found with vitamin D, that that tends to be depleted in twin pregnancies as well. So testing of moms with twin or multiple pregnancies, it’s really important for vitamin D, because again, just supplementing on the basis that you might need more isn’t the right thing to do, because it’s dependent on what level you’re at already. And again, whether you can absorb so how is your digestion functioning at the moment? Is it worth doing a stool test to see how it’s going, you know, how, you know how are your bowel movements do you have frequently you’re going what kind of consistency or are they and then working on that to make sure that you can absorb enough from your diet and supplementing if you need to on top of that. Yeah, 

Sandra 24:54 I mean with vitamin D, I think it’s quite established that most people do need to supplement but If you haven’t done it in the run up to pregnancy, and then we find that you’re low, we’re kind of stuck a little bit between a rock and a hard place because our upper limits or upper safe limits of supplementation. So again, that prep does become really again, so important. 

Kirsten 25:17 Yeah, I think we know I mean, if you’re doing IVF, for example, we know there’s a greater incidence of twin pregnancies and multiple pregnancies with IVF, even with the requirements put a reduced number of embryos back these days. So it’s worth bearing that in mind in the run up to IVF, and testing and supplementing accordingly, so that if you do end up having a multiple pregnancy, you’re already in a good place. Absolutely. Yeah. What about 

Sandra 25:50 I am because that’s something that’s always a little bit tricky. And do you make more blood? If you have a twin pregnancy? Yes, 

Kirsten 25:55 well, and they estimate that again, you are making even more blood because you need more oxygen to feed two babies. So you will need more iron. And again, the studies suggest that more twin pregnancies, multiple pregnancies are likely to end in anaemia. So yes, and again, that preparing for you know, having, you know, good sources of heme iron in the diet before becoming pregnant is absolutely essential, but then continuing to eat them. And in twin pregnancy, that can be difficult because you know, early in pregnancy, it can be very difficult. Nausea can be a huge issue. So getting enough nutrients in any part of pregnancy can be a really difficult thing. So yeah, I would definitely recommend sort of eating those those foods in the sort of three to six months before pregnancy. If you’ve got twins in your family, or you’re doing IVF, maybe focus on that, in case it’s you with a multiple pregnancy. Yeah, definitely. Yeah. 

Sandra 27:03 And we talked about prenatal or postnatal depletion or depression, and particularly for mental health, there’s two nutrients that I always like to focus on anyway, which is zinc. And omega three, which is so important for your brain health and for your emotional health. And then, again, do we have a higher need for both of those? 

Kirsten 27:27 I think we do. Definitely. I mean, Omega three, I think is a really important one. For multiples. I mean, we know that we need healthy fats for brain development. And also to protect the mother’s brain. So again, that’s carrying through to that postpartum period. There’s also evidence that having sufficient healthy fats in the diet contributes to healthy birth weight. So if you’re having twins or multiples, that’s important, because they tend to be smaller. And also that it may impact gestation, interestingly, so if you want to try and maintain a multiple pregnancy as long as possible, and bear in mind that term is around about 37 weeks for for twins and multiples, and less obviously, for multiples, then Eating Enough Healthy Fats is really important. But yeah, so omega three, again, we can test for that. And I would I would recommend that but again, it’s it’s getting it into the diet, pre pregnancy, but also carrying it through pregnancy. Definitely supportive. And I would, unless there’s a reason to not do it, I would tend to err towards the higher end of dosages for twin pregnancies. Definitely. Yeah. 

Sandra 28:55 And that’s I don’t know if I would have mentioned it, but you know, Babybel take from the mums stores. And you know, we store Omega three in the brain, our brain is mostly made from fats. And the thing is, baby will be prioritised above you and some swelling in most instances that, you know, we come back to this whole idea that if as long as you look after mom, baby will be fine, you know, whether the baby’s been born yet or not look after the mom and the baby will be fine. So you need to really make sure that you’re looking after your brain health and your nutrient stores and you know, also, I suppose, avoiding the things that deplete your nutrients, you know, as well as making sure that you’re taking them in. Yeah, 

Kirsten 29:43 I think that’s you know, that’s a really good point about looking after mum. I don’t like this idea of sort of eating for two or eating for three. I don’t think that’s quite that’s too blunt at all. To say that, you know, okay, you’re you’ve got twin pregnancy. Now you’re eating for three, it’s definitely not right. But I think that, you know, you do need to feed yourself consciously, and I think be very focused on what you’re eating. And as, as the pregnancy goes on, I tend to find that women find it more difficult to eat large meals. So that’s why we need to be really conscious about what we’re eating, because it needs to be nutrient dense at each meal, it might be much smaller meals that you can choose to eat, in order to maintain those energy reserves, those nutrient reserves for the mom, because like you say, if she’s, well, then the babies will be well, your body is designed to be able to manage that. And so you know, if you’re eating properly during pregnancy, that that will maintain reserves. 

Sandra 30:58 And what about so we talked about some of the micronutrients? What about the macronutrients? So the fats, carbohydrates and proteins? Do we have to be more mindful about any of that? 

Kirsten 31:11 Yeah, I definitely am more mindful of protein. Because I think that, you know, protein contains the amino acids, which are the building blocks of life. And obviously, we’re not just building one life, we’re building two men twin pregnancy or possibly more. So we need to ensure that we’re eating enough protein. And again, that’s on an individual basis. Protein is obviously a key part of repair as well. And when we’re having a pregnancy, we’re obviously expanding the ligaments or stretching. And then afterwards, that all that’s coming back to a relatively normal, so relatively normal place, and repairing, so we need all the amino acids to do that. So I always like to get my clients to focus on the quality sources of protein, you know, lean meats, eggs, they want to some vegetarian sources, you know, like tofu or tempeh, that’s fine as well, beans. The thing about some of the vegetarian sources like beans and lentils is they’re great, they, they’ve also got good amounts of fibre in them, which is great for keeping the bowel moving during pregnancy. But they’re less dense in protein. And you tend to fill up more quickly because they’re full of fibre. And so that can be less beneficial when you haven’t got much space because you’ve got this huge pregnancy pressing on your stomach. 

Sandra 32:44 Also pulses and legumes can bind to nutrients and transport them out rather than allowing you to actually absorb them. So I mean, beans a brilliant source of like soluble fibre and you know, antioxidants suddenly, if you buy the darker coloured ones, but yeah, I suppose be mindful of the fact that they also can sort of almost crowd out other foods. So if you’re focusing on them, so this is, I suppose, if you’re vegetarian, or dare I say vegan, then building GB vs. G. 

Kirsten 33:20 Yeah, I have, I have to say, I have not worked with anybody who has been vegan, but I do think it would be more of a challenge. And I certainly think that it might, whilst I respect everybody’s reasons for being vegan, it might be worth considering adding in some animal sources of protein during pregnancy, just not just for your baby’s benefit, but for your own health. And that sort of, you know, we’ve discussed postpartum depletion, that possibility of falling into depletion, post pregnancy is very real, I think. So certainly, you know, trying to get eggs in and you know, you can eat a couple of, you know, two or three eggs every day that would that would be beneficial. Get some coli, B vitamins, get some protein, I think that would be something and a move in the right direction nutritionally. But, you know, I do think it’s more of a challenge. 

Sandra 34:21 It’s tricky, because obviously, some people are really restricted by their religious beliefs, you know, and that’s just not going to be possible. And then, you know, but then I think it does become really important to work with an expert who can make sure that you, you stay well, and baby Stay well. And like you said, if it’s a sort of personal choice, perhaps, you know, from moment in time, you know, maybe just look at more ethical sources of animal products if that feels possible for you. I mean, I know it’s a really difficult conversation to have but so tricky. You know, we’re looking at you know, In a vegan diet, we’re looking at the lack of Omega three Bucha, the 12 iodine, which is so important for your thyroid. 

Kirsten 35:12 And thyroid, which is so crucial all the way through pregnancy and the demands on mum for thyroid in a twin pregnancy more so so yeah, absolutely. 

Sandra 35:24 Yeah, can be an iron as well can be quite tricky. Yeah. So how do we know if we’re getting enough done? What are some of the tests that we should be asking for I mean, is it just simply going to the GP or midwife and saying, you know, key check, I 

Kirsten 35:39 don’t think you’re going to get everything you need from your GP, or your midwife, unfortunately, you probably could get a basic blood panel, from your GP or the midwife. And that would be useful, certainly for giving you things like iron status, you might be able to get vitamin D that way, maybe, maybe possibly be 12, folate, which, which is a good place to start. But for example, thyroid, it may not be possible to get a full thyroid panel, that’s really important to understand. You know, often thyroid issues can begin in pregnancy, because of the demands. We’re making the thyroid hormones for baby or babies for quite a long time during pregnancy. So it’s a big drain. So that’s worth seeing a specialist so that you can get some support on getting some labs, I also recommend getting tested for omega three, and that you wouldn’t be able to get that through your GP. And I think also a stool test is really valuable pregnancy. So again, the kind of stool tests that you would get from your GP wouldn’t be as comprehensive as what we would offer in terms of looking at the microbiome and the types of bacteria that are living there and looking at inflammation and whether anything needs to be done in that area. So I think that’s really important as well. Really 

Sandra 37:07 optimising your digestion. Again, ideally, you do that before beforehand, because there’s so much again, our hands are tied so much in pregnancy, if there’s something that pops up that we want to specific, particularly for want to remove something potentially pathogenic. That is going to prepare, it’s all about the preparation, isn’t it? Work? Yeah, I think also ideas quite a good one. Yeah. 

Kirsten 37:35 Test is really, really worth doing. Yeah. Do that as part of the thyroid. 

Sandra 37:43 And so what areas of twin pregnancies needs more support then other than what we’ve just talked about? Yeah, 

Kirsten 37:51 I mean, obviously, nutritionally, I would always recommend people get some advice on nutrition for a twin pregnancy. You know, even a well researched, well read, person probably won’t be able to find out enough, particularly without the test. So always reach out and get some extra help. I think it’s really important to think about the postpartum period, and not just about that depletion element. So again, preparing preconception during pregnancy, but also then preparing for that period postpartum. So even things like batch cooking, and all of those good things, but also preparing for how you’re going to feed. So how are you going to feed the babies? Are you going to try to breastfeed? If you are going to breastfeed, then being really conscious that you might need some extra support? Breastfeeding, twins and multiples is more challenging. It’s totally doable, but it is more challenging. And I think it’s worth understanding that you know, if your babies go straight into NICU, for example, that you may want to have colostrum to give them even if you don’t manage to be longer term, if you can get the colostrum early doors. So learning how to do that and considering maybe trying to get some before the babies arrive, and put, you know, put it in the freezer so that you’ve got it and then if you’re ill or you can’t do it when the babies arrive, at least you’ve still got that and you’re helping them to develop their gut and their lovely microbiome. So definitely look at getting the right support for twin and multiple breastfeeding. There’s a great lovely group on Facebook which I always want people to which is run by a collection of twin and multiple parents and some of them are also lactation consultants always look for an IBC I see that tation consultant has a wonderful woman on there who is his one and she’s also a multiple parent herself. She’s with Catherine Stagg. She’s just fabulous. But I think also it’s that community, which is very good for, you know, your mental state postpartum, in Europe in the middle of the night and needing to be able to talk to other moms that are also in the same situation is very important. So getting that support, I certainly found that if I’d known what I knew post postpartum that I’ve managed to find out about breastfeeding before I would have had an easier journey. Because it was challenging. 

Sandra 40:39 I know, I mean, I always do this as well, I’m like, research, you know, research your nearest, you know, breastfeeding cafe, find your find a breastfeeding consultant, put them in your phone, so that once the baby’s here and you need the help, you’re not then you know, blurry eyed, trying to just, you know, because you’ve just then it’s so hard to get it get all you know, work with one of us who can just help you kind of, you know, make sure that you’ve got, you know, you asked for the help, maybe upfront, just say, you know, baby might get here from from week 30, you might want to say to people, you know, if you’re popping in like he’d bring me a lasagna or something for the freezer, you know, like, don’t bring me flowers. 

Kirsten 41:23 I mean, me flowers. Yeah, 

Sandra 41:26 bring them a meal for free. And I suppose, I mean, I had a baby and special care, and they just absolutely steamrolled me into giving her formula. There was like, just No, and you know, this was now 14 years ago. So things hopefully have changed. But it’s do you think it’s worth kind of researching your formulas and things like that beforehand, as well. 

Kirsten 41:51 I definitely do. And I’m getting some advice about that from somebody who can understand the formula and the products that are in it, because some are definitely better than others, and some have got quite a lot of nasties in them is is a good thing to do. And I don’t actually know how much it’s, you know, changed, I think it might change from one hospital to another. But certainly, my experience was also to be driven into bottle feeding and the most important thing was to get baby fed, which whilst I understand that it is important to feed baby, I think that you know, a little bit more support can help women to get to breastfeeding sooner. So yeah, if you are going to then have to have done some research and not be sort of steamrollered into a particular brand because that’s the one the hospital uses is a really a good thing to have done. And then just sort of understanding your own needs for nutrition and postpartum if you’re breastfeeding are still increased, you know, you still have a need for nutrient dense meals, higher Calif. calorific value. You know, because you’re producing extra food source for not just one, but two, two little people. 

Sandra 43:13 And not much more fluids as 

Kirsten 43:15 well, much more fluids, you might need a drink about three litres a day, or possibly even more, definitely don’t become dehydrated, because then Milk Milk source world will be much more likely to dry up. And I always say to all my Mommies to, to keep snacks nearby but healthy snacks. So you know, if you need to keep a jar of peanut butter almond butter in a bedside table, and you know, a box of almond crackers or something own crack, because then at least you’ve got something that’s healthy and nutrient dense that you can have. So you don’t start feeling you know, depleted in the middle of the night because that can be very real as well. And then you can end up sort of rushing downstairs and pulling out the first thing that comes out. Which is chocolate biscuit or what 

Sandra 44:07 I used to always get my pot and I actually recommend all my clients to tell their partners to before they leave for work to put a pint of water at every place where I might possibly sit down because once you know you want the baby to feed them because the minute you they latch on, you’re parched, and then you can’t get up and Unknown 

Kirsten 44:29 it was so true. 

Sandra 44:31 But also, I mean, I try they say that the more like the more sort of bottles and things that you have at home, the less likely you become to breastfeed and I guess that is true but at the same time I imagine as a twin parent, you might want to share the feeding even if it’s getting induced to a bottle to have breast milk if you’re able to also pump in between them and personally I don’t even know how you know You’d never sleep because you’re like, either feeding or pumping. But do you think it’s, it could be a good idea to kind of research the bottles and the teats and you know, make sure you’ve got plastic free things and all of this. 

Kirsten 45:12 Yeah, you definitely want to find BPA free teats and bottles and understand how you’re going to sterilise them and all of those sorts of things, it can definitely be worthwhile having a bottle, you know, and I don’t think that anybody should be guilted into not using a bottle if they know if they want to, because it is very challenging, it’s challenging enough with one. But if you’ve got more, it’s it’s hard work. And definitely, you know, if, if the other parent or grandparent or somebody can help with that, that there will definitely be a benefit to it. Often lactation consultants can give good advice about which, you know, teats are better to use, so that if you’re trying to breastfeed and bottle feed, that you don’t get rejection of the grass, because obviously, there can be problems with that, if you’re bottle feeding at the same time, so it’s good to sort of arm yourself with that information beforehand. I think if you prepare for all of those things, none of them might happen, you might sail through breastfeeding. And it might be the easiest thing in the world, or it might be really challenging, but if you’ve already done the research, then you’ll have that ready to go. And you won’t have to try and find it when you’re already exhausted. And trying to find out information and probably feeling quite emotional. And you know, it’s difficult, if you feel you can’t do the one thing that you’re supposed to be able to do, which is feed your babies, then that that can be a very emotional time. So if you prepare for, you know, difficulties, rather than trying to deal with them at the time, that’s a good thing to do. 

Sandra 46:57 Yeah, I imagine also, because you have such a sort of turnover of kind of feeding, changing, sleeping, and then you know what their sleep, but you know, they sort of sleep in shifts, and then you sort of never get your shift. But if you are able to get that one hand, just that one feed over to somebody else, then you could get a stretch of say four hours sleep, that is going to actually really help your breast milk production. Because sleep and I think protein and fats, those are the three kind of magic things that if you can get them all in, and you know, I know it’s hard to sleep, ever, when you’ve had a baby, certainly when they’re little, but if you could just get somebody to help you. 

Kirsten 47:40 Definitely. And I think if the other if the other parents could even do that sort of last feed of an evening, so that you can go to bed early and maybe sleep between sort of nine and 12 then at least if you’re getting up to do that 12 You’ve had a block of three hours and that will really help because it is very difficult to get a break when you’ve got to and during the day, you probably won’t have that much time to sleep if you’re on a rotation of feeding on a couple of if you’re trying to get them to put weight on you may have to feed every couple of hours. And I always say to people you know you were saying about some you know, grandparent feeding or so if somebody is going to come round during the day. Yes Don’t come and bring me flowers, please bring me food. And the other thing is that if you’re going to hold the baby then you’re holding the baby so I can go and have a sleep you know that’s really important or a wash. Yeah, or a wash exactly, but something that will give you some time back so whilst you’re delighted to see a friend or a family member, if it can be somebody that you can trust to watch the babies for half an hour whilst you have a shower or two hours whilst you have a nap then that’s that’s going to be really beneficial to your health and I think that’s more important than coming around to have you know a coffee probably made and you know, a piece of cake that you don’t actually need Yeah, 

Sandra 49:09 I remember having after having my first and the in laws came with you know there’s so many people in the house and we had a split level flat at the time and I was running up and down stairs after 10 days in hospital with the baby and special care and I was running up and down the stairs it’s teas and coffees and you know no one pro about food and I remember thinking I was quite offended time but people I don’t know do they that you know they don’t bring a cake but you know that’s not as useful you know, I think if anyone’s listening to this and their daughter or friend is about to have a any baby let alone twin babies. Go go in unstack the dishwasher. Yeah, restock it and hold the baby. If mom is happy. You know not everyone is happy and for people to hold it. A plan you should never impose yourself. And that’s what I think I do think it’s I believe it’s actually okay to impose yourself in terms of that dishwasher thing. So it was the one thing I mean, I could have cried, if someone would have done that for me, I think, and then just bring a meal. anaemia will do. And even, there’s so many healthy options now in the supermarket, even like deliciously Ella, or, you know, or even cook have some really, really good options. And, you know, just and also think about the fact that, you know, you’re kind of a One Armed Bandit, when you’re, when you’ve just had a baby. I mean, if you’ve got twins, you have no arms. But if you’ve got one, you know, you’re sort of eating with one hand. So any you know, don’t bring me something that needs two hands to eat, it needs to be something you can just literally grab and have. 

Kirsten 50:48 Lately, definitely, I think that’s, that’s so important just to give people people some time back, which is it’s valuable time that they can use for rest, which is so important postpartum. I think there was one other thing that I was thinking about that I found really difficult, which was actually just getting out of the house. So somebody wants to come round and help you get out of the house, that’s also really valuable. Because, again, if you’ve got to change one baby change another time, you’ve done all that you just don’t feel like 

Sandra 51:27 somebody who’s, you know, somebody 

Kirsten 51:29 who was sick or wakes up to feed and you know, all all of a sudden, it’s you know, you’re starting all over again, you don’t want to leave. So sometimes just having somebody who can come and help you, in those early months, the first three, four months when it’s a real challenge, and you’re just learning. You know, even if you’ve been a mum before, or a parent before to a single turn, it is different to having twins. And I’m, you know, having spoken to parents who’ve had, you know, Singleton’s and then had twins, they’ve been just as shocked as those of us who had twins first. And I’d think about even things like, you know, how are you going to get exercise, pushing the buggy is great. But think about, you know, where do you live? Is your buggy going to be too wide to push on the path? So do you need to have a buggy, that’s one in front of the other so that you can actually easily push it on the footpath or, like me, are you not going to be able to get a buggy out at all? Because you live in the middle of the countryside? In which case, how are you going to carry them and I carried both on the front, whilst tiny. And then when they got bigger, I carried one on the front and one on the back. So you know all those things, you just, it’s worth thinking about them early doors, because then you don’t get overwhelmed with I’ve got so much to think about. And you know, I don’t know how to do it or so these are just some of the things that you can sort of prepare for while you’re pregnant. I 

Sandra 52:56 mean, it just sounds it sounds lovely, but also horrendous. So does anything you can do to make it those early days. Easier. Yeah. 

Kirsten 53:09 Separation 

Sandra 53:10 useful. So, yeah. So we’re just we’re sort of running out of time, but I just wanted to because I know people will ask about supplementation, what do you think about? You know, do you think it’s important to supplement and keep supplementing during, like during breastfeeding? Or? Yeah, 

Kirsten 53:32 I do, I would carry on taking pregnancy multinutrient postpartum. But again, in terms of supplementing, per se, I wouldn’t supplement without testing or without getting specialist advice. Because otherwise, I think you’re just, you know, as we discussed before, you could potentially be spending a lot of money on supplements, and if your digestion is not working very well then won’t be absorbing or if you don’t need it, then you’ll just be paying it out. It’s just expensive way so whilst I do think that supplementing can be very beneficial, I would always advise you know, try and get your nutrients from the diet first, and get some specialist advice in terms of whether you do need additional support from supplements for a short period of time. Yeah, 

Sandra 54:26 absolutely. So Kirsten, how can people find you if they want to get in touch? 

Kirsten 54:32 Um, I’ve got a website, www.kirstenmooring.com Or you can find me on Instagram @kirstenmooringnutrition and I’m usually in one or other of those places. 

Sandra 54:47 And you obviously you have loads and loads of experience for twin pregnancies but help people in all areas so 

Kirsten 54:57 I do because of my own experience. I’m particularly interested in twins but I take a strong interest in unexplained infertility. So those who’ve had miscarriages and recurrent miscarriages because we know that there is so much that we can do in terms of trying to unfold that story and find out what’s lying underneath and what the imbalances might be the driving those those unexplained stories that might actually be explained. Just unexplored just unexplored. 

Sandra 55:30 Thank you so much. It’s been lovely. 

Kirsten  55:31 Thank you so much. Really enjoyed it. Sandra 55:37 I really enjoyed this chat. I hope you enjoyed listening to this episode. Please like save, share and rate this podcast if you found that useful as it helps us reach more people. Also, don’t forget your 10% discount at test with nervous using the code fertility and if you’re looking for a fertility specialist to support you are practitioners can be contacted over at www.fertilitynutritioncentre.org And they all offer a free strategy call to help you decide on your next steps on your journey. Thank you for listening.