Pregnant with Twins? What Eating for Three Really Looks Like

Don't skimp on nutrition when you're pregnant with twins. Find out what changes you need to make—and why!

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Congratulations, you're pregnant with twins! It's exciting to plan for the arrival of your little ones—picking out two of everything can be twice as fun! But when it comes to eating, you may feel overwhelmed thinking about what changes you may need to make. What you eat during this time can make a huge difference in the health of your little ones. We know you're excited and exhausted and probably a bit overwhelmed, so we'll keep things simple. Consider this a primer in twin pregnancy nutrition.

Eat for three?

You've heard that once you're pregnant, you'll need to eat for two. So, what if you're pregnant with twins? Does that mean you need to eat for three?

Unfortunately, there's actually no truth in that old wives' tale. While you do need more calories when you become pregnant—and even more with a twin pregnancy, you certainly don't need to triple your caloric intake. How many more calories do you need? About 400 to 600 compared to the 340 to 450 calories necessary for a singleton pregnancy, according to Caroline Passerrello, MS, RDN, LDN, spokesperson for the Academy of Nutrition and Dietetics.

But you should look for quality, not quantity in those extra calories. Passerrello recommends choosing nutrient-dense foods (the kind that provide serious nutritional bang for their buck). You can add the calories throughout the day or consider adding a mini-meal if you notice you're getting especially hungry at a certain point in the day.

Since we’re talking about calories, it’s also wise to discuss weight gain. “Weight gain during pregnancy is best discussed before conception and in the beginning stages of pregnancy, so you have the best nutritional tips during the organ development stages which are very early in pregnancy,” says OB/GYN and women's health expert Jessica Shepherd, MD.

Dr. Shepherd uses The Institute of Medicine guidelines for twin gestation when discussing weight gain with her patients. These guidelines are based on pre-pregnancy weight so when considering twin pregnancies, the recommended weight gain is 37 to 54 pounds for women at a normal weight (BMI of 18.5-24.9), 31 to 50 pounds for women who are overweight (BMI of 25.0 to 29.9), and 25-42 pounds for obese (BMI > 30) women.

Add the right vitamins and minerals

Besides the additional energy from calories, Passerrello notes women pregnant with twins will also have an increased need for certain nutrients including zinc (found in beans, nuts, seeds, beef, chicken, milk, whole grains), copper (found in nuts, seeds, and shellfish), vitamin B6 (found in fortified cereals, beans, nuts, bananas, beef, chicken, pork and fish) and vitamin C (found in citrus fruits, papaya, bell peppers, foods fortified with Vitamin C). OB/GYNs will recommend a prenatal vitamin, fortified with iron to all their patients. "It might be wise to pay a visit to a registered dietitian nutritionist," Dr. Shepherd says. "An RDN can help pinpoint your nutritional needs while identifying possible nutrient deficiencies. He or she can guide you with meal planning and assist you, with the help of your OB/GYN, with other pregnancy-related symptoms such as reflux or heartburn."

Stay hydrated

Beyond food, be sure to stay adequately hydrated. It's easy to forget the simple task of getting enough water, but dehydration can put you and your babies at risk. Start with the goal of drinking 10 cups of fluid each day as recommended by the Academy of Nutrition and Dietetics. Aim for a little more if it's hot or if you find yourself sweating more than usual, and choose plenty of fruits and vegetables, as they can also contribute to your fluid intake. And again, ask your healthcare provider and RDN to help set up specific fluid goals according to your personal needs.

Don't stress

The best advice? Don't stress! Focus on filling your plate with a variety of nourishing foods including whole grains, vegetables, fruits, lean protein (including beans, nuts and seeds) and dairy. Sip water throughout the day, take your prenatal vitamin and consider adding some smaller snacks to help you reach your caloric and nutrient needs. Rest as much as you can, and nurture your body and mind as you get ready to tackle life as a mom of multiples.

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