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Eating for three: what to eat when you’re pregnant with twins

Daphna Steinberg
Written by Daphna Steinberg

I’m pregnant with twins. What do I eat and how much weight should I gain?

When pregnant with twins, trying to get a balanced diet with enough protein, carbohydrates, calcium and energy is important for your health and your babies’ health.

Protein

Protein helps with babies’ growth and also supports your needs when pregnant. A woman pregnant with twins needs an extra 50 grams of protein each day compared to someone pregnant with one baby. What does that look like? Those extra 50 grams would be equal to 220 grams (8 ounces) of meat or eight large eggs or about two and a half cups of cooked lentils. Keep in mind that this is on top of the usual amount needed for a pregnancy with one baby. A 60 kg (132 pound) woman would need about 66 grams per day if she’s carrying one baby or 116 grams per day for a twin pregnancy. 

Carbohydrates

Your carbohydrate needs are also higher with a twin pregnancy. You should aim for a minimum of 208 grams of carbohydrates daily to help with your babies’ development, your weight gain and to prevent ketones (a chemical you make when you don’t get enough carbohydrates). This is equal to six-and-a-half slices of whole wheat bread or four cups of rice or five cups of cooked pasta or seven-and-a-half chapatis.

Calcium

Getting enough calcium is important to help with growth, as well as maintenance of bones and teeth for you and your babies. It’s also important for helping to control blood pressure during pregnancy. All pregnant women should include three to four servings of calcium daily to meet your needs. Mix and match the calcium-rich foods you enjoy to ensure you receive enough. Each of the following is considered one serving of calcium:

  • One cup of milk or fortified milk alternative (e.g. soy beverage, rice beverage, almond beverage)
  • 1/3 cup of cubed pasteurized cheese
  • One cup of yogurt

I’m feeling really nauseous – what are some tips for eating well?

It can be challenging to eat enough food if you are feeling nauseated or if your babies are not leaving you a lot of room in your stomach to eat. Here’s my advice to help you get enough to eat:

  1. Have small, frequent meals and snacks with both carbohydrates and protein, for example:
    • Fruit and cheese
    • Greek yogurt and cereal
    • Hummus and pita
    • Sandwich with a cup of milk
    • Crackers with peanut butter
  2. Include protein with every meal. Protein is found in:
    • Eggs
    • Fish – choose low mercury options like salmon, rainbow trout or sardines
    • Poultry (chicken, turkey)
    • Meat
    • Legumes/pulses (beans, lentils, chickpeas)
    • Greek yogurt
    • Cheese, cottage cheese
    • Tofu
    • Textured vegetable protein (e.g., veggie burgers, veggie dogs)
    • Nuts, nut butters (e.g. peanut butter)

We also recommend you take a prenatal vitamin each day. Discuss any other supplements with your health care provider.

What about my weight gain?

Recommended weight gain in twin pregnancies is based on your pre-pregnancy body mass index (BMI). You can calculate your pre-pregnancy BMI here.

If your pre-pregnancy BMI was between 18.5-24.9 it is recommended that you gain between 17-25 kg, or 37-54 pounds, throughout your pregnancy. If it was 25-29.9, the recommended weight gain is 14-23 kg, or 31-50 pounds. If your pre-pregnancy BMI was 30 or more weight gain of 11-19 kg, or 25-42 pounds, is recommended.

As most people with twins deliver before 40 weeks gestation, weight gain earlier in pregnancy is recommended. If you are finding it difficult to gain weight or get enough to eat, ask your care provider for a referral to a registered dietitian. 

About the author

Daphna Steinberg

Daphna Steinberg

Daphna Steinberg is a registered dietitian with the DAN Women & Babies Program at Sunnybrook.

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