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. 

The post Eating for three: what to eat when you’re pregnant with twins appeared first on Your Health Matters.

Myth 1: You can never get enough folic acid in pregnancy

“Only women who have added risk factors for neural tube defects will need to take 5mg per day of folic acid in the first trimester,” says Steinberg. Otherwise, most women only need 1mg per day of folic acid. Ideally, all women of childbearing age should be taking folic acid even before they are pregnant.

Myth 2: I should limit my salt intake to prevent high blood pressure

Restricting your salt intake any more than before you became pregnant doesn’t seem to have any impact on your blood pressure. Instead, “focus on getting enough calcium and vitamin D,” says Steinberg. Milk products include both of these, and you should aim to have 3-4 servings every day. Another good source of calcium is your prenatal multivitamin.

Myth 3: Honey is a good substitute for sugar

If you are looking to cut down the amount of sugar you eat, honey is not a good substitute, especially during pregnancy. “Honey has just as much sugar in it as sugar. Plus, honey is not always pasteurized, and pregnant women should avoid eating unpasteurized foods,” says Steinberg. Instead, use an artificial sweetener. Always be sure to check the label though, as not all sweeteners are safe for consumption during pregnancy. The Canadian Diabetes Association has a comprehensive list of sweeteners.

Myth 4: I’m eating for two

It turns out this old saying is, well, outdated. “You should be eating twice as healthy, not twice as much,” says Steinberg. Too much weight gain can lead to a big baby, and a vaginal delivery can cause trauma (like shoulder fractures and nerve damage) to a big baby.

Myth 5: I shouldn’t eat any fish

Not all fish is bad in pregnancy- in fact, it’s a great source of protein and omega-3’s. “The fish you want to avoid is raw or undercooked fish, like sushi, and fish that is high in mercury,” Steinberg says. Types of fish that are high in mercury (and therefore should be avoided) include:

• Fresh/frozen tuna
• Shark
• Swordfish
• Marlin
• Orange roughy
• Escolar
• King mackerel
• Tilefish

Additionally, you should limit your intake of albacore “white” tuna to no more than 300 grams (6 ounces) per week.

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