Nutrition and Weight Gain Recommendations during a Multiple Pregnancy


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What to know about how much to eat and how much weight to gain while pregnant with multiples

  • Learn how many calories you need when pregnant with twins or multiples

  • Understand which nutrients are especially important when pregnant with multiples

  • Determine appropriate weight gain when pregnant with twins

Eating for two takes on a whole new meaning when you’re pregnant with twins (or more!). Weight gain recommendations increase as compared to a singleton pregnancy, along with the calorie guidelines and nutrient intake recommendations.1

Dietary recommendations for multiples pregnancies are set out to optimize fetal growth and development, as well as reduce pregnancy complications.2 With an increased demand on nutrient stores, moms carrying multiples have increased nutrient needs throughout their pregnancy.3

Read more: How much Weight should I Gain during Pregnancy?

How many calories do you need if you’re pregnant with twins?

While Dietary Reference Intakes have been established for singleton pregnancies, none have been set for twin pregnancies.4 Because a twin pregnancy requires higher weight gain goals, the American College of Obstetricians and Gynecologists recommends about 300 more calories per day for each baby.

For example, a pregnancy with twins would mean eating about 600 or more calories per day over what you ate before becoming pregnant.1,5

If you are pregnant with triplets or more, it is best to discuss your nutrient needs with your doctor.

These calories can be spread throughout the day into mini-meals and snacks, especially because eating larger meals become uncomfortable for most women later in pregnancy.

Need help finding ways to fit in those extra calories? Come chat with our team of registered dietitian nutritionists, fellow moms, and lactation specialists (including a twin mom!), available from Monday – Friday 8 am – 6 pm (ET). Chat now!

What nutrients do I need when pregnant with twins?

It is assumed that the need for vitamins and minerals is higher in a twin pregnancy than it is in a singleton pregnancy, but unfortunately there is not enough research on twin and higher multiple pregnancies to have established amounts of each nutrient.2 It is always best to consult with your doctor on your specific needs.

Since adequate evidence is lacking when it comes to nutrient needs for twin pregnancies, health professionals recommend sticking with only 1 prenatal vitamin per day to meet your needs.5

Specific nutrients that are important to focus on while pregnant, whether with singletons or multiples, including protein, folate, vitamin D, DHEA, iron, calcium, magnesium and zinc.6,7,10

Read more: Which Nutrients do I need during Pregnancy?

How much water do I need to drink when pregnant with twins?

Don’t forget about hydration! While there aren’t specific recommendations for how much water should be consumed during a twins or multiples pregnancy, the American College of Obstetricians and Gynecologists recommend 8 to 12 (8oz) cups for a singleton pregnancy.11 Aim for the upper end of this recommendation, and perhaps a little more while drinking to thirst.

Fluid needs increase with pregnancy as it is important for your babies’ blood flow and removal of waste.5

How much weight should I gain when pregnant with twins?

Gaining the right amount of weight helps support your babies’ growth and development, which is particularly important for pregnancies with twins or multiples because of the increased risk of preterm labor and low birth weight.2,10

Weight gain, specifically by 28 weeks of pregnancy, is especially important as it has a significant impact on the babies’ growth rate.4

Weight gain recommendations vary from woman to woman based on a number of factors such as body size and pre-pregnancy weight, but in general for a twin pregnancy, the recommendation is 37-54 pounds.8,12

At this time there is not enough information on weight gain for higher multiples (for example, triplets, and quadruplets) to suggest any guidelines.12 Discuss your specific weight gain goals with your doctor who is familiar with your specific healthcare needs.

It may feel like you need a complete diet overhaul to keep up with the demands of growing more than one baby, but if you’re already consuming a generally nutritious and balanced diet, continue eating this way simply with larger portion sizes and potentially more frequent snacks.

Learn about: Coping with a Fear of Weight Gain in Pregnancy

Tips for nutrition and weight gain during a twins pregnancy

Talk to your healthcare provider to determine your weight gain goals

Meet those weight gain goals by increasing your daily calories with nutrient rich whole foods such as fruits, vegetables, whole grains, and lean protein. Add snacks and mini meals to comfortably increase your calorie intake.

Read more: High Protein Meal Plan for when Pregnant or Breastfeeding Twins and Multiples

Increase your fluid intake throughout the day to ensure you are adequately hydrated

If you’re bored with plain water, try flavoring your water with lemon, cucumber, or a splash of 100% fruit juice, or flavor it with fresh herbs such as mint or basil.

Read more: Tips for Staying Hydrated during Pregnancy and Breastfeeding

In addition to taking your prenatal vitamin, increase food sources of important nutrients

Food sources of these important nutrients include:

Folic acid from green vegetables, nuts, beans, peas, seafood, eggs, dairy, and fortified grains.13

Zinc from red meat, poultry, beans, nuts, whole grains, dairy, and fortified cereals.14

Magnesium from great leafy vegetables, legumes, nuts, seeds, and whole grains.15

Iron from lean meat and seafood, as well as beans, nuts, and fortified grains. Enjoy iron rich foods alongside vitamin C rich foods, such as citrus fruit, strawberries, kiwi, and bell peppers, to help with absorption.16

Calcium from dairy, tofu, dark leafy green vegetables, almonds, and canned fish with bones.17

Vitamin D from fortified dairy products and fatty fish. Note that it can be difficult to reach the recommended amount of vitamin D from diet alone and supplementation may be beneficial.9 Always speak with your healthcare provider before taking any additional supplements.

Protein from fish, poultry, dairy, eggs, beans, tofu, nuts, and seeds.

Read more:

Why Does Folate Matter for Babies Tots, and Mama?

What Should I Know about Iron Deficiency Anemia During Pregnancy?

Why Does Calcium Matter for Babies, Tots, and Mama?

Why Does Vitamin D Matter for Babies, Tots, and Mama?

Protein: Getting Enough of the Best Sources

Add nutritious snacks through the day

While weight gain, calorie, and nutrient needs are different for a multiple pregnancy compared to a singleton pregnancy, it doesn’t have to be complicated. Your doctor or a dietitian can help determine the best dietary recommendations for you to meet your goals for a healthy twin (or more!) pregnancy.

A great way to add additional calories are nutritious snacks eaten throughout the day. This is particularly helpful once you begin feeling full quickly as your babies begin taking up more room.

Read more: Healthy Snack Ideas during Pregnancy

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Our Happy Experts are a team of lactation consultants and registered dietitian nutritionists certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday - Friday 8am-6pm (ET). Chat Now!

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