Eat When Pregnant with Twins

You’ve just had an ultrasound with your doctor and found out you’re pregnant with twins. You may think of this as an excuse to load up on food to feed two mouths instead of one. However, twin pregnancies are considered high-risk pregnancies, as they require a little more attention and care than a normal pregnancy. It is important that you eat foods and maintain eating habits that will provide all the necessary nutrients for you and for both of your babies. Rather than overload on carbs or sugary foods, you should focus on eating mineral and nutrient rich meals that will ensure your babies are healthy in and out of the womb.

Steps

Adjusting Your Diet

1. Increase your daily calorie intake. Part of the myth of having twins is true: you will need to up your calorie intake for the day. You should consume about 600 extra calories a day, depending on your pre-pregnancy BMI, activity level, and physician's recommendations.
   • You can also calculate the number of calories you'll need each day by multiplying the number of kilograms you weigh by 40 or 45. So, for example, if you weigh 62 kilos, you can multiply that number by 40 and by 45 to get a range of 2,480-2,790. This range represents the number of calories you should probably eat each day.
   • However, how you get these calories is even more important than the amount of calories you consume. You should maintain a well-rounded diet that has a balance of protein, carbs, and healthy fats. 20 to 25 percent of your calories should be from protein, 45 to 50 percent of your calories should be from carbs, and 30 percent of your calories should be from healthy fats.
   • Avoid overeating and going over your suggested calorie intake. Rapid weight gain can put your babies at risk and lead to other health issues.
2. Consume food high in essential vitamins and minerals. When you’re pregnant with twins, it’s important to fortify your diet with enough vitamins and minerals in every meal of the day. Focus on increasing your levels of folic acid, calcium, magnesium, zinc, and iron, as well as several other vitamins and minerals to keep your babies healthy.
   • Protein: An average size woman needs 70 g of protein a day. Pregnant women are advised to consume 25 g more protein per baby, so add 50 g to your daily protein intake when you are pregnant with twins. Protein helps your babies to grow and develop their muscles in the womb. Go for high protein sources like lean meats (beef, pork, turkey, chicken) as well as nuts, yogurt, milk, cottage cheese, and tofu. Avoid fatty protein sources such as fatty cuts of beef or pork, sausage, bacon, and hot dogs.
   • Iron: This is a key nutrient to ensuring your babies grow properly and have a healthy birth weight. Consuming iron while pregnant will reduce your risk of hypertension, anemia, and preterm delivery. Get at least 30 mg a day of iron. Good iron sources include red meat, seafood, nuts, and fortified cereal.
   • Vitamin D: This nutrient helps to increase blood circulation in your placenta and helps your babies absorb calcium in the womb. Pregnant women should get between 600-800 IU (International Units) of Vitamin D a day.
   • Folic acid: Maintaining high folic acid levels will help reduce the risk of birth defects. Consume at least 600 mg of folic acid a day. Most prenatal vitamins contain folic acid (or folate). You can also find it in the form of spinach, asparagus, or fruits like oranges and grapefruits.
   • Calcium: Consume at least 1,500 mg a day of this essential nutrient. Infants need a lot of calcium to build strong bones as they develop in the womb. Milk and yogurt are good sources of calcium.
   • Magnesium: This is another essential nutrient that will help to decrease your risk of premature labor and help to develop your babies’ nervous systems. Have at least 350-400 mg per day of this nutrient. You can get magnesium from nuts like pumpkin seeds, sunflower seeds, and almonds, as well as wheat germ, tofu, and yogurt.
   • Zinc: You should consume at least 12 mg of zinc per day. Maintaining high zinc levels will lower your risk of preterm delivery, a low birth-weight for your babies, and prolonged labor. A good source of zinc is black-eyed peas.
3. Have meals that cover all five food groups. Your daily meals should cover all five major food groups (fruits, vegetables, grains, protein, and dairy) to ensure you are getting the right balance of nutrients and minerals.
   • Have 10 servings of grains a day. For example, 10 servings of: one slice of multigrain bread, ⅔ cup of cereal, ¼ cup of muesli, and ½ cup cooked pasta, noodles, or rice.
   • Consume nine servings of fruits and vegetables a day. For example, nine servings of: ½ cup of vegetables like spinach, asparagus, or baby carrots, one cup of salad, one medium fruit like apple, banana, or ½ cup of fresh berries, two smaller fruits like plums or apricots, and 30 g of dried fruit.
   • Consume four to five servings of protein a day. For example, four to five servings of: 65g cooked lean meat like beef or pork, 80g cooked chicken or turkey, 100g cooked fish like salmon or trout, two eggs, 170g cooked tofu, 1 cup legumes or lentils, and 30g nuts like almonds, seeds like pumpkin seeds, and tahini.
   • Have three to four servings of dairy a day. For example, three to four servings of: one glass (250ml) of non-fat milk, one glass of soy or rice milk with added powdered calcium, one tub (200ml) of yogurt, and one to two slices of hard cheese.
4. Eat cakes, cookies, and fried foods on rare occasions. Though you are not restricted to not eating these unhealthy foods, you should only eat them in small amounts and on the rare occasion when you have a craving for cookies you cannot ignore. Avoid consuming empty calories, as this can lead to an unhealthy weight gain and provides little nutritional value for your babies.
   • You should also limit your consumption of artificial sugars, such as candy and sodas. Avoid foods cooked in trans fats and go for foods cooked in healthier oils like olive, coconut, and avocado oil.
5. Avoid certain types of food during pregnancy. As with a normal pregnancy, you should avoid certain foods when pregnant with twins, including:
   • Raw or partial uncooked eggs.
   • Raw or undercooked meat.
   • Sushi.
   • Raw shellfish.
   • Cold cured meats, such as deli meats.
   • Herbal teas.
   • Unpasteurized cheeses, which may contain the listeria bacterium. (Queso dips often contain unpasteurized cheese.)
   • While doctors used to recommend pregnant women stay away from peanuts, studies now suggest that eating peanuts and other tree nuts (as long as you are not allergic to them!) during pregnancy can help reduce your babies' risk of developing allergies to them.
6. Create a daily meal chart. One way to ensure you get enough nutrients while pregnant with twins is to create a meal chart that you can fill in every day. It should contain all five food groups as well as the suggested servings of each food group. You can then note how many servings you ate per day and note any gaps or missed food groups in your meals.
   • Go grocery shopping with a list based on the suggested servings per day. This will help you limit any unhealthy meals and ensure you are consuming enough vitamins and minerals through the food you eat on a daily basis.

Adjusting Your Eating Habits

1. Have healthy snacks to help with nausea and sickness. These symptoms are common early in your pregnancy and can last up to 16 weeks. It’s important to try to still eat and drink despite any nausea or morning sickness. Rather than tuck in for a big meal, eat small healthy snacks throughout the day to keep your nausea in check. This will also help improve your digestion and reduce any heartburn you may be feeling while pregnant.
   • Keep crackers, fruits (berries, plums, and bananas are all easy to eat fruits), low-fat yogurt packs, pre made smoothies (with no additives or preservatives) and protein snacks on hand for quick, easy to prepare snacks.
2. Drink enough fluids. Sipping water throughout the day will ensure you stay hydrated. Though you may end up running to the bathroom every five minutes, drinking lots of water will help with your babies’ blood flow and waste removal.
   • You should drink about 10 cups (2.3) liters of water each day while pregnant. You can confirm you are well hydrated by looking at your pee; it will be pale in color if your body is hydrated.
   • Try to drink more water earlier in the day and then reduce your water intake after 8 pm. This will allow you to sleep longer at night without having to get up constantly to use the bathroom.
   • You can have some caffeine while pregnant. Limit it to 200mg a day -- about two cups of brewed coffee. Avoid higher intakes than this, as high caffeine intake during pregnancy is associated with infant health problems. Avoid consuming caffeine at the same time as you take iron supplements or eat foods that contain iron, as caffeine may interfere with iron absorption. Wait to eat for at least an hour after having a cup of coffee.
   • There is no safe level of alcohol consumption while pregnant.
3. Eat foods high in fiber to help with constipation. As your babies grow, they will put pressure on your bowels. Your gut will also need to slow down its digestion process to absorb all the vitamins and minerals you are consuming. So you will likely experience constipation when pregnant, and will need to consume high fiber foods to help your gut digest.
   • If you experience constipation, eat more fruits, vegetables, legumes, nuts, seeds, and bran based cereals throughout the day. You should also do light exercise like walking and gentle stretching to keep your bowels regular and stimulate your digestive system.
4. See your doctor if you experience rapid weight gain or frequent headaches. Twin pregnancies have an increased risk of preeclampsia. In this condition, the mother has increased blood pressure, protein in her urine, and more swelling than normal in pregnancy. Swelling is especially pronounced in the face and hands. Rapid weight gain and headaches are possible symptoms for preeclampsia and require immediate examination by your obstetrician.
   • Your obstetrician will treat your symptoms based on the severity of your condition. She may recommend bed rest and medication for less severe cases, or the immediate delivery of the babies, which is the only “cure” for preeclampsia, for more severe cases.
   • You should be aware that the recommended weight gain for twins is more than for a single pregnancy. Healthy women with a normal BMI before pregnancy should gain between 37-54 pounds during a twin pregnancy, as opposed to between 25-35 pounds for a single pregnancy. Your doctor will recommend a weight gain that's appropriate for you.
5. Talk to your doctor if you experience any preterm symptoms. Twins have an increased chance of being born early or preterm. If you experience any bleeding or vaginal discharge, diarrhea, pressure in your pelvis or lower back, and contractions that become more frequent and close together, you should notify your doctor or obstetrician.
   • Even if you may not be going through pre term labor, it’s important to address these symptoms for the safety of your babies.

Taking Supplements

1. Talk to your doctor about vitamin and mineral supplements. Most pregnant women can get the necessary iron, iodine, and folic acid from their diet, but your doctor may also suggest taking supplements if you skip meals often, have a low appetite, or have other health issues.
   • Avoid taking supplements without consulting your doctor first.
2. Do not double your supplements when you are pregnant with twins. Having too many vitamins and minerals in your body can be harmful to your babies.
   • If you are vegan, or do not eat a lot of dairy in your diet, you may need to take calcium supplements. Vegans may also need a B12 supplement. As well, pregnant women should take a folic acid supplement each day to ensure they have the right amount of folic acid in their system.
   • Do not take fish liver oil supplements, high dose vitamin supplements, or supplements containing vitamin A as these can be harmful to your babies.
3. Ask your doctor about herbal supplements before you take them. The FDA does not evaluate or regulate natural herbal supplements, so the quality and strength of the supplement may vary between different manufacturers or even different batches. However, the FDA recommends that pregnant women always check with their doctor about the safety of taking an herbal supplement before buying it or consuming it. Some herbal supplements may contain products that are not safe for pregnant women and may endanger your babies.
   • If you are interested in herbal supplements to help alleviate any issues in your pregnancy, speak to a trained, certified herbalist. Ask your doctor for a referral to a reputable herbal specialist.

Tips

• Remember that while it's important to eat a balanced diet, it's equally important to treat yourself. Pregnancy comes with many stresses, so if you feel like the occasional ice cream or chocolate, it's okay to indulge from time to time (unless you're diabetic or develop gestational diabetes).

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Sources and Citations

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