Pregnant with twins: eating well

Should I eat more than if I was expecting one baby?

The healthy eating advice for mums-to-be of twins or more is the same as that for women expecting one baby (NCCWCH 2011, NICE 2011). So you don't need to eat significantly more.

The best advice is to listen to your body, and eat when you're hungry. You need to eat well, so that you and your babies get all the right nutrients. This will also ensure that you gain enough weight to help your babies to grow well (NICE 2011). Try to have a healthy, balanced diet.

Your daily meals should include a variety of foods from the four main food groups:
  • Fruit and vegetables, whether fresh, frozen, tinned, dried, or juiced. Try to have at least five portions a day.
  • Starchy food, such as rice and noodles, potatoes, pasta and bread, wholegrain where possible.
  • Foods rich in protein, such as lean meat, fish, eggs and pulses. Include at least two portions of fish a week, including oily fish, if you can.
  • Dairy foods such as milk, cheese and yoghurt, which contain calcium.
You need plenty of iodine in your diet to help your baby's development. Dairy products, sea salt, and sea fish such as cod are good sources of iodine. Try not to have more than a teaspoon (6g) of salt a day.

Do I need any extra vitamins or supplements?

However many babies you are expecting, you should take 400 micrograms (mcg) of folic acid daily for the first 12 weeks of your pregnancy.

Your doctor may also recommend you take a daily pregnancy multivitamin. If you don't eat oily fish, you may want to take an omega-3 fish oil pregnancy supplement, but discuss it with your doctor first.

When you're between 20 weeks and 24 weeks pregnant, you should have a blood test to check your iron levels. If your iron levels fall too low, you will develop anaemia (NCCWCH 2011: 62).

Anaemia is more common in mums expecting twins (NICE 2011). Your doctor will prescribe an iron supplement during your pregnancy, if you need it (NICE 2011, Tamba 2009). Always follow the advice of your doctor when taking supplements in pregnancy (Tamba 2009).

How many calories do I need?

It's hard to say how exactly many calories you need, because everyone's needs are slightly different. Rather than counting calories, try to eat when you're hungry, and choose healthy foods. It's fine to snack between meals if you need an energy boost.

Because you're carrying two babies, you're likely to put on more weight than if you were expecting one. But there's certainly no need to eat for three.

In fact, taking in more calories than you need may do you more harm than good (Ballard et al 2011, NCCWCH 2011: 56). You could put on too much weight, which will make you feel uncomfortable and expose you to other health risks (NCCWCH 2011: 60).

Eating more than you need won't benefit your babies or prevent them from being born with a low birth weight (NCCWCH 2011: 66). So a high-calorie diet is not recommended for mums-to-be (Ballard et al 2011, NCCWCH 2011).

If you're wondering how you can get the healthy-eating balance right, take a look at our trimester-by-trimester meal planners.

Where can I get advice about eating well?

Your doctor may talk to you about healthy eating at the beginning of your pregnancy during your booking appointment (NCCWCH 2008, NCCWCH 2011: 74). After that, you can talk about your diet during your routine antenatal appointments.

Mums who gain good advice from a registered dietitian may be less likely to give birth to babies with a low birth weight (Luke 2003, NCCWCH 2011: 56).

Your doctor may refer you to a dietitian if:
  • You feel that you would benefit from one (NCCWCH 2011: 16).
  • Your body mass index (BMI) is more than 30, or is lower than 19 at the beginning of your pregnancy (NCCWCH 2011).
  • You're worried that you are putting on too much weight during your pregnancy, not putting on enough weight, or are losing weight (Tamba 2009).

Will my babies get enough nutrients if I sometimes struggle to eat?

It can be difficult to eat well when you're expecting twins. You may be battling pregnancy symptoms such as nausea and sickness (PRODIGY 2008), indigestion and constipation.

Rest assured that sickness won't threaten your babies' well-being, as long as you're able to keep some food down, and drink plenty of fluids (NCCWCH 2008, Tiran 2004).

This can be tough, because your pregnancy symptoms may be worse than if you were pregnant with one baby. That's because of the increased amount of pregnancy hormones circulating your system (Tamba 2009).

Just eat whatever you can cope with. Your babies can catch up on their nutrients later on in your pregnancy when you're feeling better. However, speak to your doctor as soon as you can if:
As your pregnancy advances, you may find that you don't feel like eating much. You may feel very full, very soon after eating and drinking. Eating little and often may be easier for you than sitting down to three main meals a day (Tamba 2009).

Meanwhile, get some nutrition ideas for each trimester from our daily meal planners. You can also connect with other mums-to-be of twins in our Multiples group.


Ballard CK, Bricker L, Reed K, et al. 2011. Nutritional advice for improving outcomes in multiple pregnancies. Cochrane Database of Systematic Reviews. [pdf file, accessed March 2012]

DH. 2012. Healthy Start Vitamins. Healthy Start, Department of Health. [Accessed April 2012]

Luke B, Hediger ML, Nugent C, et al. 2003. Body mass index - Specific weight gains associated associated with optimal birth weights in twin pregnancies. J Reprod Med. 48: 217-224d

NCCWCH. 2008. Routine antenatal care for healthy pregnant women.
[pdf file, accessed June 2011]


NICE. 2011. Antenatal care for women who are pregnant with twins or triplets: understanding NICE guidance. [Accessed April 2012]

PRODIGY. 2008. Nausea and vomiting in pregnancy. Clinical topic. [Accessed April 2012]

Tamba. 2009. The healthy multiple pregnancy guide. Guildford: Twins and Multiple Births Association


Track your baby’s development

Trying to conceive? | Sedang cuba hamil?