How to Eat When You're Pregnant With Twins, According to an RD

Here are four ways to make sure you're getting all the nutrients you need.


As the shock of Beyoncé's Internet-breaking baby announcement (twins!) wears off, people have begun to joke about Bey's enviable ability to "eat for three." But a twin pregnancy doesn't exactly mean triple the ice cream and pizza. The fact is, for a woman carrying multiples, a balanced, nutritious diet is key for the health of both mom and her babies. Below are four ways a twin mommy-to-be can make sure she's getting the nourishment she needs throughout her pregnancy.

Bump up your calories

But not by too much. According to the American College of Obstetrics and Gynecology, a woman pregnant with multiples needs an additional 300 calories per day per baby. So a woman carrying twins should aim to consume an extra calories 600 daily. To put that in perspective, 600 calories is roughly the amount found in a half-cup of brown rice, a half-cup of black beans, and a side of guacamole.

Another way of assessing your calorie needs: A woman with a normal BMI (between 18.5 and 24.9) who's pregnant with twins should consume 40 to 45 calories per kg of body weight. So say your normal healthy weight is 150 pounds; that's about 68 kilograms, which puts your daily calorie needs somewhere between 2,700 and 3,000.

While you should never restrict calories during pregnancy (especially with twins), it’s helpful to have a grasp of true calorie needs, and use that information to guide your choices. For example, a veggie burrito (roughly 900 calories) and a pint of gelato (1,000) could each account for about a third of your total daily requirement.

Focus on protein

When you’re busy growing not one, but two human beings, consuming adequate protein is critical—for the babies’ growth, and mom’s needs too. The Institute of Medicine recommends that, starting at the beginning of the second trimester, a woman pregnant with twins consume an extra 50 grams of protein per day above her non-pregnant protein needs. (Click here to figure out your personal, non-pregnant protein "RDA.") Fifty grams of protein is the amount in 4 to 5 ounces of cooked chicken breast, 6 ounces of plain Greek yogurt, and two large eggs.

Another way to ensure an optimal protein supply is to aim to get about 20% of your total calories from protein, about 40% from fat, and 40% from carbohydrates. For a woman who needs 2,700 calories per day, that’s 135 grams of protein, about 120 grams of fat, and 270 grams of carbohydrates (with an emphasize on fiber-rich carbs, like pulses, whole grains, veggies, and fruit).

If you’re concerned about consuming too much protein or too little, an app that tracks macronutrients may help, even if you use it temporarily. If you’re a vegetarian or vegan, you may want to consult with a dietitian who specializes in plant-based diets.

Get into an H2O routine

To stay hydrated, pregnant women need three liters of water a day. Some of that requirement can be met with high liquid foods, like yogurt, soup, fruits, and veggies. However, you'll probably still need to drink about 10 cups of plain water (8 ounces each) over the course of a day.

To get into a water-drinking routing, think of your day divided into four blocks: 1) the time you wake to mid-morning 2) mid-morning to lunchtime 3) lunch to mid afternoon 4) mid-afternoon to dinner. Aim to drink 2-3 cups of water during each of those blocks, with a few caveats. Cut off your fluids early enough in the evening so you won’t be running to the bathroom all night. And remember that if you’re active and perspiring, you may need to drink a bit more during and after exercise.

Eat whole foods

Good nutrition is key for every pregnancy. But for a woman carrying twins, a few nutrients are particularly important: calcium, zinc, magnesium, iron, omega-3 fatty acids, antioxidants, and vitamins D, C, and E.

Choosing meals and snacks made with nutrient-packed whole foods is the best place to start. But talk to your doctor to see if she feels you need supplemental forms of specific nutrients to hit the recommended goals.

And again, consider consulting with a dietitian if you need personalized guidance and support. This type of professional coaching can help you meet your nutrient needs not only during pregnancy, but also during postpartum breastfeeding needs.

Cynthia Sass is Health’s contributing nutrition editor, a New York Times best-selling author, and consultant for the New York Yankees. See her full bio here.

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