Do I need to eat more if I'm pregnant with multiples?
Yes. If you're pregnant with multiples, you need more calories than a woman who's carrying just one baby.
A general guideline is to add 300 calories a day for each baby. So if you're carrying twins, you'd add roughly 600 calories to your usual diet. This amount may be different if you were overweight or underweight before you got pregnant, so talk with your provider to come up with an eating plan that has the number of calories that's appropriate for you.
Whether you're carrying twins, triplets, or more, plan to eat at least five times a day (three meals and two substantial snacks), even if you don't feel especially hungry.
Of course, not all calories are created equal. Make each one count by limiting sugar and eating a variety of foods packed with the nutrients you need, including protein, carbohydrates, and fats. Cheese, milk, meat, eggs, nuts, and healthy oils all fuel your babies' growth. Round out your diet with lots of fruits, vegetables, and whole grains.
How much weight should I gain if I'm pregnant with multiples?
Gaining the right amount of weight is necessary to nourish your growing babies. Try to put on pounds starting early in the pregnancy – when your babies are developing rapidly and you still have room to fill your stomach. The Institute of Medicine (IOM) recommends the following weight gain ranges for women carrying twins based on their pre-pregnancy body mass index (BMI):
- 37 to 54 pounds if you started at a normal weight (BMI of 18.5 to 24.9)
- 31 to 50 pounds if you were overweight (BMI of 25 to 29.9)
- 25 to 42 pounds if you were obese (BMI of 30 or higher)
According to the IOM, there isn't enough data to make weight gain recommendations for women pregnant with triplets or more. If you're expecting three or more babies, ask your provider for a weight gain target that's right for you.
If you were underweight before pregnancy, you'll have to put on extra weight quickly to catch up. Your provider can help you set healthy weight goals throughout your pregnancy.
Follow one woman through her pregnancy with twins and watch her give birth.
Will I need to take a special kind of prenatal vitamin?
Prenatal vitamins are important, but you don't need a special formula for twins and triplets. A standard prenatal supplement will do just fine.
A supplement is the best way to ensure that you get vital nutrients such as folic acid, iron, and calcium. Your provider can recommend specific brands and doses.
Women carrying more than one baby are at a higher risk for iron-deficiency anemia during pregnancy. Your provider will monitor your iron level to make sure you're getting enough. If you're not, she may recommend that you take an iron supplement.
High doses of iron can sometimes lead to constipation and nausea, so talk to your provider about ways to avoid these problems.
How much water do I need if I'm pregnant with multiples?
Even if you're the type of person who never goes anywhere without a water bottle, pay extra attention to how much water you're drinking now that you're carrying multiples. Women who are pregnant with one baby are advised to drink 10 8-ounce cups of water (or other hydrating beverages) each day, so that's probably a good starting point for you too.
But every woman is different – you may need a little more or less water than someone else. Ask your provider for specific advice on fluid intake.
Of course, drinking extra fluids means you'll be making extra trips to the bathroom (especially as your babies grow larger), but you can use this as a chance to check if you're hydrated. Aim to drink enough water to keep your urine clear or pale yellow. If it's cloudy or dark yellow, drink more.
It's especially important to prevent dehydration in the second half of pregnancy because having multiples can raise the risk of premature labor and early delivery.
Can I exercise if I'm pregnant with multiples?
If you're a healthy, active woman with multiples on the way, you can probably continue to exercise during your pregnancy, as long as your provider gives you the go-ahead.
Keep it slow, relaxed, and gentle. Your body – and your babies – may not be able to handle intense workouts. Good options include swimming, walking, and prenatal yoga.
Be sure you're hydrated before, during, and after your workout. And no matter what exercise you enjoy, stop immediately if you develop signs of overheating, such as nausea, dizziness, or a racing heart.
That said, carrying more than one baby is a workout in itself, and some women may need to commit to extra rest or avoid doing certain types of exercise. For example, aerobic exercise may be off-limits if you're at risk of delivering your baby early.
Discuss your workout routine with your provider to make sure you and your baby stay healthy during your pregnancy, and be sure to tell your provider if you develop signs of preterm labor, such as abdominal pain or bleeding. Preterm labor is a reason for you to stop exercising altogether.