All you need to know about nutrition during twin pregnancy

A nutritionist’s take on what to eat during twin pregnancy

You already know that good nutrition is key to a successful pregnancy and will also impact the future health of your unborn baby. The fact that you are having twins makes this even more important since you now need around 600-1000 calories per day. You need to make each calorie count by adding the right nutritional value. So, what does this actually mean in terms of food? Let us break it down for you in the easiest way. No need to fret here.

Let’s start with the most basic question.

How much weight can you gain when you are pregnant with twins?

Here is a look at how much weight gain is recommended by experts when you are pregnant with twins. A pregnant woman can gain weight based on her pre-pregnancy weight and pre-pregnancy body mass index. The following figures will give you a fair idea of the ideal weight gain:

Pre Pregnancy BMI Total weight gain at term
Underweight
(<18.5 kg/m2)
17-25 kg
Normal weight
(18.5-24.9 kg/m2)
17-25 kg
Overweight
(25.0-29.9 kg/m2)
14-23 kg
Obesity
(>=30.0 kg/m2)
11-19 kg

Mind the calories

To be able to gain or restrict the amount of weight you gain throughout your pregnancy, you need to be aware of the calories that you get from the food you eat. A pregnant woman with a single baby needs about 300 Kcal in addition to her daily requirement of calories. On the other hand, experts recommend that a woman with twins needs an extra 600-1000 Kcal per day. Frequent and healthy snacks can help you meet your calorie requirements.

Remember these –

i) About 60 percent of your daily energy requirements must come from carbohydrates.

ii) Choose complex carbohydrates, which in addition to ensuring slow release of sugar, will also give you fibre that helps in pregnancy-related constipation. Foods made from whole fruits, vegetables, green leafy vegetables, whole wheat, unpolished brown rice, jowar, bajra, millets like ragi and little millet, are great choices for complex carbs.

iii)Fats also provide energy, but remember these are concentrated sources of calories, so keep track of them. A teaspoonful of fat (about 5 g) gives about 40 Kcal. So, it is important that you choose the good fat that you get from walnuts, sesame seeds, almonds, and avocados.

iv) Avoid vanaspathi and margarine and don’t reuse oil that has been used for deep frying. Butter and ghee are good options to use but moderately. All this talk about fat and calories doesn’t mean you should completely stay away from fats. Remember that fat-soluble vitamins like vitamin A, D, E and K need fat for absorption and these nutrients are very important for your baby’s growth.

v) Fat is also essential for the formation of your baby’s brain cells. This is just one example of how fats are utilized, so don’t skimp on them, but at the same time, don’t go overboard.

Building blocks:

Protein power

Protein, iron and folic acid are the building blocks of your baby’s skeletal, muscle and brain systems. They also provide the building blocks for the additional blood formation that you require.

Additional protein is extremely important in order to reduce and prevent the complications of preeclampsia, gestational diabetes and preterm labour, which are more common in twin pregnancies rather than in single pregnancies. However, it is best if you check with your doctor as to how much protein you need to eat. Whatever amount is needed, make sure that you choose protein sources, which are healthy and not rich in saturated fats. Chicken without the skin, lean meats, egg whites, low-fat milk, paneer, pulses, green peas, sprouts are good sources of protein. A nifty way of increasing protein in your diet without increasing the quantity is adding a couple of teaspoons of skimmed milk powder to your porridge or smoothie.

Pump up the iron

Iron is another important nutrient during pregnancy. The Indian Council of Medical Research recommends about 35 mg per day for pregnant women. Typically, your doctor will add an iron supplement of the appropriate dosage to your diet, keeping in mind your specific requirements. However, these can cause nausea and constipation, so remember to eat it with a meal. Iron is also more easily absorbed if paired with a protein-rich meal or vitamin C-rich meal or acidic foods like curd. On the other hand, caffeine blocks iron absorption. Apart from iron supplements, don’t forget to consume iron-rich green leafy vegetables. These provide fibre which helps in reducing constipation.

Load up on the folate

Folic acid, apart from helping in the neural tube and brain development of the baby, helps increase the birth weight. This is of extreme importance in twin pregnancies. Folate supplements (about 0.5 mg per day) are always part of the mother’s diet but ensure that you also include foods that are natural sources of folate. Green leafy vegetables, dals, nuts and organ meat like liver are good sources of folic acid.

Don’t forget Calcium

Another important nutrient is calcium as it aids in the proper formation of bones and teeth of the unborn child. It also helps in the secretion of calcium-rich breast milk during breastfeeding. Similarly, iodine and vitamin A, B 12 and C are important nutrients. To ensure that you get all the nutrients, eat a varied diet that covers all the food groups.

Banish the salt

Twin pregnancies come with an increased risk of preeclampsia; a condition in which the mother has increased blood pressure, protein in the urine (which is detected by urine analysis), and more swelling in the legs than is normal during pregnancy. This doesn’t mean you cannot do anything about it.

Lots of pregnant women with twins or triplets carry their delivery to term without any complications. It means that you have to be careful about avoiding certain foods that can contribute to preeclampsia, such as foods high in sodium or salt. So, avoid the papads, namkeens, pickles and the chaat masala.

Eat salads without salt or the salad dressing. Remember it’s not just the salt that is visible that needs to be avoided but also the hidden salt that comes with certain foods. For example, most packaged foods contain preservatives which are sodium-based. Ketchups, salad dressings, cheese spreads, readymade sauces, fast foods, ready-to-eat noodles and microwavable snack items are rich in sodium.

Stay hydrated with H2O

Dehydration is one of the main causes of preterm labour. In India, when it is almost always hot through the year, make sure you drink up. Plenty of fluids, including 8 to 10 glasses of water a day, will keep you hydrated and meet your fluid requirements.

You will know that you are well-hydrated if you have to take frequent trips to the bathroom and your urine is very pale in colour. Try and drink water between mealtimes so that it doesn’t compete with solids for the space in your tummy. Keeping a water alarm on your smartphone every two hours or so can help you remember to drink up. Thin buttermilk, coconut water, flavoured water, vegetable and fruit infused water and diluted fresh fruit juices are all tasty ways to meet water requirements.