Pregnancy Health: Weight Gain When Carrying Twins

Information on normal weight gain when carrying twins and what to expect in body changes. Also included are health and nutrition guidelines.

Healthy weight gain is important for all pregnancies, but is especially important for women expecting twins. Proper weight gain and good nutrition during pregnancy can prevent premature labor and birth, as well as low birthrates, which affect as many as 50% of twin pregnancies.

Weight gain during pregnancy is the body's way of preparing for birth. The physiological changes that occur such as a 50% increase in blood volume, expansion of the uterus, increased breast size, water and fluid retention, accumulation of fat stored in the body in preparation for breastfeeding, as well as the weight of two babies, two placentas, and amniotic fluid, all contribute to the number of pounds gained during a twin pregnancy.

Until recently few studies had examined weight gain in women carrying twins. Conventional advice suggested gaining 35 to 40 pounds, about 10 pounds more than for a singleton pregnancy. Current research however, indicates that optimal weight gain may be as much as 40 to 50 pounds, although height, pre-pregnancy weight, and body type also play a role in the amount of weight a woman pregnant with twins should gain.


In addition, the pattern of weight gain appears to be more important than the total number of pounds gained. Twins are considered full-term at 36-37 weeks gestation and their development follows a slightly different schedule than that of singletons.

Average weight gain in the first trimester for women carrying twins is 5 pounds. Many women experience severe and prolonged morning sickness when pregnant with twins and do not gain any weight and some women even lose weight. A woman who is heavier pre-pregnancy may not gain any weight either. If the woman is thin, she may experience a weight gain of 10 to 15 pounds to "fatten" her up.

The period between 20-28 weeks gestation is the most significant period of growth for twins. Maternal weight gain during this period is critical. The rule of thumb is to gain 24 pounds by 24 weeks. A woman carrying twins often experiences constant hunger day and night throughout the pregnancy and it is usually not difficult to gain weight once morning sickness has subsided.

Between 28 and 36 weeks gestation the development of twins slows down simply because there is less room for them to grow. Maternal weight gain also slows down. Because of the expanding uterus, there is very little room to eat conventional size meals - especially when combined with drinking the two gallons of water every day necessary to prevent dehydration and pre-term labor.

While a normal diet of 2000 calories consists of approximately 30% fats, 50% carbohydrates and 20% protein, women carrying twins should increase caloric intake to as much as 2700 to 3500 calories per day, as well as increase fats to 40%, and decrease carbohydrates to 40% of the diet. Protein remains the same at 20% of total diet. If necessary, consult with a dietician to get foods with the best nutritional value into your diet.

In other words, go for the cheeseburger, but skip the fries. And forget about portion control - it is not uncommon for many women carrying twins to eat an 8-ounce steak every night for dinner during the last trimester of pregnancy. Eat frequently throughout the day and prepare snacks ahead of time for those middle-of-the night hunger pangs. Not eating frequently enough may cause blood sugar to drop and increase the likelihood of fainting. Snacks should be high in protein, such as peanut butter, cheese, eggs, nuts, yogurt, and protein bars or shakes.

Weight gain through sound nutritional practices is one of the few things a pregnant woman has control over. It's the least she can do to give her babies a healthy start on life.

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