Pregnancy can come with many unexpected surprises. Although it’s less common, multiple pregnancies do exist. Naturally, there are approximately one pair of twins born within 250 pregnancies, one set of triplets born within 10,000 pregnancies and one set of quadruplets in every 700,000 pregnancies (1). Like a singleton pregnancy (one baby), being pregnant with multiples requires additional planning and requirements. Continue reading to learn more about the nutrition recommendations for multiples.

Nutrition for Pregnancy With Multiples

A woman’s nutritional status during pregnancy has a big impact on her offspring’s future health. When carrying multiples, you are at more of a risk of (2) :

• • Early Labour
  • Iron Deficiency 
    • Check out our blog post on iron needs during pregnancy.
  • Gestational Diabetes
    • Check out our blog post on Gestational Diabetes.
  • High Blood pressure
  • Severe morning sickness
  • Miscarriage or Stillbirth
  • Postpartum Depression
    • Check out our blog post on Postpartum Depression. 

Once pregnant, nutrition becomes more challenging, which just gets more challenging if you’re carrying more than one baby. Having multiples increases calorie demands and the risk of nutritional deficiencies (3).

As mentioned above, when carrying multiples, you are at risk of preterm labour. Most multiples deliver before 40 weeks of gestation. It’s recommended to gain weight earlier in pregnancy to support the growth and development of the babies and achieve the appropriate weight gain (4&5). To help ensure that you gain an appropriate amount of weight, you should try to consume more protein each day (5). 

Similarly to carrying singletons, with multiples, you must also increase your calorie intake. The chart below offers recommended guidelines for additional calories (6). However, the more babies one is having, the more challenging it can get. We recommend working with your health care team to ensure you are getting the most up-to-date recommendations.

While carrying multiples you should pay extra attention to certain nutrients. Below is a list of some key nutrients, but check out our full blog post on Important Nutrients for Pregnancy.

Important Nutrients for Pregnancy

• • Macronutrients:
    • Protein
  • Carbohydrates
  • Omega-3 Fatty Acids
  • Micronutrients (Minerals):
    • Folate
    • Iron 
    • Choline
  • Micronutrients (Vitamins):
    • Vitamin A
    • Vitamin B12
    • Vitamin D
  • Fluids
    • Around 10 cups
    • Check out our blog post on fluid requirements during pregnancy. 

Additionally, to help promote a healthy pregnancy, a prenatal supplement is recommended. These prenatal supplements are in addition to the food you eat. Supplement recommendations for multiples differ from singleton pregnancies, since additional nutrients are needed for both you and your babies.

Final Notes from The Nest

Pregnancy can be challenging and with more babies comes more challenges. Nutrition is a way to help you navigate such challenges and reduce your risk for additional ones. We strongly recommend working with a Registered Dietitian if you are pregnant with multiples, in order to ensure you are getting the nutrients both you and your babies need! If you’re expecting multiples, reach out to us to book a free call now!

Article Written by Bailey McDonagh

 References

1. Multiple pregnancy and birth: Twins, triplets, and high order Multiples (booklet) [Internet]. Reproductive Facts. American Society for Reproductive Medicine; [cited 2022May28]. Available from: https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/multiple-pregnancy-and-birth-twins-triplets-and-high-order-multiples-booklet/ 
2. Multiple pregnancy (triplets or more) [Internet]. Pregnancy Birth and Baby. Australian Government; [cited 2022May28]. Available from: https://www.pregnancybirthbaby.org.au/multiple-pregnancy 
3. Zgliczynska M, Kosinska-Kaczynska K. Micronutrients in multiple pregnancies—the knowns and unknowns: A systematic review. Nutrients. 2021;13(2):386. https://doi.org/10.3390/nu13020386
4. Steinberg D. Eating for three: What to eat when you’re pregnant with twins [Internet]. Your Health Matters. Sunnybrook; 2019 [cited 2022May28]. Available from: https://health.sunnybrook.ca/women/eating-for-three-weight-twins/ 
5. Nutrition in pregnancy [Internet]. Sunnybrook Hospital. Sunnybrook Health Science Centre; [cited 2022May28]. Available from: https://sunnybrook.ca/content/?page=nutrition-pregnancy 
6. Brazeau-Gravlle P. Obstetrical Health Promotion Nutritional Guidelines for a Multiple Pregnancy. Ottawa: Ottawa Hospital; 2017. 
7. Available from: https://www.ottawahospital.on.ca/en/documents/2017/01/p334english.pdf/
8. Health Canada. Prenatal nutrition guidelines for Health Professionals – Background on Canada’s Food Guide [Internet]. Ottawa: Government of Canada. 2010 [cited 2021 Nov 21]. 7 p. Available from: https://www.canada.ca/en/health-canada/services/publications/food-nutrition/prenatal-nutrition-guidelines-health-professionals-background-canada-food-guide-2009.html
9. Alberta Health Services. Nutrition guidelines for pregnancy [Internet]. Alberta: Alberta Health Services. 2019 [cited 2021 Nov 21]. 54 p. Available from: https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-pregnancy.pdf
10. Mayo Clinic [Internet]. Rochester: Mayo Foundation for Medical Education and Research; c2021 [updated 2019 Dec 19; cited 2021 Nov 21]. Pregnancy diet: Focus on these essential nutrients; [about 3 screens]. Available from: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082