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Twin Pregnancy and Third Trimester Nutrition

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Keeping up with the nutritional needs of twin babies can be a struggle in the last three months of pregnancy. While being told you need to eat more might sound like a dream come true, it isn't always easy to fulfill that requirement when you're carrying two rapidly growing babies who are squashing your stomach and intestines, making it hard to eat. It's also especially important to make healthy food choices to make every calorie count toward your good health and your babies'.

Getting Enough Calories

Getting enough calories will help your babies grow to their optimal size. Twins often weigh less than singletons of the same gestational age simply because they have to share the nutritional bounty with their sibling. You can counteract low birth weight -- which can cause health complications for twin newborns -- by consuming additional calories, starting in the second trimester and continuing through the third. Recommendations for calorie intake when carrying twins vary. Some experts recommend consuming an additional 600 calories per day over your normal intake, but others recommend higher amounts, 40 to 45 calories for every 2.2 pounds that you weigh or between 3,000 to 3,500 calories per day if you're normal weight before pregnancy. Obese women should eat between 2,700 to 3,000 calories per day.

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Protein Intake

Pregnant women normally need around 60 grams of protein per day, but if you're carrying twins, you need to greatly increase your intake so you can support the third trimester growth of two little bodies. Experts recommend anywhere from 100 to 175 grams of protein a day in the last three months of twin pregnancy. To meet this protein intake requirement, eat 7 or 8 ounces of high-protein foods, such as meat, poultry or fish, plus four-to-six servings of dairy foods such as milk or cheese daily.

Calcium Needs

Increasing your dairy intake will also help you meet your increased need for calcium, which helps build strong bones and teeth -- yours and your babies'. The Piedmont OB/GYN Group in Greenville, South Carolina, recommends getting 2,500 milligrams of calcium per day in the third trimester of pregnancy, double the recommended dose of calcium for non-pregnant women. Ask your doctor for his recommendations on calcium intake. Dairy products and leafy green vegetables can up your calcium intake. Your body can only absorb around 500 mg of calcium at one time, so divide your daily doses into two or three parts if you take supplements to meet your needs.

RELATED: Your Pregnancy Eat-out Guide

Meeting Your Iron Requirements

In the third trimester, your iron stores provide your babies with the iron they need after birth. Your blood volume may double to meet both babies' needs as well as your own. Unless you increase your iron intake, you will likely develop anemia because the available red blood cells, which carry oxygen, are diluted by the increased volume. Iron-rich heme foods include meat, poultry and fish; heme -- which means blood -- sources of iron are better absorbed than non-heme sources found in whole grains, legumes, nuts and other non-heme foods. Eating foods high in vitamin C along with grains and vegetables high in iron can also increase absorption. The Piedmont OB/GYN group recommends taking two 30 mg iron tablets daily in the third trimester to meet your needs.


Twins take up a disproportionate amount of abdominal space. This leaves less room for stomach expansion, so you don't feel like eating very much at one time. Your intestines are also cramped and sluggish, meaning you're prone to constipation, which might also decrease your appetite. Eating small amounts of high-quality food at frequent intervals might be the only way to meet your nutritional needs in the third trimester. Don't waste calories on non-nourishing foods such as sweets. To ensure that you meet your nutritional needs, your doctor might suggest taking additional supplements beyond the usual prenatal vitamins.

Suzanne Robin is a registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology. She also has extensive experience working in home health with developmentally delayed or medically fragile children. Robin received her RN degree from Western Oklahoma State College. She has coauthored and edited numerous books for the Wiley "Dummies" series.

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