As the mama-to-be of multiples, you'll need to approach pregnancy weight gain differently than moms of singletons. Gaining the recommended amount can help you avoid certain complications during your pregnancy as well as postpartum complications. It lowers the risk of your babies being born low birth weight or premature and reduces the chance they'll need to stay in the neonatal intensive care unit (NICU).
But just how much should you plan to gain? It depends on a number of factors — including how many babies you're expecting and how much you weighed at the start of your pregnancy. Your practitioner will come up with recommendations tailored specific to you, but here’s an overview of the guidelines.
How much weight to gain in a twin pregnancy
One factor that plays into pregnancy weight gain recommendations is body mass index (BMI), a number calculated using your height and pre-pregnancy weight. (Use this National Institutes of Health BMI calculator to compute yours.)
BMI numbers correspond with different categories:
- Underweight: <18.5
- Normal: 5 to 24.9
- Overweight: 25 to 29.9
- Obese: 30 or greater
Most practitioners advise women who start their twin pregnancy at a normal BMI to gain 37 to 54 pounds. You should gain a little more (between 50 and 62 pounds) if you were underweight and a little less (between 31 and 50 pounds) if you were overweight. If you have a body mass index of 30 or greater, experts generally recommend gaining 25 to 42 pounds.
That's nearly 50% more than what's recommended in a singleton pregnancy (talk about heavy lifting!).
"I only gained about 25 pounds in my entire first pregnancy, so I was super shocked at how much I gained so quickly with the twins," says What to Expect Community mom Laur-0-saurus. "I was up 13 pounds at 11 weeks."
Community mom Mrspfc had a similar experience: "I gained 16 pounds with my 7-pound, 1-ounce singleton and I’m at about 26 pounds with my 31 weekers," she says.
Gaining pregnancy weight can feel challenging and sometimes scary, but remember that it's only temporary. Dropping 30 pounds within a couple of weeks after delivering twins is not uncommon. All that excess fluid (extra blood volume, amniotic fluid, and water weight) — not to mention the weight of your babies themselves — goes away rather quickly after birth. Studies show that among twin moms with appropriate weight gain, most weigh only 5 to 8 pounds above their pre-pregnancy weight six to eight weeks after delivery.
"I gained 50 pounds!" says What to Expect Community mom jossieb-27. "I had my twins and two weeks later I was back to exactly what I was before getting pregnant, with no exercise or diet."
"I'm just telling myself that weight gain is inevitable and a necessary part of this," says Community member NCmomtobe2018.
Expecting more than one baby? The What to Expect app helps you track weight gain, nutrition, and growth, plus offers expert tips and advice from other parents of multiples.
How much weight to gain in a multiples pregnancy
If you’re pregnant with triplets or a higher order of multiples, your health care team will come up with personalized recommendations for you. According to the American College of Obstetricians and Gynecologists (ACOG) and Institute of Medicine (IOM), there just isn’t enough data to issue guidelines for these types of pregnancies.
Twin pregnancy weight gain chart
Here's what to aim for depending on your starting weight. Expecting triplets or more? Take these numbers as rough estimates. Your doctor will help you determine the right amount of weight gain for you.
How much weight to gain each trimester in a twin pregnancy
Does this mean that if your practitioner has advised you to gain 35 pounds, and a full-term twin pregnancy is 37 weeks to 38 weeks, you should aim to gain about a pound a week? Ah, if only it were that simple.
The fact is that in a multiple pregnancy, each trimester presents its own challenges. Here's what they are and what you should aim for:
First trimester
Your primary weight-gain challenge now may be nausea. You have nearly double the pregnancy hormones that make singleton expectant moms queasy, so it's possible you'll have more intense morning sickness (and it's more likely it will last all day).
The good news: For some women, eating small amounts of food can actually help calm the stomach. If you're one of the lucky ones, try to make the healthiest choices possible while working around cravings and nausea, and aim to gain about a pound a week through the first trimester.
If you aren't so lucky, try not to worry. You can catch up later. Just be sure to take your prenatal vitamin and sip fluids so you don't get dehydrated. Tell your practitioner if you can't keep any food or liquid down, and ask about switching your prenatal vitamin if it makes you sick.
"I was so sick for the first 18 weeks of my twin pregnancy that just eating whatever I could keep down was priority, says Community member rbb5640. "After 18/19 weeks, I started feeling better and then ate like a monster lol. Twin pregnancy is hard!"
Second trimester
If you're lucky, your nausea will have eased around the 12-week mark. (For some, it's more like week 16 or even week 20.)
Women pregnant with multiples should eat around 300 extra calories per baby per day, so now's your chance to really load up on the nutrition your growing babies need.
If you gained no weight during the first trimester (or if you lost weight due to your nausea and vomiting), your practitioner may suggest gaining 1½ to 2 pounds per week during your second trimester. (If you've been gaining steadily through the first trimester, aim for 1½ pounds a week.)
If you need to catch up, it's time to supercharge your pregnancy diet with extra servings of protein, calcium, and whole grains. Whole milk (with powdered milk mixed in, for an extra calcium kick), cottage cheese, beef, and turkey are good options to get the nutrients you need.
"I gained nothing first trimester," says Community member laoko. "37 weeks now and up 47 pounds, which is great, per my OB. Most of that was second trimester."
Third trimester
Your goal in your third trimester is to continue gaining 1½ to 2 pounds per week through your seventh month. By 32 weeks, your twins may weigh about 4 pounds each. Think about it: That's 8 pounds of babies alone, which is as much baby weight as many moms of singletons carry to term.
That doesn't leave much room for food, which is why heartburn and indigestion are all too common in the final stretch of multiple pregnancies.
But don't give up on your healthy eating plan. Your babies are really growing now, and they need the nutrients a well-balanced diet provides.
Expect to gain a pound a week or less in the eighth month, and just a pound or so total during the ninth. (This makes more sense when you remember that most multiple pregnancies don't make it to 40 weeks.)
Weight gain with multiples is different from weight gain with a single baby, but it doesn't have to be complicated. If you're unsure how much weight you should put on — or how to go about doing it — talk with your doctor. You may also be referred to a dietitian or advised to use nutritional supplementation for extra support. Your practitioner can help guide you toward steady, healthy weight gain throughout pregnancy.
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