Eating a good balanced diet is important in any pregnancy but is even more so in a twin pregnancy. Good nutrition not only ensures your babies get the best possible start in life but it may also help lower your risk of complications.

The following chart is the diet recommended to the author at antenatal class by educator Carolyn Sutcliffe

Cereals/breads 6+ serves or more per day

Fruit/vegetables 5+ serves or more per day

Dairy 5+ serves per day

Meat/fish/eggs 3+ serves per day

Nuts/seeds 1 serve per day

Oils/fats 1 or 2 tbsp per day

The average weight gain in a twin pregnancy is 18-22kg (25-27kg for a triplet pregnancy). For a healthy pregnancy you should aim for a 4-5kg gain across the first 3 months and then 2 - 2.2kg gain per month thereafter. This is a guide only. Your actual weight gain will depend on many factors including your pre-pregnancy weight. If you have any concerns about your weight or nutrition discuss these with your LMC.

For more information on how healthy eating during pregnancy can help prevent complications please click here to go to the Blue Ribbon Baby site.

Essential Nutrients

Carrying twins or more puts an exceptional strain on your body and as a result your body can quickly become depleted of essential nutrients; this is especially true if you suffer from bad morning sickness. The following nutrients are particularly important for the health of your growing babies.

Folic Acid

Folic acid is very important in early pregnancy and should be taken for the first 12 weeks at least (some research suggests that there may be benefits in taking folate for the duration of the pregnancy). Ideally folic acid should be taken for the 3 months prior to conception as well. Folic acid helps prevent neural tube defects that cause birth defects such as spina bifida etc. All pregnant mothers are advised to take at least 800mcg per day. You should discuss folic acid with your LMC to check whether you need to increase your dose now you are expecting twins.

Folic acid can also be found in the following foods:

• Green leafy vegetables
• Beans and Peas
• Citrus and Kiwifruit
• Fortified foods (Certain cereals and breads)

Note: Folate is very sensitive to heat so foods with folate should be eaten raw or only lightly boiled to ensure maximum nutritional value.

Many mothers report nausea after taking their folic acid in the early stages of pregnancy. If this happens to you try taking your folic acid just as you go to bed as it seems to be better tolerated at this time of day. (anecdotal evidence only!!)

Iron

In twin pregnancy the mother's blood volume increases by about 1,500ml (3 pints). This increase in blood volume means that more iron is required to make sufficient haemoglobin. Iron is also needed by the placentas and foetuses. Insufficient iron can lead to anaemia. The most well known symptom of anaemia is fatigue. However iron-deficiency anaemia in pregnancy is also associated with a higher risk of premature delivery and low birth weight babies. Therefore it is important to include iron-rich foods in your diet.

Iron comes in two forms haeme iron and non-haeme iron. Haeme iron is found in meat, poultry and fish and is the type most readily absorbed by our bodies; red meat is a particularly good source. Non-haeme iron is found in vegetables, legumes and grains. It is also the type of iron most commonly used in fortified foods. Non-haeme iron is not absorbed by the body as efficiently as haeme iron is, so a diet rich in both haeme and non-haeme iron is essential to ensure that you have sufficient iron stores for a multiple pregnancy. Consuming vitamin C at the same time as iron rich foods helps your body absorb iron so try to have fruit with a meal or a glass of orange juice etc. Also try to avoid tea or coffee at meal times as the phenols in these interfere with iron absorption. If you are taking calcium supplements try to take them between meals as they also interfere with iron absorption.

Iron supplementation may not be necessary during the first trimester. However many mothers will require iron tablets in the second or third trimesters. Iron supplements do however have some unfortunate side-effects. Constipation and nausea are perhaps the most common side-effects. To avoid nausea try taking your iron supplements at bedtime, and to lessen the effects of constipation ensure you have a fibre-rich diet.

Calcium

Calcium is essential for your babies' growing bones. Dairy is undoubtedly the best source of calcium. However calcium is also absorbed from canned fish, tofu, selected green vegetable (kale, cabbage, watercress etc), almonds and sesame seeds.

Protein

Protein is essential for the development of all new cells. It is also required by the foetus for growth and cellular development. Poor protein intake during pregnancy may result in low birth weight babies. Animal products such as dairy foods and meat are complete proteins (they contain the 8 essential amino acids our bodies can not produce). Leafy green vegetables, cereals, legumes, grains, beans, broccoli and peas are all sources of incomplete proteins (proteins which are lacking in one or more of the 8 essential amino acids). A good mixture of complete and incomplete proteins in your daily diet will help ensure a sufficient supply of protein for your babies and your own body. Adequate protein intake is particularly important in the second and third trimesters.

Water!!

It is very important to stay hydrated during your pregnancy. Dehydration can trigger Braxton Hicks contractions. ensuring you drink enough water will help to prevent constipation, decrease your chances of bladder infections, and help your body rid itself of toxins and fluids.