Weight Gain With Twin Pregnancy

Pregnant woman weighing on scale.
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Many women are concerned about the amount of weight they will gain during pregnancy. As you might suspect, a woman who is having multiples will see more of an increase on her scale than if she were only having one baby. It's not just that she's eating more. The extra weight can be attributed not just to the babies' combined weights, but also to extra fluid, tissue, uterine growth, and the increased blood volume needed to supply the placenta(s) with nourishment for two or more babies.

Guidelines for Twin Pregnancy Weight Gain

In 2009, Dr. Barbara Luke introduced new guidelines for weight gain during pregnancy with twins. Dr. Luke is a Michigan State University professor who created the guidelines for the Institute of Medicine based on a research study of more than 2,000 twin pregnancies. It evaluated maternal weight gain and fetal growth to develop models of optimal weight gain based on a woman's pre-pregnancy BMI (Body Mass Index).

Pregnancy Weight Gain Guidelines

If you are pregnant with twins, the amount of weight you should gain will depend on your starting weight.

  • Healthy, normal-weight mothers: 37-54 pounds
  • Overweight mothers: 31-50 pounds
  • Obese mothers: 25-42 pounds

Previous guidelines were developed nearly twenty years ago, and did not take into account the mother's condition prior to pregnancy. The new recommendations, Luke says, "... are the first which are BMI-specific — they are the 25th to 75th percentile of BMI-specific weight gain associated with twin birth weights of 5 pounds 8 ounces or greater at full-term.” It's hoped that the new recommendations will produce babies with optimal birth weight and reduce neonatal morbidity.

Why Weight Gain Is Important

Generally, a healthy pregnancy requires that a woman gain 25 to 35 pounds during the nine-month gestation period. But that's for just one baby. Like everything about having multiples, more is required. In most cases, about a third of the weight belongs to the babies.

Doctor recommendations vary, but most women gain about 35 to 50 pounds during a twin pregnancy, with about 10 additional pounds for every additional baby in a higher order multiple pregnancy.

Although the thought of gaining weight can be daunting, it's vitally important for the health of the babies, and for mom, too. It takes an incredible amount of energy to sustain a twin or multiple pregnancy. Maternal fat stores supply some of that energy, especially in the last trimester, when the babies are taking in every bit of nutrition that mom can ingest. That's why it's important to eat a healthy diet throughout pregnancy, and build up the fat stores to sustain your health in the later months.

Discuss your nutritional needs with your doctor or caregiver, and don't worry about the soaring scale. You've got your babies' best interests at heart.

An informal poll of parents on this site indicated that 75% of moms of multiples who responded gained between 20 and 60 pounds during their pregnancy.

Worried about pregnancy pounds? Find out how to lose weight after your babies are born.

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Article Sources
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  • Luke, B. and Eberlein, T. When You’re Expecting Twins, Triplets or Quads (3rd Edition). New York: HarperCollins Publishers, 2011. Print.
  • “Weight Gain During Pregnancy.“ ACOG.