If you’re pregnant with twins, you’re probably doubling up on a lot of things: two cribs, two carseats, two highchairs, and a double stroller. But should you double up on the prenatal?

 

By Dr. Nazaneen Homaifar

As a twin mom, I understand the great joys—and unique challenges—that come along with bringing two babies into the world at once. If you’re pregnant with twins, you’re probably doubling up on a lot of things: two cribs, two carseats, two highchairs, and a double stroller. But should you double up on the prenatal vitamin?
It sounds logical, but the answer is no. We do not recommend just taking a double dose of your prenatal routine. In fact, increased amounts of certain ingredients in a prenatal can be dangerous for both you and the babies. 

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What prenatal and supplements to take if pregnant with twins

In general, doctors recommend increased folate intake with twins. Demands for folate increase during pregnancy because it is required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (neural tube defects). For pregnant women, the recommended daily dose is 600-1000 micrograms (mcg). For women pregnant with twins, the dosage increases to 1,000 mcg a day. 

There are many other micronutrients needed to optimize fetal growth and development and reduce the risk of obstetric complications (like intrauterine growth restriction and preterm labor). Though it hasn’t been possible to conduct rigorous studies, experts have made the following recommendations for daily dietary intake for these key micronutrients

  • Calcium:  2,000 – 2,500 mg
  • Vitamin D: 1,000 international units 
  • Vitamin C: 500 –1,000 mg
  • Vitamin E: 400 micrograms 
  • Zinc: 14 – 45 mg
  • Magnesium:  350–1000 mg
  • Iron: 30mg elemental iron for non-anemic women
  • Folic acid: 1000 mcg 
  • DHA/EPA (docosahexaenoic acid/eicosapentaenoic acid): 300-500mg

Please talk to your doctor about the recommended values. If you have a history of seizures and are on anticonvulsants, or if you have a history of a baby affected by a neural tube defect, talk to your doctor about increased folic acid intake.

Weight gain with twins

And while we’re at it, let’s quickly review the recommended weight gain in twin pregnancy. The most important thing to know is that your weight gain will depend on how much you weigh at the start of your pregnancy. People who are in the “normal” weight range (body mass index of 18.5-24.9 kg/m2), are recommended to consume 3,000-5,000 calories per day. The Institute of Medicine recommends weight gain of 16.8-24.5 kg (37-54 lb) for women of normal weight, 14.1-22.7 kg (31-50 lb) for overweight women, and 11.3-19.1kg (25-42 lb) for obese women. 

Learn more about prenatal vitamins, including how to find the best one for you, here.