Eating for two, three, four…

Being pregnant means you have to start thinking, acting and eating for two! For your own health and the one of your baby, you should watch what you eat and try eating better than ever. Carrying a life inside you is a big responsibility... imagine carrying twins, triplets, quadruplets... you'd have to eat for 3, 4, 5 people!

Weight gain

Each woman is unique and each pregnancy is unique. There are still some general recommendations concerning many aspects of pregnancy, such as weight gain.

Health Canada recently adopted the recommendations of the American Institute of Medicine about weight gain during pregnancy. It is an update of the guidelines that dated back to 1990. Among other things, they take into consideration the increasing number of overweight women, but also the growing number of twin pregnancies.

The following weight gains, according to your BMI* before pregnancy are deemed optimal both for the baby – or babies – and for the mother.

Weight category (BMI)

Weight gain

Simple pregnancy

Weight gain

Twin pregnancy

Underweight (<18,5)

12,5 to 18 kg (28-40 lbs.)


Normal weight (18,5-24,9)

11,5 to 16 kg (25-35 lbs.)

17 to 25 kg (37-54 lbs.)

Overweight (25,0-29,9)

7 to 11,5 kg (15-25 lbs.)

14 to 23 kg (31-50 lbs.)

Obesity (≥30,0)

5 to 9 kg (11-20 lbs.)

11 to 19 kg (25-42 lbs.)

*BMI: Body Mass Index = weight (kg)/height (m2)

During pregnancy, your weight gain is divided between the fetus, placenta, fat stores, increasing blood volume, amniotic fluid, etc. This is why a woman pregnant with twins does not gain twice as much weight as a woman pregnant with only one child. And, for women expecting three children or more, there is not enough data to establish a desirable weight gain.

The risks of being overweight and diets

The new guidelines also stress the importance of meeting a nutritionist before getting pregnant, especially if you are overweight or obese. Since being overweight is related to risks of preeclampsia, gestational diabetes and childhood obesity, women are told to begin pregnancy with a weight closer to normal. That being said, all women would benefit from personalized advice!

One thing to remember is that it is not recommended to go on a diet once you are pregnant. Dietary restrictions could deprive the fetus or fetuses of nutrients that are essential for their development. It seems that diets would be downright dangerous because fat loss generates toxic wastes in the brain of an immature fetus'.

Calories, calories, and more calories!

During the first trimester is when pregnant women are most tired. However, your energetic needs do not increase. At most, a glass of milk is enough to meet the shortfall of one hundred calories. Add a fruit if you are carrying twins.

According to the Institute of Medicine, during your second trimester, your energetic needs increase to 340 calories per day. It represents an orange, half a peanut butter sandwich and a glass of milk.

In your third trimester, the growth of the baby happens very fast and your energetic needs increase to 450 calories per day, the equivalent of 20 grapes (125 ml or half a cup) as a morning snack, 60 ml (1/4 cup) of nuts in the afternoon and a big glass of milk in the evening.

If you are carrying multiple babies (twins, triplets, quadruplets...), add 300 kcal each day for every additional baby.

The best indicator to ensure an adequate energy intake is the weight gain and the rate of progression of weight. Medical follow-ups allow, among other things, to follow the curve of weight gain and to adjust the diet as needed.

Eat more, yes, but not just anything. Quality matters as much as quantity. Babies do not develop only with calories but also with vitamins, minerals, good fats, proteins, etc. Opt for nutritious foods while eating an occasional treat.

As the fetuses grow you find it difficult to eat enough. Your belly says there's no more vacancy! To cover your needs, feel free to eat smaller meals more often. There is nothing wrong with eating six times a day. On the contrary, you and your baby will only feel better!

Eating enough will help your children develop optimally and will help you keep your energy reserves. If you think you need a lot of energy during pregnancy, it is nothing compared to the energy you will need later to take care of your kids!


Extenso is the nutrition web reference from the University of Montreal’s NutriUM Centre universitaire de nutrition préventive. Extenso’s mission is to raise public awareness on better nutritional health through an objective interpretation and effective circulation of current scientific knowledge about nutrition.

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