10 Foods to Avoid in a Twin Pregnancy (and What to Eat Instead)

Expecting twins means your nutrition matters more than ever. You’re growing two babies at once, which means your body has higher nutrient needs and a greater demand for safe, wholesome food choices. While it can feel overwhelming to navigate all the “do’s and don’ts,” knowing which foods to limit or avoid can help keep you and your babies healthy. Keep reading to learn 10 high-risk foods to avoid during a twin pregnancy (plus what to eat instead)!

Expecting twins means your nutrition matters more than ever. You’re growing two babies at once, which means your body has higher nutrient needs and a greater demand for safe, wholesome food choices. While it can feel overwhelming to navigate all the “do’s and don’ts,” knowing which foods to limit or avoid can help keep you and your babies healthy. Here are 10 foods to avoid during a twin pregnancy (plus what to eat instead).

1. Deli Meat

Cold cuts and lunch meats may carry Listeria, a harmful bacteria that can cause serious pregnancy complications. Although the risk is rare, pregnant women are about 18 times more likely to develop listeriosis than non-pregnant women.

Safer swap: Choose freshly cooked chicken, turkey, or beef slices. If you really want deli meat, heat it until steaming hot to reduce the risk.

2. Prepackaged Fruits & Vegetables

Fruits and vegetables are essential in pregnancy, but ready-to-eat salads or pre-cut produce can harbor bacteria if not stored or handled properly.

Safer swap: Buy whole fruits and veggies and wash them thoroughly at home. Prepping your own produce is the safest option.

3. High-Mercury Seafood

Fish like king mackerel, shark, swordfish, and tilefish contain high levels of mercury, which can negatively affect your babies’ brain development. While high-mercury fish should be avoided, low-mercury seafood is encouraged. Omega-3s found in seafood (especially DHA) are true pregnancy superfoods. Eating low-mercury seafood regularly may help reduce the risk of preterm birth, support fetal cognitive development, and even lower the risk of postpartum depression. Read my other blog post “Is Seafood Safe to Eat During Pregnancy?” here for a a full breakdown on how to choose the best options.

Safer swap: Choose low-mercury fish such as salmon, sardines, tilapia and shrimp.

4. Sushi

Sushi made with raw seafood increases your risk of foodborne illness during pregnancy. It’s also best to avoid sushi made with high-mercury fish such as swordfish, shark, ahi tuna and eel.

Safer swap: Cooked sushi rolls (like shrimp tempura or California rolls) can satisfy the craving without the risk.

5. Raw Eggs

Uncooked or undercooked eggs may contain Salmonella. This includes homemade Caesar dressing, cookie dough, hollandaise sauce and runny eggs like sunny side up.

Safer swap: Many premade sauces and carton egg products use pasteurized eggs (always check the label). Fully cooked eggs are completely safe and highly recommended in pregnancy because they’re a rich source of choline, a nutrient that supports fetal brain development and helps reduce the risk of birth defects.

6. Unpasteurized Dairy

Soft cheeses, raw milk and unpasteurized yogurt may contain harmful bacteria that can pose serious health risks in pregnancy. It’s best to avoid all soft cheeses like blue cheese, brie, camembert, goat cheese, queso fresco, and queso blanco even if they are labeled as pasteurized due to the high moisture content that can cause bacteria growth even after pasteurization. 

Safer swap: Stick to pasteurized dairy products and hard cheeses. You’ll still get the calcium and protein your twins need without the risk.

7. Artificial Sweeteners

Some sugar substitutes, like saccharin, are not recommended in pregnancy. Others may negatively affect gut health, dysregulate appetite in mom and result in stronger sweet preferences in your babies later in life.

Safer swap: Use small amounts of natural sweeteners such as honey, maple syrup or fruit purées when you want a touch of sweetness.

8. Greens Powders

Many greens powders are not regulated for safety during pregnancy and may contain herbs or additives that aren’t recommended for expecting moms. 

Safer swap: Blend a nutrient-rich smoothie with spinach, kale, frozen fruit, and Greek yogurt for a safe and satisfying boost of vitamins and minerals.

9. Energy Drinks

Energy drinks are high in caffeine and often contain herbs or stimulants that are unsafe in pregnancy. Excess caffeine may increase the risk of low birth weight, poor fetal growth and even preterm labor (especially in a twin pregnancy).

Safer swap: Stick to water, sparkling water, or small amounts of coffee or tea (aim for under 200 mg caffeine daily).

10. Unpasteurized Juice

Unpasteurized juice, cider, and kombucha can carry bacteria just like unpasteurized dairy. These can cause foodborne illness, which is especially risky in a twin pregnancy.

Safer swap: Choose pasteurized juices or make fresh juice at home and drink it right away.

Key Takeaway

When you’re pregnant with twins, it’s not just about eating enough, it’s about eating safely. Avoiding these 10 foods helps protect you and your babies, while choosing safe, nutrient-dense alternatives ensures you’re getting the fuel you need for a healthy pregnancy.

Want more guidance on what to eat during a twin pregnancy? Download my free Twin Pregnancy Nutrition Checklist & Tracker Bundle to stay on top of your meals and nutrients week by week.