Anemia and Iron
During pregnancy it is especially important to provide your body with adequate nutrition to promote healthy growth for you and your baby. Iron is a common metallic element that the body uses to make hemoglobin. Hemoglobin carries oxygen from our lungs to all the cells in our body, and then carries the carbon dioxide away.
During pregnancy iron needs are high as a result of:
- Pregnant woman have increased blood volumes (40-50%),
- The baby is developing its own blood supply,
- The placenta and uterus are growing rapidly,
- In preparation for blood loss at the time of delivery.
Anemia is a condition in which there is a reduced rate of hemoglobin in the blood. Iron-deficient anemia is by far the most common problem seen in pregnancy. First trimester nausea and vomiting often contribute to this condition. Anemia has been associated with low birth weight babies, pre-term birth, and infection. Blood tests are done routinely in pregnancy and anemia is diagnosed if:
- Hemoglobin concentration is low (less than 114 g/L in 1st and 2nd trimester),
- The hematocrit (concentration of red blood cells in the blood) value is 30% or less,
- Examined red blood cells are pale and/or an unusual size.
Symptoms of Anemia
Women who are anemic often feel tired, have low energy, and have pale skin. Anemia can also cause a person to feel lightheaded, have shortness of breath, or experience heart palpitations. Often a woman is unaware she is anemic until blood results are reported by the lab. When anemia is severe there can be unusual cravings for non-food substances like clay, ice, and paper products. This condition is called pica. If iron deficiency anemia is diagnosed, treatment is centered on increasing iron in the diet.
Proper Nutrition is Key
The current daily recommended dietary allowance (RDA) for iron is 27 mg/day during pregnancy and 9mg when breastfeeding. Within 3-4 weeks of treatment a woman’s hemoglobin levels should improve. Anemia can be caused by several other disorders including blood loss, infection, inflammation, and hereditary factors such as Thalassemia or Sickle Cell Anemia. A less common nutritional anemia is caused by a deficiency of folate or B12, sometimes seen with vegan diets.
Iron Sources and Absorption
There are two types of iron sources: animal-sourced (heme iron) and plant-sourced (non-heme iron).
Women who choose to eat meat will be getting heme iron which is easily absorbed into the body. Iron is highly available in red meats and meat eaters are less likely to be anemic. It is wise to limit organ meats especially those with a high concentration of Vitamin A (liver).
Non-heme iron is not as easily absorbed into the body. Some good sources of non-heme iron are leafy greens such as broccoli and kale, whole or enriched grains, raisins, nuts, seeds, dried beans, and other black colored foods like molasses. Non-heme iron should be taken with citrus or vitamin C (orange juice) to help with its absorption. Cooking foods in a cast iron pan is an effective way to get iron into your diet.
Calcium (contained in milk products), coffee, and tea should not be eaten with iron rich foods because it can block the absorption of iron.
There are two iron compounds (ferrous sulfate and ferrous fumarate) that can be easily purchased. These supplements should be discussed with your midwife prior to purchase. It is important to know that supplemental irons often contribute to nausea and constipation. When iron is taken with meals it will decrease the side effects.
Floridix is a fruity liquid product found in health food stores and is often a preferred supplement. Always store iron safely as iron poisoning is a leading cause of accidental death in children. Iron pills often look like candy.