Iron is an essential mineral that has many uses in our body. One of the most important one is that it forms part of the haemoglobin (which in turn forms red blood cells) which carry oxygen to our cells. Anaemia is a deficiency in haemoglobin, which can be due to a number of reasons, one of which is caused by low iron.
Iron deficiency anaemia is very common in pregnancy. Your body has to make almost 50% more blood while you’re pregnant to circulate through the placenta and around the body, and therefore your iron requirements also increase. Anaemia doesn’t always cause symptoms but can leave you feeling tired, breathless, weak, and dizzy. It is diagnosed via a blood test checking your haemoglobin level (less than 110g/l is considered low). In the UK, this is normally done at your first consultation, at 28 weeks, and repeated at 36 weeks if it was low at the last sample.
Studies have shown that anaemia increases the risk of preterm birth and low birth weight babies, as well as the risk of bleeding, impaired cognitive and immune function in the mother. Babies born to anaemic mothers are also more likely to become anaemic in childhood, which can negatively affect their cognitive development and growth. On the other hand, haemoglobin levels greater than 132g/l at 32-36 weeks are associated with premature birth and increased blood pressure; so supplement carefully.
Iron is renowned for being difficult to absorb as many things interfere with its absorption, such as calcium, phytates (found in whole grains, legumes, nuts and seeds), and polyphenols (antioxidants found in plants). Therefore supplementation can take up to 6 weeks to take effect. There are two types of dietary iron: heme and nonheme. Heme iron is present in red meat, poultry and seafood. Plants and fortified foods contain nonheme iron. Heme iron has a greater bioavailability than nonheme iron; in order words, you absorb iron better when it comes from meat and seafood than if it comes from vegetables or pulses. On the bright side, many fruits and vegetables contain Vitamin C, which enhances the bioavailability of iron, and overcomes the inhibiting effect of phytates, polyphenols and calcium. Thus, vegetables and pulses still play an important role in maintaining healthy iron stores.
So how do you make sure that you maintain adequate iron levels throughout your pregnancy?
Ideally you’d be reading this before you have conceived, in which case I’d advise you to check your haemoglobin levels with your GP and ensure they are 120g/l or above, as getting them up during pregnancy is even harder. If they aren’t, the below guidelines are just as applicable before, during and after pregnancy.
MAINTAIN AN IRON RICH DIET
Ensure you consume lots of the following foods high in iron:
-White beans, kidney beans, chickpeas, lentils
-Dark green leafy vegetables: spinach, kale, dandelion greens, beet greens, swiss chard, turnip greens
-Pumpkin seeds, cashews
-Apricots, raisins, persimmons, mulberries, dates, prunes, pomegranates, figs, watermelon
-Beef, chicken, oysters, sardines, tuna, clams, mussels
EAT IRON RICH FOODS WITH:
-Fruits high in vitamin C (citrus fruits, kiwi, guava, papaya, pineapple, berries, mango, lychee, tomato)
-Vegetables high in vitamin C (sweet peppers, dark leafy greens, cauliflower, broccoli, brussel sprouts, kohlrabi, cabbage, bok choi, asparagus, sweet potato, snow peas, herbs)
-Rose hip tea (made with fresh or dried rose hips, washed, and simmered for 15 minutes)
*Fruits and vegetables are best eaten raw or very lightly cooked as vitamin C is heat sensitive and can be destroyed during the cooking process
*Avoid cooking these vegetables in aluminium pots or with aluminium utensils as this will also destroy the vitamin C
AVOID the following foods within TWO hours of eating an iron rich meal or taking iron supplements:
-Black, green or herbal teas
If your prone to anaemia, or if you haemoglobin is borderline low but not enough for you to need supplements, there are over the counter liquid iron supplements such as floradix or spatone. These are often quite well tolerated and don’t cause as many side effects as the tablets. However they are also not as concentrated and will therefore take a bit longer to increase your iron stores.
If you are taking iron supplements, be sure to follow the guidelines above and take these with vitamin C, plenty of water and fibre rich foods to avoid constipation. If the tablets make you feel nauseous, try taking them at night just before you go to bed so that you can sleep through the nausea. In addition to the supplements, you should still be eating iron rich foods.
Good luck and I hope these suggestions help!