You probably know that the body is dependent on iron to produce haemoglobin — the protein that helps red blood cells carry oxygen throughout the body. But did you know that being deficient in this mineral can cause your fertility to dwindle and may have serious adverse health effects on your baby? Read on to know more!
Iron needs during pregnancy
As pregnancy progresses, your blood volume will gradually increase and so will your iron needs. According to the British Committee for Standards in Haematology (BCSH), the physiological iron requirements of pregnant women are three times higher compared to those who are menstruating.
However, in the UK, iron supplements are not routinely prescribed during pregnancy. The reason is that iron absorption increases three-fold during the third trimester plus you’re no longer menstruating — no more blood (and thus iron) losses.
So, there’s no need to worry about iron intake during pregnancy?
Unfortunately, you may be iron deficient without even realising it: the WHO estimates that the global prevalence of anaemia among pregnant women is 41.8%.
If you’re planning to conceive, make sure to have a full blood count at least 3 months before trying. That’s because it takes about this much time for the body to build iron reserves.
Here are a few extra reasons why you should aim to correct any iron deficiency before you get pregnant:
Mild or moderate iron deficiency early during pregnancy can severely and permanently impact foetal brain development even though the mother’s iron status is not low enough to cause anaemia. The baby will be at higher risks of delayed growth and brain abnormalities causing slow language learning and comportment issues.
Iron-deficiency anaemia during pregnancy has been linked to increased rates of preterm deliveries, giving birth to low-weight babies as well as increased risks of infant and maternal mortality.
Mild iron deficiency may upset mother/infant relationships — an iron-deficient mother may be less sensitive and emotionally available for her baby. This lack of maternal interest and affection may cause the baby to rely less on the mother for reassurance.
Anaemic mothers are more vulnerable to postpartum depression.
Should you take iron pills then?
You don’t need to unless your GP has given you a prescription. Be careful: taking more iron than your body needs can cause your blood pressure to increase significantly — this could hinder your baby’s growth.
Plus iron pills can have nasty side effects like nausea and constipation.
Are you prone to anaemia? Further blood tests may be warranted
If you think you may be at risk of anaemia — if you’ve had two or more pregnancies close together, if you’ve lost a significant amount of blood recently and if you’re younger than 20 — talk to your doctor about the need for more sensitive blood tests.
Routine blood tests such as haemoglobin and haematocrit levels indicate full blown anaemia and do not give a clear picture of tissue iron stores. To help you catch iron deficiency before it aggravates, a serum ferritin test is recommended — again with your GP’s advice.
What you can do to make sure you have enough iron
Whether you’re taking supplements or not, you should aim to include iron-rich foods at most meals.
There are two types of dietary iron:
Haem iron — Found in animal products like beef, chicken or fish.
Non-haem iron — Found in plant-based products like broccoli, spinach, seeds, nuts, beans and pulses, soybeans and potatoes. Fortified products — such as some commercial juices or breakfast cereals — also contain non-haem iron.
What’s in a name? Well, lots when it comes to dietary iron. You see, haem iron is more bioavailable than non-haem iron. What this means is that our body absorbs and utilises haeme iron much more efficiently compared to iron found in plants. The ‘culprits’ here are the phytate and fibre found in plant cells.
So if you’re not a vegetarian or a vegan, make sure to have some animal protein for breakfast, lunch and dinner. For instance, you can have a chicken sandwich for breakfast, some fish fillet for lunch and a beef steak for dinner.
What if you’re vegan or vegetarian?
Don’t worry: there’s no need to become a beef eater during these nine months. As mentioned, plant foods are also good sources of iron; you simply have to help your body absorb more of this non-haem iron. That’s very easy: simply make sure to include a vitamin C containing food — any fruit or veggie that’s yellow, orange, red or green — when you’re having some ‘plant iron’.
Here are some easy and yummy combos:
Have a kiwi, an orange or half a grapefruit just before your meal;
Mix some tomato salsa (preferably home-made) with your beans;
Liven up your spinach-avocado salad with some strawberries or a mix of yellow, green and red bell peppers;
Have a side of roasted or steamed cauliflower with your lima beans;
Add some chopped carrots and broccoli florets to your macaroni and cheese.
Load up your spaghetti sauce with pureed tomatoes, some chopped carrots and serve with a side of green beans.
Just be creative!
Beware of inhibitors of iron absorption
Besides phytates and fibre, the following will also interfere with iron absorption:
Calcium: Hinders absorption of both haem and non-haem iron;
Caffeine: Found in coffee, tea, colas and chocolate. Adding milk to coffee appears to further decrease iron absorption;
Tannic acids (tannins): Found in tea, tannins can suppress non-haem iron absorption by as much as 50%! Green tea and some herbal teas also appear to have a small inhibiting effect on iron absorption.
Indian spices: Chillies, coriander, tamarind and turmeric also contain tannins.
So, no more beloved Java and oh-so-fragrant tea? Not necessarily: just try to take the beverages mentioned above between meals at least 2 hours prior to and after an iron-rich meal.
Planning to have Indian food: simply choose a meat-based dish or remember to have some vitamin-C rich foods on the side.
An extra word about iron supplements
If you’ve been prescribed some iron pills, avoid taking these with calcium supplements, dairy products, coffee, tea, colas or chocolate. You may also consider not taking your supplements with meals that are high in fibre and phytates.
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Mihaila et al (2011) Identifying a Window of Vulnerability during Fetal Development in a Maternal Iron Restriction Model. PLOS ONE. 6(3):e17483.
Murray-Kolb LE and Beard JL (2009) Iron deficiency and child and maternal health. Am J Clin Nutr. 89(3):946S-950S.
Samman et al (2001) Green Tea or Rosemary Extract Added to Foods Reduces Nonheme-iron Absorption. Am J Clin Nutr.73(3):607–612.
Tuntipopipat et al (2009) Inhibitory Effects of Spices and Herbs on Iron Availability. Int J of Food Sci and Nutr. 60(s1):43–55.
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