Your iron level will naturally fall as your pregnancy progresses. Firstly, your blood circulating volume increases by 30% so your haemoglobin (iron) level will fall due to dilution of your blood contents. Secondly, in the last third of your pregnancy (and during breast feeding) your baby starts to draw on your iron stores.
What kind of symptoms can you experience if your haemoglobin is low?
Tiredness, weakness, headaches, palpitations, dizziness, shortness of breath on exertion and hair loss are some of the typical signs of anaemia.
It is important to have a good haemoglobin for labour and birth; this gives you better reserves for the inevitable blood loss that occurs when your baby is born. A good haemoglobin also supports your energy level as a new mum, assists in establishing breast feeding and has a role in protecting from infection.
It is therefore beneficial for you and your baby if you obtain the best haemoglobin you can during your pregnancy. Here is my list of general tips:
- Don’t drink tea or coffee before or immediately after meals; wait at least 1-2 hours. These drinks reduce the absorption of iron in your food.
- Include vitamin C with meals where possible (such as a small glass of orange juice).
- Eat dairy products as snacks rather than with meals (as calcium can also reduce the absorption of iron from the gut).
- Eat five portions of fruit and vegetables a day.
Iron in the diet comes in two forms; haem iron and non-haem iron. Haem iron is found in animal derived foods and non-haem iron in plant derived foods. Non-haem iron (plant iron) is less easily absorbed through the gut. This means that vegetarians have a tendency to iron deficiency.
Foods that Enhance Iron Intake:
- Lean red meat
- Oily fish, such as salmon, sardines, fresh tuna (no more than 2 portions of oily fish a week if pregnant or breast feeding, no more than 4 cans of tuna a week in pregnancy)
- Vitamin C, such as fruit and juices
- Fermented products, such as soy sauce and bread
Foods that Inhibit Iron Absorption:
- Calcium, particularly from milk and dairy products
- Phytates, present in cereals, grains, nuts and seeds
- Polyphenols and tannins, found in tea, coffee, herbal infusions, green leafy vegetables
Dietary changes alone are not sufficient to correct an existing iron deficiency in pregnancy and iron supplements are necessary.
If your haemoglobin or iron stores (ferritin) are low and you need iron tablets:
- Take on an empty stomach, one hour before meals, with a source of vitamin C to maximise absorption
- Other medications or antacids, tea or coffee should not be taken at the same time.
Once the haemoglobin is within the normal range, treatment should be continued for a further 3 months.
Iron tablets can cause side effects, such as diarrhoea or constipation, upset stomach and your stools will turn black.
Please remember to keep iron tablets out of sight and reach of children.
RCN Iron Deficiency and anaemia in adults