Iron in pregnancy and postpartum

Let’s talk about iron and it’s importance in pregnancy and postpartum.

Pregnancy can be such a nutrition juggle can’t it!

There are so many things to consider: what to eat, what not to eat. It can feel like a hard nut 🌰 to crack!

Iron is such an important micronutrient, vital for your baby’s growth and development.

No wonder your needs go up 1.5 fold 😮‍💨

Plus if you are vegetarian or vegan or following mainly a plant based diet and eating mostly non haem sources it can be even more challenging to eat enough iron rich foods without feeling like you are bursting at the seams.

Did you know? Anaemia prevalence rates are at ~25% of Australian pregnant women with even more elevated risk for Aboriginal and Torres Strait Islander women.

Some facts on iron:

🤰🏻 During pregnancy, the volume of blood in your body increases, and so does the amount of iron you need.

🤰🏻Your body uses iron to make more red blood cells (haemoglobin) which carry oxygen to your baby for their growth and development in the womb.

🤰🏻Having adequate iron when pregnant also means your baby has enough stores in their bodies to last for 4-6 months (post birth) before needing to switch to getting iron from solid foods.

🤰🏻Your iron requirements are 1.5x higher during pregnancy - 27mg/day

🤰🏻Low iron & low haemoglobin can then result in iron deficiency anaemia. This can make you feel very lethargic, weak and drained making it hard to get through the day & fight off infections.

🤰🏻It can also affect the baby’s growth and lead to low birth weight and preterm birth!

🤰🏻In addition, birthing your baby can significantly deplete your iron stores and iron deficiency in the postpartum period has also been linked to higher rates of postpartum depression.

🤰🏻You are less likely to become iron deficient if your iron levels are in the normal range before pregnancy but unfortunately it can still happen and careful monitoring is important.

So what foods are high in iron?

The best sources of iron come from haem iron foods which are better absorbed by your body compared to non-haem sources.

Haem iron sources come from animal foods which include:

• Red meat

• Chicken

• Fish

• Liver - note: limit to 50g per week as it is very high in Vitamin A which can be harmful to your baby’s growth and development

Non-haem iron sources are derived from

plant foods and include:

• Legumes ie chickpeas, black beans, baked beans, lentils

• Nuts and nut butters

• Green leaf vegetables

• Wholegrain breads

• Iron enriched breakfast cereals

• Dried fruit

• Milo, Ovaltine

Can you increase absorption of iron from non-haem sources?

Yes, by serving and eating non-haem sources alongside Vitamin C rich foods you can increase absorption.

Some vitamin C rich foods include: tomatoes, berries, oranges (and orange juice), kiwifruit, capsicum, broccoli.

Studies have also shown that eating meat alongside non-haem sources increases iron absorption too.

So, in order to maximise your overall iron absorption a meal that combines an animal food, 2-3 iron rich plant foods and at least one vitamin C source is IDEAL.

An example: 2 lamb chops (haem) + 1 cup of spinach (non-haem) + 3-4 florets or 1/2 cup of broccoli (non-haem and vitamin C) + 1/2 tomato (vitamin C).

Are there foods or drinks that decrease absorption?

Tea and coffee, if consumed with a meal can reduce the absorption of iron. So it’s best to enjoy these drinks in between meals if you are anaemic.

Who is at risk of iron deficiency?

• If you follow a vegetarian or vegan diet

• Previous history of anaemia

• Severe morning sickness due to not meeting iron requirements and reduced overall absorption

• Poor diet

• Multiple pregnancies that are close together

When should I get my iron tested?

Often your iron will be tested early on in your pregnancy and then again during the second and/or third trimester.

You can also ask your birth team for a blood test if you are feeling increasingly tired or run down.

It is also a good idea to have a blood test done after your 6 week postpartum check to see if your iron stores are starting to increase again.

Will I need to take an iron supplement if my levels are low?

It is best to chat to your obstetrician, GP or midwife if your blood tests show that your iron and/or haemoglobin are low. They can advise you if/when you need to start taking iron supplements alongside a high iron diet.

I have heard calcium interacts with iron. Is this true?

Calcium and iron compete for absorption in the body so it may be beneficial to seperate these into two supplements that are taken at seperate times.

The Womb Nutrition dietitians can guide you to select supplements that will optimise your iron absorption.

This blog post has general information only and is intended to educate and does not replace medical advice. Please always consult your medical team for personalised advice for you and your baby.

For a comprehensive and personalised assessment please contact me via email if you are struggling to meet your iron needs. I am here to help :)

I would love to support you to enhance your nutrition and iron intake during pregnancy and postpartum to ensure both you and your baby are in the best health possible.