Pregnant women need more iron
The focus of World Iron Awareness Week this year falls on the role of iron in pregnancy. A local study, Growing Up in New Zealand, raises concerns that very few pregnant women follow recommended dietary guidelines during this crucial time of their and their baby’s lives. In fact, when it comes to high protein foods, only one in five are managing to reach the daily target.
Iron deficiency is the leading nutritional deficiency around the world, with a huge impact on global health. Around one in 14 New Zealand women are lacking in iron, and this number is thought to be much higher during pregnancy. This is partly due to an increase in blood volume that occurs normally during pregnancy, but also the extra demands the growing baby and placenta place on the mother’s iron stores.
Iron has multiple functions in our body: it carries oxygen around, creating energy and assisting cell metabolism; it helps support a healthy immune system and prevent infection; it assists with brain development, enhancing cognition, concentration and mental performance. It’s also thought to play a role in social behaviour, especially in toddlers and children. Without iron, our bodies gradually become anaemic, lacking in essential red cell haemoglobin.
Iron deficiency in pregnancy causes fatigue, increased risk of infection, and a higher likelihood of postnatal depression. It is also appears to be associated with poor emotional bonding between mum and baby (known as ‘‘attachment’’) and difficulty breast feeding. As the birth process usually involves a degree of blood loss, mums who are already anaemic can struggle to cope with this – low iron and anaemia in the first few weeks after your baby’s birth can be responsible for turning a tiring but joyful time into a very difficult experience.
As well as impacting on the mother’s health and wellbeing during pregnancy, iron is crucial for the healthy growth of the baby, especially in terms of early brain development. Iron deficiency is associated with higher maternal and foetal mortality, as well as an increased risk of premature delivery and low birth weight babies.
As a general rule, women tend to require more iron than men, due to the monthly blood loss from menstruation. However, during pregnancy the requirement increases dramatically, with women needing two to three times the usual daily amount to maintain healthy stores.
Being mindful of your diet when pregnant is the first step towards avoiding iron deficiency. If, for whatever reason, you have a restricted diet, or are struggling to eat due to morning sickness, I would recommend talking to your doctor, midwife or a dietitian early on, so they can advise you on any supplement or special foods you may need to stay healthy.
Focusing on iron-rich foods is important, and especially the ‘‘haem’’ type of iron that is found in red meat, chicken and fish. This type of iron is absorbed much more readily from the gut than the ‘‘non haem’’ iron found in vegetables, fruit, legumes, cereals and eggs.
If you are vegetarian, try to ensure you have extra vitamin C with your meals (like citrus fruit, blueberries or kiwifruit) as this will help get the most iron from your food for you and your baby.
Recommended daily amounts of iron during pregnancy are around 27mg per day – if you think that a lean fillet steak has around 6mg of iron, and a cup of cooked spinach has 2mg, it is easy to see how you can fail to eat adequate quantities. Fortified cereals and breads, containing extra iron, are a good option, especially if you are not a big meat eater. If you are concerned, a simple blood test can check your iron stores. Your doctor or midwife will then be able to recommend either some simple dietary changes that may help, or suggest some supplements for the remainder of your pregnancy.
For more information, visit ironweek.co.nz. ❚ Dr Cathy Stephenson is a GP and medical examiner.