WHY IRON IS IMPORTANT IN PREGNANCY
First of all, let me assure you that if you are pregnant and your iron is low, your body is probably not malfunctioning! In pregnancy, you have 50% more blood circulating to support the growth of the placenta and your baby which increases your need for iron.
Iron deficiency increases your risk of having a premature baby or a baby with low birth weight. Research has also shown that babies born to an iron deficient person have a higher chance of being iron deficient themselves, which can impact organ function and growth.
To find out if your iron is low, your provider will test the amount of Hemoglobin in your blood (Hemo means “blood”, globin means “protein”). There are a lot of blood tests that can measure iron in the body, but 70% of the iron in your body is in the hemoglobin, which is why this is the most common test.
If you suspect you may be iron-deficient, ask your provider to also test your ferritin level. Ferritin is a storage form of iron in the body and can be depleted before our hemoglobin shows any signs of iron deficiency (Please note that a blood test for ferritin may not be covered by your insurance plan!).
IRON RICH DIETS
It is pretty well-known that meat is very high in iron. The type of iron in meat (heme iron) is highly absorbable by our bodies. So, eating meat everyday is an easy way to increase iron in your diet.
Vegetarians and Vegans, don’t fret! Iron deficiency is no more common in vegetarians than in meat-eaters, even though plant-based proteins contain a less-absorbable form of iron (non-heme iron). You can find plenty of lists online of foods that are high in heme and non-heme iron.
The RDA for pregnant persons is 27mg. When looking at a Nutrition Facts label, iron is listed on the bottom as a percentage. To find out how many milligrams of iron a food item contains, multiply the percentage on the label by 18. Example: Iron 10% x 18 = 1.8mg Iron. I don’t believe turning nutrition into numbers and calculations is generally helpful, so just use this info to be aware of foods that are higher in iron and to compare different products to make the best choice for you.
If iron has been added to a food, you will see that listed on the ingredient list; this type of iron is not as well absorbed as a food item that naturally contains iron. However, this does not mean that you shouldn’t eat iron-fortified foods as they still contribute to your overall iron intake.
Something else that is very important to know is that there are foods that can increase how well your body absorbs iron (“Enhancers”) and foods that can interfere with iron absorption (“Inhibitors”). Following is a list of these items and at the end of this post, you will see specific ideas on how to work these into your diet:
|Vitamin C (Sources of Vitamin C)||Phytates (found in grains and legumes, have a small effect on iron absorption)|
|Cooking in a cast iron skillet (this can double the iron content of your meal!)||Polyphenols and Tannins (found in coffee and tea)|
|Naturally fermented foods (fermented foods list)||Dairy products and Calcium supplements|
|Meat, poultry, and fish||Fiber (found in whole foods that are good for us so don’t restrict your fiber intake)|
|Phosoprotiens (found in eggs, do not stop eating eggs as the protein and fat is beneficial)|
If you are not iron-deficient, there is no need to supplement. Iron supplementation in the absence of iron deficiency has no proven benefits.
Iron deficient? Prenatal vitamins supply some iron, but it may not be enough to bring your iron levels up enough. Here is what I recommend:
-Meal plan daily sources of iron in your diet combined with some iron enhancers AND
-Take an iron supplement as recommended by your care provider. Continue to take the supplement through the postpartum period until you can have your iron levels
IDEAS FOR INCREASING IRON ABSORPTION
- Cook your food in a cast iron skillet
- Ground beef (heme) + tomatoes (Vit C) = i.e. spaghetti sauce, chili, stir fry.
- Add quinoa (non-heme) to sloppy joes or meatloaf (heme) (tempeh joes or lentil loaf for vegetarians).
- Take your Iron supplement between meals with a small glass of OJ-but not with your coffee.
- Take your Calcium supplement before bed, at least 2 hours after your last meal.
- Top your morning iron fortified oatmeal or toast (non-heme) with blueberries or strawberries (Vit C).
- Drink some hot molasses (recipe for hot molasses).
- Add lentils (non-heme) to your soups and salads (Vit C).
- Snack on bell peppers and broccoli (Vit C) dipped in hummus (non-heme).
- Wait to drink coffee (even decaf) or tea for about 2 hours after your breakfast.
- Use tempeh (fermented soy) instead of tofu in recipes.
- Sprinkle hemp seeds (non-heme) on your salads, soup, and grapefruit (Vit C).
- Instead of wheat pasta, try alternatives, such as quinoa or soybean pasta.
- Add bell peppers (Vit C) to your eggs (non-heme), cooked in cast iron.
- Consider adding a small amount of meat to your vegetarian meals if you are not a strict vegetarian.
Sarah Rawitzer is a Registered Dietitian/Nutritionist, Certified Prenatal Health Coach, Certified Doula (DONA) and works at Minnesota Birth Center.