Iron in your pregnancy diet

Iron in your pregnancy diet

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Why you need iron during pregnancy

Even before you're pregnant, your body needs iron for several reasons:

  • It's essential for making hemoglobin, the protein in red blood cells that carries oxygen to other cells.
  • It's an important component of myoglobin (a protein that helps supply oxygen to your muscles), collagen (a protein in bone, cartilage, and other connective tissue), and many enzymes.
  • It helps maintain a healthy immune system.

But during pregnancy you need a lot more of this essential mineral. Here's why:

  • The amount of blood in your body increases during pregnancy until you have almost 50 percent more blood than usual. You need extra iron to make more hemoglobin.
  • You need extra iron for your growing baby and placenta, especially in the second and third trimesters.
  • Many women need more because they start their pregnancy with insufficient stores of iron.
  • Iron-deficiency anemia during pregnancy is associated with preterm delivery, low birth weight, and infant mortality.

How much iron you need

Pregnant women: 27 milligrams (mg) of iron per day

Nonpregnant women: 18 mg

You don't have to get the recommended amount of iron every day. Instead, aim for that amount as an average over the course of a few days or a week.

Food sources of iron

There are two forms of iron: heme and non-heme. Heme iron is found only in animal sources and is easier for your body to absorb. Non-heme iron is found in plants, iron-fortified foods, and supplements. Red meat, poultry, and seafood contain both heme and non-heme iron. To make sure you're getting enough, eat a variety of iron-rich foods every day.

Red meat, poultry, and fish are some of the best sources of iron. (Liver supplies a very high concentration of iron, but it also contains unsafe amounts of vitamin A, so it's best to limit it to one or two servings a month during pregnancy.) If your diet doesn't include animal protein, you can get iron from legumes, vegetables, and grains.

Amount of heme iron in a 3-ounce serving of common animal protein sources:

(Note that 3 ounces of meat is about the size of a deck of cards.)

  • 3 ounces lean beef, chuck: 3.2 mg
  • 3 ounces lean beef, tenderloin: 3.0 mg
  • 3 ounces roast turkey, dark meat: 2.0 mg
  • 3 ounces roast turkey, breast meat: 1.4 mg
  • 3 ounces roast chicken, dark meat: 1.1 mg
  • 3 ounces roast chicken, breast meat: 1.1 mg
  • 3 ounces light tuna, canned: 1.3 mg
  • 3 ounces pork, loin chop: 1.2 mg

Amount of non-heme iron in common plant sources:

  • 1 cup iron-fortified ready-to-eat cereal: 24 mg
  • 1 cup fortified instant oatmeal: 10 mg
  • 1 cup edamame (soybeans), boiled: 8.8 mg
  • 1 cup lentils, cooked: 6.6 mg
  • 1 cup kidney beans, cooked: 5.2 mg
  • 1 cup chickpeas: 4.8 mg
  • 1 cup lima beans, cooked: 4.5 mg
  • 1 ounce pumpkin seeds, roasted: 4.2 mg
  • 1 cup black or pinto beans, cooked: 3.6 mg
  • 1 Tablespoon blackstrap molasses: 3.5 mg
  • 1/2 cup firm tofu, raw: 3.4 mg
  • 1/2 cup spinach, boiled: 3.2 mg
  • 1 cup prune juice: 3.0 mg
  • One slice whole wheat or enriched white bread: 0.9 mg
  • 1/4 cup raisins: 0.75 mg

Making the most of the iron you eat

You don't need to eat a big slab of meat to satisfy your daily iron requirement. Adding just a little meat or fish to a meal helps your body absorb more of the iron in the other foods on your plate.

Here are a few more tips for getting as much iron as possible from your diet:

Cook in a cast iron pan. Moist, acidic foods, such as tomato sauce, are especially good at soaking up iron this way.

Include a source of vitamin C (like orange juice, strawberries, or broccoli) with every meal, especially when eating vegetarian sources of iron, like beans – the vitamin C can help you absorb up to six times more iron.

Many healthy foods contain "iron inhibitors," which are naturally occurring substances that can interfere with iron absorption. Examples of iron inhibitors include phytates in whole grains and legumes, polyphenols in coffee and tea, oxalates in soy foods and spinach, and calcium in dairy products.

If you have low iron or iron-deficiency anemia, some experts believe you shouldn't eat iron-inhibiting foods at the same time as iron-rich foods. Others believe it's okay to eat these foods together as long as your overall diet includes plenty of iron-rich and vitamin C-rich foods. Your provider or a dietitian can work with you to create a prenatal nutrition plan that supports healthy iron levels.

If your provider has prescribed iron supplements, take them one hour before or two hours after meals because iron is absorbed most easily on an empty stomach. Taking the supplement with orange juice – which is high in iron-enhancing vitamin C – can boost absorption. (But don't take your iron pill with milk, coffee, or tea because these can interfere with iron absorption.)

Calcium also hinders iron absorption, so if your provider has recommended you take both an iron and a calcium supplement (or antacids that contain calcium), ask for advice on how to space them out during the day.

Should you take an iron supplement?

Although your body absorbs iron more efficiently during pregnancy, you might not get enough of the mineral from your diet. Many women start their pregnancy without enough iron to meet their body's increased demands and are unable to bring their levels up through diet alone.

At your first prenatal appointment, your healthcare provider will probably recommend a prenatal vitamin with about 30 mg of iron. Unless you have (or develop) anemia, this should be sufficient, so don't take additional supplements unless your provider advises you to.

What happens if you don't get enough iron

When you don't get enough iron, your stores become depleted over time. And if you no longer have enough iron to make the hemoglobin you need, you become anemic.

Iron-deficiency anemia can sap your energy and cause many other symptoms, especially if you have a severe case. It can also make it harder for your body to fight infection.

It may even impact your pregnancy: Iron-deficiency anemia – especially in early or midpregnancy – has been linked to a greater risk of preterm birth, having a low-birth-weight baby, and fetal or newborn death. See our complete article on iron-deficiency anemia.

If you're anemic when you give birth, you're more likely to need a transfusion and have other problems if you lose a lot of blood at delivery. And some research suggests an association between maternal iron deficiency and postpartum depression.

Your baby does a good job of taking care of his iron needs while he's in your uterus. He'll get his share of what's available before you do. That said, if you're severely anemic, it may compromise your baby's iron stores at birth, raising his risk for anemia later in infancy and possibly hurting his growth and cognitive development.

Can you get too much iron?

Yes. Aim to get no more than 45 milligrams of iron a day. If you take more than that (either from an extra iron supplement or from your prenatal vitamin), it can cause your blood levels of iron to rise too high, possibly causing problems for you and your baby.

For example, too much iron can increase your risk of developing gestational diabetes or oxidative stress, an imbalance in the body that's thought to play a role in infertility, preeclampsia, and miscarriage, and has been linked to heart disease and high blood pressure. Take iron supplements during pregnancy only under the supervision of your healthcare provider.

Side effects of iron supplements

Iron supplements can upset your gastrointestinal tract. The most common complaint is constipation, which is already a problem for many pregnant women. Try drinking prune juice if you're constipated. It can help you stay regular – and is actually a good source of iron!

You may also have nausea or (more rarely) diarrhea. If your supplement makes you feel queasy, try taking it with a small snack or at bedtime.

Talk to your provider if you're experiencing other side effects – if you're not anemic and your prenatal vitamin has more than 30 mg of iron, it may make sense for you to switch to one with a lower dose.

If you are anemic, you may be able to prevent stomach problems by starting with a supplement that has less iron and gradually building up to the dose you need. You could also try taking the iron in smaller doses throughout the day. Your provider may suggest trying different iron supplements to find one that's easy on your stomach. For example, some moms-to-be have fewer side effects from a timed-release iron supplement, although the trade-off is that the iron isn't absorbed as well this way.

Finally, don't worry if your stools look darker when you start taking iron. That's a normal and harmless side effect.

Watch the video: What is the importance of iron in pregnancy diet? - Edwina Raj (May 2022).