Iron deficiency anemia is a common health issue, particularly for individuals of childbearing age. It is a condition that is often overlooked or thought to not be a big deal, however it requires attention due to its potential impact on health and well-being. It is estimated that around 90% of people of childbearing age do not have adequate iron stores to meet the increased demands of pregnancy. The prevalence of anemia during pregnancy varies, but numbers vary from 30%-80%. Then everyone loses some blood during childbirth. So, you can see how anemia can quickly spiral out of control.
Why Should I Care About Iron Deficiency?
Anemia is when you don’t have enough red blood cells or hemoglobin to carry oxygen to the tissues throughout your body. Iron deficiency is the most common cause of anemia. If your tissues don’t have oxygen, well, that’s not good. When you’re pregnant, your blood volume needs to increase by 50%, which requires a lot of iron.
The Risks of Iron Deficiency Anemia:
Fatigue and exhaustion
Heart issues for mom like palpitations, fast heart rate, low blood pressure, or even an enlarged heart
Thyroid issues for mom
Postpartum hemorrhage and increased need for blood transfusions after delivery
Low milk supply in breastfeeding
Intrauterine Growth Restriction (IUGR), or a baby that is too small
Having a premature baby
Stillbirth
Maternal death
What Can I Do About Anemia If I Am Pregnant or Postpartum?
A lot!
Ask your provider to check your Hemoglobin (hgb). This is often included on a Complete Blood Count or CBC so you may have already had it checked. If the result is less than 11 g/dL, you may be anemic. If your provider didn’t mention it, it’s possibly because they see it so commonly that it is sometimes only treated when it gets really bad. Talk with your provider about your results.
Eat iron-rich foods at every meal! Iron-rich foods include:
Highly Absorbable Iron:
Meat: Beef, pork, lamb, chicken, turkey, and eggs
Seafood: Salmon, sardines, clams, shrimp, and tuna
Organ meats: Liver and kidney
Not As Easily Absorbed Iron:
Beans and lentils
Dark leafy greens: Spinach, broccoli, Brussels sprouts, and cabbage
Nuts and seeds: Almonds, cashews, pistachios, pumpkin seeds, flax seeds, and hemp seeds.
Tofu
Consider encapsulated beef liver pills which are highly absorbable and rarely cause side effects because it is a whole food source. Beef liver is also high in lots of other vitamins and minerals you may need. Iron supplements are also an option, but they are not typically as absorbable and lots of people don’t take them consistently due to gastrointestinal side effects.
Pair your iron-rich foods and/or iron supplements or encapsulated beef liver pills with a food source of vitamin C for even more absorption power! Vitamin C-rich foods include:
Citrus fruits: Oranges, kiwis, pineapple
Strawberries
Broccoli and Brussels sprouts (also iron-rich)
Bell peppers
Anemia and Low Milk Supply
While there is no research linking iron deficiency anemia and low milk supply, iron plays a crucial role in lactation. Iron deficiency can prevent essential milk-making breast tissue growth and development during puberty and pregnancy, cause a delay in the milk increasing in volume after giving birth, disrupt the hormonal balance necessary for milk production, and cause fatigue preventing the mother from feeding as frequently as necessary.
Overall maternal health, including adequate iron levels, is essential for the optimal functioning of hormonal systems related to breastfeeding. Iron deficiency in nursing mothers can lead to fatigue and reduced energy, which can indirectly affect breastfeeding. Stress and exhaustion can impact the body's hormonal balance, potentially influencing oxytocin release and, consequently, the milk ejection reflex. Effective management of iron deficiency through diet and supplementation, as part of overall health care, can support better breastfeeding experiences.
Sources:
Breymann, C. (2015). Iron Deficiency Anemia in Pregnancy. Seminars in Hematology, 52(4), 339-347. https://doi.org/10.1053/j.seminhematol.2015.07.003
Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 14, Iron Nutrition During Pregnancy. https://www.ncbi.nlm.nih.gov/books/NBK235217/
Amy G. Cantor, MD, MPH; Christina Bougatsos, MPH; Tracy Dana, MLS; Ian Blazina, MPH; and Marian McDonagh, PharmD. Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnancy: A Systematic Review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 2015;162:566-576. doi:10.7326/M14-2932
Lisa Marasco, MA, IBCLC, & Diana West BS, IBCLC. Making More Milk: The Breastfeeding Guide to Increasing Your Milk Production, Second Edition. ISBN-10 1260031152