Iron in Pregnancy: How much iron does a pregnant woman need?

There are many physiological changes that occur to support the growing baby during pregnancy. For example, a pregnant woman’s blood volume increases by up to 50% but red blood cells only increase by around 30% This leads to a natural haemodilution more than any other time in the lifespan of a human.

Overall there is a 2-3 fold increase in iron requirements and inadequate iron levels affect a huge number of women, up to 40% of pregnant women, which equates to almost a quarter of a million women every year in the U.K alone.

It can be difficult to get enough iron from food alone and it’s estimated that between 24% – 50% of women already have inadequate levels at their booking appointment – the first appointment they have with a midwife. Whilst we can get iron from food, it may not be absorbed well or be sufficient to meet the increased requirement for iron during pregnancy. Once you develop inadequate iron levels during pregnancy, diet alone can’t increase levels enough. In this case, iron supplementation is recommended.

Iron is a vital micronutrient that plays an important role in not only oxygen transport but also normal energy metabolism, cognitive function, immune function, cell division and the formation of red blood cells and haemoglobin. Despite the importance of iron, nearly 2.1 billion people worldwide are living with insufficient iron levels, regardless of their country of origin or their economic situation.

Having inadequate iron levels during pregnancy is common but has many wide-ranging health implications for both mum and baby. Iron supports a healthy pregnancy for both Mum and baby.

The number of complications associated with having inadequate iron is rather concerning but there are many ways that we can support women and prevent inadequate iron levels

Whilst iron supplementation can help prevent a pregnant woman from developing inadequate iron levels it is particularly important for certain groups:

● Two closely spaced pregnancies <1 year
● pregnant with more than one baby
● Follow a vegetarian or vegan diet
● Teenage pregnancy
● Don’t consume enough iron-rich foods
● Have a heavy pre-pregnancy menstrual flow
● Recent history of significant bleed
● Have a history of inadequate iron levels before your pregnancy

Insufficient iron is progressive and is generally described in terms of three stages of progressively increasing severity.
1. Depletion of iron stores
2. Impaired haemoglobin production
3. Iron deficiency anaemia
Until becoming pregnant many women may not have ever had their iron levels checked or considered the possibility of having inadequate iron levels. For women that are trying to conceive iron intake is really important and identifying individual risk of becoming or already having inadequate iron levels is paramount if we are to avoid further symptoms.

Iron intake is particularly important in the last trimester of pregnancy because this is when the growing baby begins to build their own iron stores ready for the first 6 months of life. These stores are used until babies start on solids.

However, early intervention may encourage the maintenance of iron levels throughout pregnancy and may reduce the need for much more expensive, risky & uncomfortable treatments later on in pregnancy. Especially for women that are at an increased risk of developing inadequate iron levels.

Many mums may feel affected by the symptoms of inadequate iron levels during pregnancy, including tiredness & fatigue and finding it hard to concentrate. The symptoms aren’t limited to pregnancy either and often women may mistake these symptoms for exhaustion after birth.

The benefits of taking iron can’t be understated when required and ensuring that you have adequate iron intake throughout pregnancy will lead to a healthier pregnancy.
Iron intake plays a vital role in supporting a healthy pregnancy for both mum and baby but may also lead women to have more enjoyable pregnancies by reducing symptoms that become a daily challenge – such as tiredness or poor functionality.
Many women go from feeling exhausted to having more stable energy levels, looking and feeling much better following iron supplementation when their bodies have needed it.

As mentioned, iron requirements increase significantly during pregnancy and it’s important to think about iron intake in order for you to meet the new demands of the placenta, growing baby and extra blood volume.

The World Health organisation recommends an iron intake of a 30mg per day during pregnancy.

Essential minerals, like zinc, magnesium, sodium, and iron, aren’t made by our bodies. They come from rocks, soil, and water. Plants absorb these minerals as they grow. Then, when we eat the plants or eat an animal that’s eaten those plants, our bodies receive the minerals we need to live. Iron, therefore, has to come through our diets. Iron supplements can be a great way to hit your daily nutritional requirement, particularly if you are pregnant to make sure you’re reaching your daily requirement.

Some foods act as barriers to our body’s ability to absorb iron sufficiently. Even if you’re eating foods high in iron, your body might not be absorbing all of it if your diet is also full of certain foods. Foods that inhibit iron absorption include:

● Dairy
● Eggs
● Tannins (found in tea and coffee)

While some foods can inhibit the absorption of iron, some foods and vitamins can enhance our ability to absorb iron. Foods that have high iron content or increase iron absorption include:

● Vitamin C
● Beta-Carotene
● Beef, Chicken & Fish

Choosing an iron supplement that is well absorbed can also ensure you are getting the maximum amount of iron from your supplement. For example, Active Iron has 2X better absorption compared to standard iron sulfate, meaning the iron in each capsule is highly bio-available.

Eating a rich and varied diet filled with nutrient dense foods, essential vitamins and minerals means you are supporting your body to get the good stuff it needs, to maintain your health and wellbeing as well as your baby’s.

When it comes to diet and iron intake it may be helpful to know that there are two types of iron in food, iron from animal products, known as haem iron and iron from plant foods, known as non-haem iron. Haem iron is absorbed by the body far better than non-haem iron and red meat is a rich source of iron. Non-haem iron is found in plant foods such as: kidney beans, chickpeas, lentils and fermented soy products like tofu.

See full list below:

● Red meat
● Fish
● Poultry
● Chickpeas
● Tofu
● Lentil
● Green peas
● Tomato juice
● Broccoli
● Unsulphured dried apricots or raisins
● Spinach
● Fortified cereal
● Sauerkraut
● Seeds

Due to the greatly increased requirements, it may not be possible to get all that you need through diet alone. Therefore, taking an iron or pregnancy supplement can ensure that you are getting everything that you need.

As identified, getting enough iron from diet alone can be tricky and so supplementation is often recommended. Supplementing with iron from the first trimester of pregnancy, especially for those that are of an increased risk of inadequate iron levels, can help avoid the need for high dose oral iron later on in pregnancy.

High dose oral iron can often lead to uncomfortable side effects for mum, such as constipation, nausea and diarrhoea – some of which you may be already experiencing during pregnancy.

Liquid iron supplements are often proposed as an alternative for those who experience side effects. It is suggested the liquid format is gentler on the stomach and easier for the body to absorb. However, liquid iron supplements often contain low levels of iron and therefore the dose may be inadequate for mum and baby’s iron requirements.

Active Iron is different. Its groundbreaking formula is clinically proven to deliver 2X better absorption of iron sulfate and is 6X less likely to cause gut irritation compared to other iron supplements. This means it helps avoid the common side effects of iron supplements, including constipation and nausea, making it Kind & Strong.

Active Iron is also clinically proven to increase iron stores by 94%, resulting in a significant improvement in energy levels.

Active Iron Pregnancy Plus is a great option because it offers a complete nutritional solution for mum & baby and in my view is the one of the best iron supplements for pregnancy. It is a specially developed, combination product with 21 essential nutrients to provide complete nutritional support to mum and baby throughout pregnancy.

Iron is a vital micronutrient that supports the transportation of oxygen, amongst other things, and is especially important during pregnancy. All women need more iron during pregnancy and should consider iron supplementation early in pregnancy and discuss this with their midwife to help avoid developing inadequate iron levels and the nasty side effects of high dose oral iron.

Key points:
● Iron requirements significantly increase during pregnancy.
● There are several known factors that increase your risk of developing inadequate iron levels.
● It is important to include either animal and/or plant-based sources of iron in your diet.
● Supplementing with iron early in your pregnancy can increase iron levels and avoid the need for high dose oral iron if iron levels deplete further.
● Not all iron supplements are equal – Active Iron’s Kind & Strong formula is non-constipating and clinically proven to increase iron levels.