woman with iron deficiency anemia

One of the most common problems in pregnancy is anemia. It is estimated that every third pregnant woman in the world is anemic. One of  the main reasons for that is iron deficiency. Most woman start pregnancy with a low iron storage in the first place. Check out how you can boost your iron intake in early pregnancy and avoid anemia later on during your pregnancy.

What is anemia?

When you’re pregnant her blood volume increases significantly. It can increase up to 50% more than when you are not pregnant. Your body needs to make more red blood cells for all that extra blood.

Red blood cells carry hemoglobin, a protein that carries oxygen from the lungs to other organs and cells in your body. The body needs iron to make that hemoglobin. If you don’t have enough iron in your system hemoglobin is going to be low indicating that you are anemic.

The fact that so many woman are anemic in pregnancy is partly due to the fact that even before pregnancy their iron levels were low. Anemia is still very common even with women who are taking prenatal supplements which typically contain iron.

How do I know if I am anemic?

At the beginning of your pregnancy a routine blood test is done to see in what state you’re starting your pregnancy. Since it is normal that physiological changes happen during pregnancy a second blood test is done, usually in the second half of your pregnancy. This blood test can show if you developed anemia during your pregnancy which is quite common.

Most women don’t feel any additional symptoms when being anemic during pregnancy. In extreme cases symptoms can include:

  • Dizziness
  • Fainting
  • Tiredness
  • Pale lips and fingertips
  • Pale inside of bottom eyelid
  • Sore tongue and cracked lips
  • Shortness of breath
  • Swelling of the ankles and palpitations
  • Loss of appetite
  • Indigestion
  • Dry mouth and smooth tongue
  • Dry brittle nails
  • Tingling in fingers and toes

What can you do about it?

Usually if you are anemic your doctor will subscribe you an adequate iron supplement that will help you boost your iron storage. But there are things you can do to try to prevent anemia in the first place.

It is important to check your blood at the beginning of pregnancy. If it shows that you your hemoglobin and hematocrit levels are low at the beginning of pregnancy immediately start an iron rich diet.

Eating an iron rich diet from the beginning of your pregnancy will increase your iron intake naturally and prevent anemia later on. It is better to eat iron rich food since iron from food is better absorbed than from supplements. Also supplements can have side effects like constipation, heartburn, nausea and vomiting.

It is important to know that iron is found in animal sources as well as in non animal sources. The difference is that our body can absorb iron from animal sources (heme-iron) much better than iron from vegetables and grains. That’s why red meat is the best source of iron.

Liver is an excellent source of iron but should be avoided in pregnancy! High levels of Vitamin A, which are found in liver, are associated with birth defects.

The recommended intake of iron for pregnant woman is 27 mg /day.

Here is a list of foods which will help prevent anemia in pregnancy.

Meats and Fish

FoodServing sizeIron (mg)
Meat and Poultry
Duck, cooked – high source
75 g (2 ½ oz)1.8- 7.4
Moose or venison, cooked – high source75 g (2 ½ oz)2.5-3.8
Beef, various cuts, cooked – high source75 g (2 ½ oz)1.4-3.3
Ground meat (beef, lamb), cooked75 g (2 ½ oz)1.3-2.2
Lamb, various cuts, cooked75 g (2 ½ oz)1.3-2.1
Chicken, various cuts, cooked75 g (2 ½ oz)0.4-2.0
Pork, various cuts, cooked75 g (2 ½ oz)0.5-1.5
Ground meat (turkey, chicken, pork), cooked75 g (2 ½ oz)0.8-1.2
Turkey, various cuts, cooked75 g (2 ½ oz)0.3-0.8
Fish and Seafood
Octopus, cooked – very high source
75 g (2 ½ oz)7.2
Oysters, cooked – very high source
75 g (2 ½ oz)3.3-9.0
Seafood (shrimp, scallops, crab), cooked75 g (2 ½ oz)2.2-2.3
Sardines, canned75 g (2 ½ oz)1.7-2.2
Clams, canned75 g (2 ½ oz)2.0
Fish (mackerel, trout, bass), cooked75 g (2 ½ oz)1.4-1.7
Tuna, light, canned in water75 g (2 ½ oz)1.2
Vegetables and Fruits
Spinach, cooked – high source125 mL (½ cup)2.0-3.4
Tomato puree125 mL (½ cup)2.4
Edamame/baby soybeans, cooked125 mL (½ cup)1.9-2.4
Lima beans, cooked125 mL (½ cup)2.2
Asparagus, raw6 spears2.1
Hearts of palm, canned125 mL (½ cup)2.0
Potato, with skin, cooked1 medium1.3-1.9
Snow peas, cooked125 mL (½ cup)1.7
Turnip or beet greens, cooked125 mL (½ cup)1.5-1.7
Prune juice125 mL (½ cup)1.6
Apricots, dried60 mL (¼ cup)1.6
Beets, canned125 mL (½ cup)1.6
Kale, cooked125 mL (½ cup)1.3
Green peas, cooked125 mL (½ cup)1.3
Tomato sauce125 mL (½ cup)1.3
Grains Products
Oatmeal, instant , cooked – high source175 mL (¾ cup)4.5-6.6
Cream of wheat, all types, cooked175 mL (¾ cup)5.7-5.8
Cereal, dry, all types30 g (check product label for serving size)4.0-4.3
Granola bar, oat, fruits and nut1 bar (32 g)1.2-2.7
Cracker, soda6 crackers1.5-2.3
Oat bran cereal, cooked175 mL (¾ cup)2.0
Pasta, egg noodles, enriched, cooked125 mL (½ cup)1.3
Milk and Alternatives
Yogurt, soy175 mL (¾ cup)2.0
Meat Alternatives
Tofu, cooked150 g (¾ cup)2.4-8.0
Soybeans, mature, cooked175 mL (¾ cup)6.5
Lentils, cooked175 mL (¾ cup)4.1-4.9
Beans (white, kidney, navy, pinto, black, roman/cranberry, adzuki), cooked175 mL (¾ cup)2.6-4.9
Pumpkin or squash seeds, roasted60 mL (¼ cup)1.4-4.7
Peas (chickpeas/garbanzo, black-eyed, split), cooked175 mL (¾ cup)1.9-3.5
Tempeh/fermented soy product, cooked150 g (3/4 cup)3.2
Meatless (sausage, chicken, meatballs, fish sticks), cooked75 g (2.5 oz)1.5-2.8
Baked beans, canned175 mL (¾ cup)2.2
Nuts (cashews, almonds, hazelnuts, macadamia, pistachio nuts), without shell60 ml (¼ cup)1.3-2.2
Eggs, cooked2 large1.2-1.8
Sesame seeds, roasted15 mL (1 Tbsp)1.4
Meatless, luncheon slices75 g (2.5 oz)1.4
Hummus60 mL (¼ cup)1.4
Almond butter30 mL (2 Tbsp)1.2

Source: “Canadian Nutrient File 2010”

Vitamin C helps absorption of iron

It is important to know that iron is poorly absorbed  by our body in the presence of certain elements. Calcium prevents the absorption of iron from food into our blood that’s why it is important not to eat milk products with iron rich food. The same is true for coffee and tea. On the other hand vitamin C helps absorption of iron. That means it is good to drink some orange or tomato juice with iron rich food. High in vitamin C are also peppers, lemon, grapefruit, strawberries, kiwis.

Vitamin C helps absorption of iron.
Calcium, tea and coffee prevent absorption of iron.

Although it is quite common to get iron deficient in pregnancy it is also possible to prevent anemia with a healthy iron rich diet. You just have to think about it at the very beginning of your pregnancy, start an iron rich diet as soon as possible and discuss it with your doctor. This way you will give your body the time to adjust to the changes coming and possibly prevent anemia in a natural way.

Photo credit: Iron-deficiency Anemia, Peripheral Blood Smear by Ed Uthman, 5 weeks pregnant by Thomas van Ardenne