Pregnancy Supplement - Iron

Sep 17 2007

Pregnant women need extra iron to make the hemoglobin in the fetus and in the extra maternal blood required for pregnancy. The Institute of Medicine recommended a daily supplement providing 30 mg of iron. This recommendation was based on the following evidence:

Pregnant women who take iron supplements have higher hemoglobin levels.
Hemoglobin is necessary for body function.
Iron at low doses poses no dangers to the mother or fetus.

Iron is so needed by the baby that it is the only nutrient for which the fetus will act as a parasite, taking what it needs from the mother. Resulting anemia in the mother will cause fatigue and increased susceptibility to other illness. It puts a strain on her heart and puts her in danger should she bleed too much at delivery.

Although it is possible to get sufficient iron for pregnancy through diet, the average woman’s diet does not supply adequate iron. Before supplements are taken, however, the hemoglobin level in the mother’s blood can be measured and the need for supplementation determined individually. In fact, a hemoglobin test is a routine part of the first prenatal visit or preconception visit. If a woman does not take supplements, the hemoglobin level should be repeated early in the third trimester (about 26 to 28 weeks) to see if her need has changed. If her hemoglobin at either time is low enough to be considered anemic, further testing can be done to determine the precise cause of the anemia. Iron deficiency is only one possible reason for anemia.

Foods high in iron include - Pregnancy Supplement - Iron

Blackstrap molasses
Dried legumes (beans)
Liver
Oysters
Prunes
Shellfish
Some meats, especially beef and pork
Foods somewhat high in iron include:
Brown or fortified white rice
Eggs
Fish, chicken, lamb
Oatmeal
Shredded wheat
Vegetables: greens, potatoes, broccoli, acorn squash (for greens, the greener the vegetable, the more iron it supplies)
Wheat germ
Whole wheat or fortified white bread

The iron in meat (heme iron) is absorbed more readily than the iron in vegetables or grains (nonheme iron). A cup of cooked green beans, for example, contains the same amount of iron as a cup of beef stew, but the person eating the beef stew will get more iron. While vegetarian diets can be more than adequate in iron, especially with a high intake of legumes, vegetarians may have to be somewhat more careful about making sure they eat enough iron-rich foods.

The absorption of iron from the diet is enhanced by vitamin C. Take your iron with orange juice, grapefruit juice, or tomato juice.

Certain foods or medications, including antacids and dairy, interfere with iron absorption. Iron should not be taken with milk. This may be somewhat of a challenge to organize as pregnant women drink milk frequently.

The amount of iron contained in vitamin tablets generally is not sufficient to meet the needs of late pregnancy. Women should take separate tablets of iron.

Iron tablets come in several forms-ferrous sulfate, ferrous gluconate, and ferrous fumarate-and under various trade names. The amount of total iron in a supplement is not the amount of elemental iron in the supplement. Elemental iron is the available or absorbable part of the tablet. To allow you to absorb 30 mg of iron, the tablet strength should be 150 mg of ferrous sulfate, 300 mg of ferrous gluconate, or 100 mg of ferrous fumarate. As iron can suppress zinc levels, do not take more than this dosage, unless you are anemic and your physician or midwife advises extra iron.

If you develop digestive distress after taking iron on an empty stomach, you can take it with meals. In this case, drink milk between meals. Some women find liquid iron preparations easier on the stomach.

Excessive iron intake tends to make the stools dry and firm, causing constipation. An occasional woman responds to iron with diarrhea. In either circumstance, you can try changing the type of iron you take from a tablet to liquid or from one of the three available compounds to an other (e.g., ferrous fumarate to ferrous sulfate). If this doesn’t help, the supplement strength may have to be reduced. You may have to experiment a bit to see which type and how much iron you can take comfortably. If you reduce your supplement, be sure to compensate with an increase of iron-rich foods on a daily basis.

An iron overdose can be dangerous. Keep your iron tablets where small children cannot get them. The second most common form of poisoning seen in pediatric emergency rooms comes from children eating their mothers’ iron tablets.