Iron during pregnancy and lactation

Iron deficiency is one of the most common nutritional risk factors during pregnancy, childbirth, and breastfeeding. Many women have little or largely empty iron stores at the beginning of pregnancy. As a result of the mother’s anaemia, miscarriages and premature births can occur. The need for iron is exceptionally high during pregnancy because of the increasing blood volume in the mother and the need for iron storage in the child’s tissues. An iron deficiency during pregnancy can manifest through symptoms such as dry lips and skin, cracked mouth corners, or brittle nails. What helps, and how can you prevent it?

Iron: essential for health

Iron is a vital trace element for the human organism that must be ingested daily with food. The micronutrient is absorbed in the gastrointestinal tract, and from there, it is transported into the bloodstream. Daily, small amounts of iron are lost through the intestines, skin and kidneys. If these losses are not replaced, iron deficiency can develop over time.

Iron is an essential component of the haemoglobin in the red blood cells, the erythrocytes. These tireless oxygen transporters supply the entire organism with its 60-100 trillion cells with oxygen. Iron is also a red muscle pigment (myoglobin) component, and numerous enzymes are directly involved in energy provision.

Three to five grams of iron are stored in the body. These stores include the proteins hemosiderin and ferritin. They are present in the liver, bone marrow, spleen and muscles.

During pregnancy, the mother-to-be needs iron, and the unborn child also builds up iron stores. The need for iron, therefore, increases in pregnant and breastfeeding women.

 

How is iron deficiency shown?

The main symptoms of iron deficiency are:

• tiredness and exhaustion
• Loss of performance and lack of concentration
• headache
• brittle fingernails and dry pale skin
• cracked corners of the mouth
• Tingling in hands and feet
• hair loss
• shortness of breath
• palpitations
• increased susceptibility to infectious diseases.

If the iron supply is insufficient, the iron stores only empty slowly. Symptoms usually only appear when the formation of new red blood cells is impeded.

Possible consequences of iron deficiency

For the unborn child, an iron deficiency not only means risks due to the mother’s increased susceptibility to infections but also increases the risk that the child will not weigh enough at birth. Miscarriages, premature births or growth disorders can also be the result of anaemia.

In addition, the mother’s risk of depressive moods and stress increases, which in turn can affect the mother-child relationship.

It should be noted, however, that only severe and long-lasting anaemia causes health problems, while mild anaemia usually has no negative consequences for the unborn child.

 

Causes of iron deficiency

Insidious iron deficiency occurs due to blood loss, for example, from injuries, bleeding in the gastrointestinal tract and, particularly in women, as a result of menstruation. However, pregnancy is also a possible cause of iron deficiency if the increased requirement is not adequately compensated. Iron absorption is also disrupted in gastrointestinal diseases, for example, when too little gastric acid is formed and the food does not contain enough iron.

Women as a risk group for iron deficiency

Women between the ages of 12 and 50 are more at risk of iron deficiency than men due to monthly bleeding; the female requirement is 50 per cent higher. While men need 10 milligrams of iron daily, women of childbearing age need at least 15 milligrams.

Many women of childbearing age do not have an optimal supply of iron. Some do not have enough reserves of their own, so the risk of iron deficiency anaemia is exceptionally high in the event of pregnancy. However, iron deficiency is only some of that likely with a healthy and balanced diet.

Increased iron requirements during pregnancy

The growing uterus with the placenta and the fetus must be supplied with oxygen. That is why the iron requirement in the last trimester of pregnancy is twice as high as usual at 30 milligrams per day.

At birth, the newborn receives an iron supply for about four months. In addition, the baby is supplied with iron through breast milk, but only 50 per cent of this can be used by the infant. The iron requirement of a breastfeeding mother is around 20 milligrams per day.

 

Iron deficiency during pregnancy: what to do?

A doctor must examine an iron deficiency to treat and eliminate the cause. This is especially true during pregnancy, after blood loss during childbirth and while breastfeeding. The diagnosis of iron deficiency is made based on the laboratory findings of the blood. Important laboratory values ​​​​are:

• haemoglobin
• Red blood cells
• Eisen
• Ferritin
• Transferrin

In addition, examining the stool for blood and an iron absorption test (absorption disorders in the intestine) can confirm the diagnosis. The iron concentration in the blood is measured before and two hours after taking an iron tablet.

Iron deficiency is usually detected early since blood levels are checked regularly during pregnancy.

If necessary, the doctor will prescribe an iron supplement before eating, usually taken as a tablet on an empty stomach. Side effects of iron supplementation, such as blackening of the stool and possible nausea or constipation, should be discussed with the gynaecologist.

But be careful: If iron tablets cause or increase regular nausea, this can lead to a nutrient deficiency that can have adverse effects for mother and child.

Iron deficiency during pregnancy: how to prevent?

During pregnancy, the energy requirement is low, but the need for nutrients is sometimes doubled. That’s why you shouldn’t just eat more. Only through the varied consumption of foods with a high nutrient density and the extensive avoidance of “empty” calories can the requirements of pregnancy be taken into account.

A preventive administration of iron preparations during pregnancy is unnecessary if the blood values ​​are healthy.

Iron Content: Foods high in iron

Iron-rich foods are primarily meat and meat products. Iron is also present in foods of plant origin. However, it can be utilized much worse than animal iron. The additional intake of vitamin C can increase the usability of plant-based iron. It is, therefore, advisable to drink a glass of orange juice before a meal or to combine the meal with foods rich in vitamin C.

Plant-based foods high in iron include green vegetables, legumes, and whole-grain breads. It is an old wives’ tale that spinach contains considerable iron.

Certain substances can impede regular iron absorption. These include, for example, oxalic acid, which is found in rhubarb and spinach, alginates in custard powder and packet soups, tannins in coffee and black tea, and phytic acid as an ingredient in rice and soy. Antibiotics and antacids (stomach acid-neutralizing substances) also impede iron absorption.

A meat side dish should be on the menu twice a week to cover the increased iron requirement. Because of the low-fat content, beef and lean poultry are preferable. Further supplementation of the iron requirement can be achieved by eating two fish meals a week.