I am seeing a lot of iron deficiency in pregnancy these days. It seems now to be a rare event to find a woman with normal iron levels when we do her routine twenty six week blood tests. Possible reasons for these low iron levels are:

  • Lower dietary iron intakes
  • Increased demands on iron stores – particularly previous pregnancies and breastfeeding.

While iron levels have to be incredibly low to adversely affect your baby, low iron levels are not so good for mothers.  Low iron levels cause the following symptoms in pregnancy:

  • Exacerbation of the usual swelling (oedema) of pregnancy. Palpitations, and Shortness of breath,
  • Tiredness to the point of exhaustion,
  • Shortness of breath,
  • Palpitations, and
  • Exacerbation of the usual swelling (oedema) of pregnancy.

Just as importantly having low iron levels can increase your risk of needing a blood transfusion at the time of birth if you suffer any sort of haemorrhage when you give birth. Unfortunately the commonly used pregnancy vitamin supplements (Elevit, Blackmores Pregnancy Gold and others) do not contain enough iron to ensure that you have normal iron levels throughout pregnancy.

Vitamin C helps you to absorb iron while milk and common antacids (Rennies and others) inhibit the absorption of iron.

Side effects of iron supplements include nausea, constipation and very dark bowel movements. The best way to prevent constipation is to make sure you drink two litres of water per day and have two serves of All Bran cereal per day (Good luck!)

So I recommend the following approach:

Women without any history of iron deficiency and normal iron levels:

  • Take your normal pregnancy vitamin supplement throughout pregnancy and breastfeeding.
  • Take one sachet per day of Spatone liquid, dissolved in orange juice. Spatone is water containing high levels of iron (it comes from a spring in Wales). It has minimal side effects. Pharmacies and health food shops sell Spatone.

Women with a prior history of low iron levels OR low iron levels recorded during pregnancy:

  • Take your normal pregnancy vitamin supplement throughout pregnancy and breastfeeding.
  • Take a “proper” iron supplement such as Ferrograd C with orange juice once per day.
  • If you find it difficult to swallow or tolerate iron tablets take 15ml of Floradix per day.
  • If you suffer side effects from your iron treatment reducing your dose to alternate days is preferable to giving up altogether.

If all else fails we occasionally admit women to hospital for a day for an intravenous iron infusion.