Iron deficiency & supplementation in pregnancy

• Iron supplements lower the chance of needing a blood transfusion at delivery.
• Iron supplements lower the chance of having a very small baby.
• Iron supplements improve the baby’s iron level.
• Babies of mothers with untreated iron deficiency anemia are more likely to develop anemia in the first year of life.
• Infants and children with iron deficiency have poorer neurologic function.

Low-dose iron supplements, like prenatal multivitamins, are not enough for most women. Three of four women on prenatal multivitamins will have iron deficiency when they deliver their baby.

At your first prenatal visit your blood level (hemoglobin) and iron level (ferritin) will be checked. Based on these results, the table below will be used to decide on how much iron you need.

Take iron on an empty stomach at bedtime with a source of vitamin C to improve absorption. If you are found to have iron deficiency with anemia, your doctor or midwife will have more treatment recommendations.

Iron supplements may cause darker bowel movements. This is normal and is nothing to worry about. Iron supplements can cause mild nausea, constipation or diarrhea. These symptoms usually go away if you stay on iron for a few weeks.

Speak to your healthcare provider. Here are options that may be tried: (1) Changing to a different iron tablet, (2) Taking the iron tablets with food (although absorption drops by half ), (3) Using intravenous iron (for severe iron deficiency or severe anemia).

Nine of 10 women who do not take iron supplements will use up all of their iron stores during pregnancy and 1 in 5 will develop iron deficiency anemia. So, almost all pregnant women need iron supplements for the rest of their pregnancy starting at 12-16 weeks.

• Only take iron supplements if you had a large amount of blood loss at delivery, eat a diet that is low in iron-rich foods, or if you had iron deficiency at any point during pregnancy (ferritin below 30).
• You should take your prenatal vitamin after your baby is born for at least 6 months, and longer if you continue to breastfeed.