How much iron do I need during pregnancy?

Before you conceived, you needed about 15 milligrams (mg) of iron a day. That's quite a lot. Many of us probably don't actually get the recommended daily amount. During pregnancy, you need extra iron to help keep you and your baby healthy. If you don't have enough iron to fuel haemoglobin production for both of you, you may develop iron-deficiency anaemia. This is the most common type of anaemia in pregnancy and about one in five women develop this type when they are pregnant. 

What can I do to make sure I have enough iron? 

A pregnant woman requires 30mg of iron daily. As with most vitamins and minerals, food is the best source of iron. You shouldn't need iron supplements if you take care to have a diet rich in iron. This means eating lots of dark green leafy vegetables, wholemeal bread, iron-fortified cereals, potatoes, lean red meat, shellfish, raisins, prunes and pulses. 

Vitamin C helps your body absorb the iron in your diet. Try drinking plenty of orange juice or eating fruit or vegetables which are rich in vitamin C, when you have an iron-rich meal, to help prevent you from becoming anaemic. 

Tea and coffee make it difficult for your body to absorb iron, so it's best not to drink them at mealtimes. 

How will I know if I'm anaemic? 

Anemia is confirmed if your haemoglobin level is less than 11.0 gm/dl. The routine blood tests you have at the antenatal clinic will check whether your haemoglobin levels are satisfactory. It's normal for the levels to drop a little during pregnancy because there's far more fluid in your blood to dilute the red blood cells. 

Only if your levels drop very low indeed will your doctor prescribe iron tablets. 

Are some women more likely to become anaemic during pregnancy? 

Women who have a diet that is low in iron are likely to become anaemic. You're also more likely to have iron deficiency anaemia in pregnancy if your body's iron supplies have already been depleted, perhaps because you've had two or more pregnancies close together, or you had heavy periods before you became pregnant. 

If you're carrying more than one baby then the demands of each baby can also increase your risk of anaemia. 

Thalassaemia is a common cause of anemia in pregnancy. It is an inherited blood disorder where the ability to produce the haemoglobin chain, either the alpha or beta, is affected. Alpha thalassaemia is more common in Malaysia than beta thalassaemia. Read more about thalassaemia in pregnancy. 

What are the symptoms of anaemia? 

You may not be aware that you have become anaemic, although fatigue is a common sign and so is breathlessness. However, these are symptoms also experienced by many pregnant women who are not anaemic. 

Headaches, tinnitus and palpitations are other symptoms of anaemia, along with unusual food cravings. Your eyelids, nail beds and tongue may also look pale. 

How is anaemia treated? 

Your doctor will discuss your diet with you to make sure that you are eating enough of the right kinds of food, and she may prescribe iron supplements. 

The drawback with iron supplements is that while they can improve your iron levels they also have some unpleasant side effects. They can cause constipation and other tummy upsets, such as nausea, diarrhoea and tummy ache. Increasing the fibre in your diet while you're taking them can help prevent constipation and taking the tablets with a meal can help reduce the other side effects. 

If you find the side effects become a serious problem for you, ask your doctor to prescribe you another brand - or to reduce the dose, as taking less is probably better than not taking any at all. 

Could my being anaemic affect my baby's health? 

Unless you are severely anaemic, you don't need to worry about your baby. Your body will make sure that your baby gets his quota of iron before you get yours. So you'll be short of iron long before he is. Your baby makes the heaviest demands on your iron supplies in the second and third trimesters of pregnancy, so this is the time to take extra care of yourself.