Download Iron and Anaemia in Pregnancy July 2013x

Women’s
Health Division
References;
Ministry of Health, (2008). Food and Nutrition
Guidelines for Healthy Pregnant and
Breastfeeding Women – a Background Paper.
Pairman,S, Pincombe,J, Thorogood,C &
Tracey,S. 2nd Ed. (2010). Midwifery.
Preparation for practice.
www.emmasdiary.co.nz
Community Midwifery Guidelines CMDHB
Aug. 2012
Department:
Women’s Health
Approved by: Director of
Midwifery
Document Owner: M.
Pickmere (Midwife); Clinical
Midwife Educator
Update:
July 2013
ID:
A189027
Review:
July 2015
Iron and
Anaemia
in
Pregnancy
Information
for
Pregnant
Women
and
Whaanau
Anaemia in Pregnancy
Anaemia (low iron) is when there are less of the
oxygen carrying cells in the blood, which may be due
to a variety of causes.
Blood tests are checked at your first appointment and
when you are 26-28 weeks and 36 weeks pregnant.
Lack of Iron
Lack of iron (deficiency) anaemia is the most common
type of anaemia in women of childbearing age. The
body uses iron to make red blood cells. Causes include
heavy periods, a poor diet, smoking and a short gap
between pregnancies.
Effects of anaemia for the mother
• Feeling tired
• Breathless on exercising
• Infections
• Feeling the cold
• Difficulty concentrating
• Increased risk of haemorrhage (very heavy
bleeding) after the birth
• Strain on your heart, especially immediately
after birth
Effects of anaemia on baby
• Growth can be slower so baby is lighter than
average at birth
• Small placenta
• Lower amounts of oxygen getting to the baby
• Premature (before 37 weeks) birth
Food sources of Iron
• Red meat, fish and poultry –more easily
absorbed than iron found in plant based
foods.
• Tofu, wholegrain bread, cereals, egg yolk,
legumes.
•
Dried fruit, vegetables, nuts and
seeds – all contain iron.
Vitamin C helps with the absorption of iron;
• Mandarins, oranges, tamarillos and
lemons.
• Fruit juice, kiwi fruit and feijoas.
• Cauliflower, broccoli, green capsicum
and tomatoes.
The above must be eaten with meals to assist
the absorption of iron.
Avoid:
• Drinking milk, tea or coffee within two
hours of meal times or when taking
iron supplements (tablets, syrup or
water). These can block the body’s
absorption (soaking up) of the iron.
• Medicines taken to relieve indigestion
can also block the effect of iron.
Medications for high blood pressure
and thyroid deficiency have a reduced
effect if taken within two hours of
taking iron. Timing of your drugs is
important please discuss with your
midwife or doctor what is suitable for
you.
If possible, iron should be taken with a large
glass of water, half an hour before food. If this
causes a gastric upset can be taken with food.
The colour of your bowel motions and urine
can darken when taking iron.
Lack of Folic Acid
Also called folic acid deficiency anaemia. Low
levels of Folic Acid are linked to defects (or
abnormalities) in the brain or the spine (e.g.
spina bifida).
To prevent these defects, folic acid should be taken just
before becoming pregnant and during the first 3
months of pregnancy.
Alcohol can lower folic acid levels.
Women who are taking certain anti-epileptic
medications, couples with spina bifida or a history of
having babies with spina bifida should take folic acid
three months before pregnancy at the higher dose of
5mg daily and throughout the pregnancy.
Lack of Vitamin B12
Vitamin B12 levels fall in pregnancy, but are unlikely to
cause problems for most women as the body draws
upon its own stores.
• Low vitamin B12 creates tingling in the hands
or feet so it is important you report this to your
midwife or doctor.
• Vitamin B12 can be replaced by a course of
injections. Vitamin B12 deficiency (lack of) can
lead to nerve damage.
• Women following a vegetarian or, in particular,
a vegan diet should have their B12 levels
monitored during pregnancy and also during
breastfeeding.
• Women who have gastric bypass surgery are
also likely to need to have Vit B12 levels
monitored
during
pregnancy
and
breastfeeding.
Dairy products contain B12
Following the guidelines in this pamphlet may prevent
you needing supplements however, your midwife or
doctor will inform you if your blood results show
anaemia.
Most supplements are in tablet form although some
are in a liquid. Iron injections or an infusion (a drip)
may be needed to treat severe (really bad) anaemia.