IRON. Look beyond Spinach!
This morning I had a rare opportunity to really dive into something that seems to be coming up frequently in my conversations with moms: IRON!
What I absolutely love about Nutritional Therapy is the opportunity I have to encourage clients to get outside of their comfort zone with new foods to help support their body. Iron is found in a variety of foods- the most absorbable form is heme (found in oysters, clams, red meat and animall products), but there is also non-heme iron available in plant-based forms (think beans, pumpkin seeds, leafy greens, kale, broccoli- and yes- Popeye, spinach). Unfortunately, the non-heme form is less easily absorbed.
For women who are not pregnant, 18 mg of iron is the recommended intake/day.
Amazingly, a woman’s blood volume increases by about 50% over the course of her pregnancy and iron is essential in this process. For a pregnant woman recommendations shift to 27 mg of iron/ day. A whopping additional 9 mg of iron/day! (In terms of iron absorption- that it’s the equivalent of almost 5 ounces of oysters or almost 10 quarter-pounders!)
In regards to boosting iron consumption, I often share this brilliant article by Lily Nichols with clients- for the visual learners in the crowd- it really gives a sense of how much iron is actually absorbed from different foods.
Did you know to get the same amount of iron from 1 ounce of clams you would have to eat 57 cups of broccoli? Or the amount of iron absorbed from 2.5 cups of cooked spinach is equivalent to one 3.5 ounce burger? Greens can be beautiful sources of vitamin A, C, K, magnesium and folate, but certainly keep in mind the absorption factor when eating plant-based foods high in iron.
Not only does iron help support energy, stamina throughout the day, strength, breathing, and regulated blood pressure in pregnancy, but it also minimizes risks in birth and the postpartum period by regulating mood, supporting healthy birth weight, lactation, and enhances the baby’s brain & body development.
All that being said, at Gentle Landing Birth Center, we base our definition of anemia in pregnancy on a hgb (hemoglobin) level of 11 g/dL or less in the first trimester, 10.5 g/dL or less in the second trimester, and 11 g/dL or less in the third trimester. Hemoglobin (Hgb) tests measure the amount of hemoglobin in red blood cells which are essential for transporting oxygen throughout the body and carbon dioxide back to the lungs.
At these levels, we generally DO recommend that mothers supplement with iron to avoid problems associated with iron deficient anemia- most often a result of the body either not absorbing iron that’s consumed or not consuming enough iron-rich foods. (To further complicate things- note that anemia can also be caused by other nutrient deficiencies, primarily B12 or folate. The midwife team is able to run additional tests if there are concerns about microcytic anemia, a condition where the red blood cells are larger than normal, sometimes caused by a B12 or folate deficiency.)
So, what can a woman do aside from supplementation to help boost her iron intake and absorption if her tests reveal low HGB numbers?
We often suggest three simple things:
Pair iron rich foods (especially plant-based ones) with vitamin C or vitamin C rich foods. Think bell peppers, kiwi, sweet potatoes and citrus fruits! More vitamin C rich ideas here.
Cook with cast iron pans to increase iron intake- think tomato sauce with red meat in cast-iron- hits all the boxes as tomato sauce is also a source of vitamin C!
Eating calcium-rich foods at a different time than taking iron supplements or eating iron-rich foods as calcium can negatively affect iron absorption. I often suggest people have calcium rich snacks like cottage cheese, greek yogurt, or cheese at their “snack” to avoid.
Sometimes women complain of constipation when taking iron supplements and I often hear that it’s a barrier to taking iron supplements. A few thoughts in this department:
Aim to get in at least ½ pre-pregnancy body weight in ounces of water/ day.
Fuel with high fiber foods to help with bowel motility (think oats, broccoli, apples, pears, broccoli, brussel sprouts, kale, lentils, chickpeas & black beans)
Consider the form of iron that you are taking. There are some studies that seem to show that there were fewer gastrointestinal complaints in women who took iron in the form of ferrous bisglycinate.
My hope in sharing a bit about about iron, AT LEAST ONE woman takes a moment to appreciate the tremendous need for iron in pre-conception, pregnancy, birth and the postpartum. Not only for a healthy energetic pregnancy and a well-grown baby, but also for a safe delivery and peaceful postpartum period!
Today’s blog was brought to you with the help of these beloved resources and research:
Transformation through Childbirth. Katherine Bramhall
Real Food for Real Pregnancy. Lily Nichols
Real Food for Mother & Baby. Nina Plank