Pumping iron for your baby

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Jospephs Gate
Dr Preeti Khillan

Iron deficiency anaemia is the most common cause of anaemia in Australia during pregnancy, and can affect 15-25% of all pregnancies. So here’s what you can do to prevent it

Anaemia during pregnancy not only makes you feel lethargic but also puts your baby at risk. It is therefore imperative to understand how anaemia develops and how it is detected early, and what one should be do prevent it?

Anaemia is a condition when the blood is thin and there are not enough healthy red cells in the body to carry adequate oxygen to the tissues. Pregnancy puts you at risk of having anaemia due to increased demand of many minerals and nutrients necessary to make haemoglobin to carry oxygen.

Poor oxygen supply will put your baby at risk. When the tissues do not receive an adequate amount of oxygen, many organs and functions are affected. Anaemia during pregnancy is especially a concern because it is associated with low birth weight, premature birth and maternal mortality. Generally, anaemia during pregnancy is a mild condition and is easily treated if diagnosed early but it can be dangerous to both the mother and the baby, if it remain untreated.

Anaemia during pregnancy can happen due to deficiency of Iron, Folate and Vitamin B12 but most commonly it happens due to Iron deficiency.

Iron deficiency anaemia is the most common cause of anaemia in Australia during pregnancy. It can affect 15-25% of all pregnancies. Iron is important constituent of haemoglobin, a protein in the red blood cells which carries oxygen from lungs to rest of the body. When there is iron deficiency you feel easily tired and fatigued.

Iron from animal products, such as meat, is most easily absorbed. Iron from vegetables particularly spinach is not well absorbed. To enhance the absorption of iron from plant sources and supplements, it is best to consume them with a food or drink high in vitamin C—such as orange juice, tomato juice or strawberries

During pregnancy, there is natural dilution of blood leading to a fall in haemoglobin levels during pregnancy, which is caused by a greater expansion of plasma volume compared with the increase in red cell volume. This disproportion is at its peak in second trimester. Diet that does not contain iron-rich food or the body’s inability to absorb the iron being consumed during pregnancy can be an important reason for Iron deficiency anaemia. The iron demand during pregnancy is also increased to meet the demand of increasing blood volume and also to the meet the needs of growing baby.

Here are some of the risk factors for developing anaemia during pregnancy:

  • Being a vegetarian
  • Closed spaced pregnancies
  • History of iron deficiency and anaemia before pregnancy
  • Sickness during pregnancy
  • If you are pregnant with more than one baby (Multiple pregnancy)
  • Are vomiting frequently due to morning sickness
  • Don’t consume enough iron
  • Have a heavy pre-pregnancy menstrual blood flow
  • Have a history of anaemia before your pregnancy

Mild anaemia during pregnancy is generally asymptomatic and often go unnoticed. However, with severity, as it progresses, the symptoms will worsen. It is also important to note that some symptoms can be due to a different cause other than anaemia, so talking with your doctor is important. Anaemia during pregnancy can cause, fatigue, weakness, tiredness, lack of energy, trouble concentrating, paleface; lips and nails, dizzy spells, headache, low blood pressure, breathing difficulties, generally these symptoms overlap with symptoms of normal pregnancy. That’s why your GP will do routine blood tests in early pregnancy to screen for anaemia during pregnancy. Further blood test is also done later in pregnancy.

Calcium is an essential nutrient needed during pregnancy, but calcium can decrease iron absorption. So, both calcium and iron medication should be avoided to be taken at the same time

Good nutrition is the key to prevent iron deficiency anaemia during pregnancy. Dietary sources of iron include lean red meat, eggs, poultry and fish. Other options include iron-fortified breakfast cereals, prune juice, dried beans and peas, green leafy vegetables, nuts and seeds, lentils. Because it can be a challenge to eat as much iron as is suggested during pregnancy, taking iron supplements is recommended in addition to consuming these foods.

Iron from animal products, such as meat, is most easily absorbed. Iron from vegetables particularly spinach is not well absorbed. To enhance the absorption of iron from plant sources and supplements, it is best to consume them with a food or drink high in vitamin C—such as orange juice, tomato juice or strawberries.

Pre-pregnancy intake of multivitamin with iron helps in maintaining enough iron stores to prevent iron deficiency anaemia.

Calcium is an essential nutrient needed during pregnancy, but calcium can decrease iron absorption. So, both calcium and iron medication should be avoided to be taken at the same time. Minimum of one-hour gap is recommended between iron and calcium uptake.

If despite all the preventive measures you have symptoms of anaemia, consult with your doctors-GP/obstetrician. Your doctor may request few blood tests to find out the cause and severity of anaemia and will tailor the treatment accordingly. If the cause is iron deficiency additional iron supplemental iron might be suggested. Iron supplementation is generally given orally but in case you cannot tolerate iron tablet or you have side effects of oral iron supplementation, intravenous iron administration can be given.

The writer is a Senior Consultant, Obstetrics and Gynaecology, at Sunshine Hospital, as well as Director, Western Specialist Centre, Werribee

 

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