By LIANNE PHILLIPSON-WEBB

Understanding the benefits and drawbacks of iron during pregnancy and a baby’s first year often creates confusion.  Do I take extra iron during pregnancy because it’s common to become anemic, or not? Too much isn’t good, as the body has no way of excreting excess of iron, and high levels of iron compete with other minerals possibly leading to other deficiencies.  Here's what you need to know.


In utero
Although a pregnant mom-to-be sometimes is in need of an iron supplement, while in mum’s tum baby takes what he needs from mom. I’ve explained further in my book, Sprout Right: “Your baby will have stocked up on iron while in utero. This essential mineral supports the development of your baby’s brain for cognitive and behavioural maturity and makes hemoglobin, the protein in red blood cells that delivers oxygen to the body’s organs, muscles, and tissues." During the last trimester of pregnancy, baby nabs iron from mom's body and begins to store it for future use. This is why preterm babies are at higher risk of low iron levels than babies born at or close to term. 

Symptoms of iron deficiency
When our iron is low, the body increases its uptake or iron from food.  If diet isn’t supplying iron-rich foods such as in the table below, there may be a risk of low iron symptoms such as: pale skin, fatigue, irritability, dizziness, weakness, shortness of breath, sore tongue, brittle nails, decreased appetite (especially in children), frequent respiratory or intestinal infections, pica (wanting to eat nonfood items such as dirt or ice), headache in the front of your head, and itchiness.

Anemia
Iron-deficiency anemia, a lack of adequate red blood cells caused by too little iron, affects about 50 percent of pregnant women. During pregnancy, iron requirements more than double to build new red blood cells in mom and the developing fetus. A blood test will have been done during your pregnancy to check your iron level, and if anemia was found, an iron supplement prescribed. Correcting anemia can take months, and it’s important to be retested after a few months to ensure that your levels have improved. Even if you were anemic during pregnancy, one interesting study has shown that your baby won’t be predisposed to having low iron stores.* The true test of iron level for mom or baby is a blood test.  Discuss your concerns with a doctor, and a naturopath or nutritionist can help with suggestions of how to eat an iron rich, healthy diet along side supplementation if necessary.


Iron-rich foods*

Meat and Seafood
Beef (113 g)* 3.5 mg**
Lamb (113 g) 2.5 mg
Pork (113 g) 1 mg
Veal (113 g) 1.5 mg
Chicken liver (113 g) 10 mg
Beef liver (113 g) 6.5 mg
Chicken, light meat (113 g) 1 mg
Chicken, dark meat, roasted (1 leg and thigh) 2.3 mg
Turkey, light meat (113 g) 1.6 mg
Turkey—dark meat, roasted (3 slices) 2 mg
Clams (113 g) 3 mg
Oysters (113 g) 8 mg
Shrimp (113 g) 2 mg

Beans, Lentils, and Vegetables
Beans (1/2 cup/125 mL) 2 mg
Chickpeas (1/2 cup/125 mL) 2 mg
Potato (1 with skin) 2.5 mg
Pumpkin (113 g) 1.7 mg
Peas (113 g) 1 mg
Lentils, cooked (1/2 cup/125 mg) 3.3 mg
Sweet potatoes (113 g) 1.7 mg
Tomato paste (113 g) 3.9 mg
Tomato sauce (113 g) 0.8 mg

Grains and Cereals
Pasta (113 g) 1.5 mg
Bagel (28 g) 1 mg
Bread (whole wheat, 1 slice) 1 mg
Iron-fortified cereal (28 g) 4–8 mg
Quinoa flour (1/2 cup/125 mL) 8.5 mg
Quinoa, dry (1/4 cup/50 mL) 3.9 mg
Amaranth (1/2 cup/125 mL) 7.4 mg
Amaranth flour (1/2 cup/125 mL) 8.5 mg

Fruit, Juice, and Other
Dried apricots (10 halves) 1.6 mg
Figs (5) 2 mg
Raisins (113 g) 1.5 mg
Prune juice (227 g) 3 mg
Nuts (28 g) 1 mg
Tofu, firm (85 g) 3.5 mg
Blackstrap molasses (1 tbsp/15 mL) 3.5 mg
Sunflower seeds (2 tbsp/28 g) 1.9 mg
Pumpkin seeds (2 tbsp/28 g) 4 mg
Infant formula (227 g/8 oz) 3 mg

* Serving size.
** Iron content.

Iron for Babies
Iron and babies ranks up there as one of the biggest concerns for new parents when it comes to feeding their babies.
If your baby was born at close to her due date at a birth weight above 3 kg (6 lb, 6 oz) and breast- or formula-feeds well, she’s unlikely to have low iron. Unless there has been blood loss for some reason, you don’t need to be overly nervous about deficiency.

Iron found in breast milk has easier absorption than formula milk and food, because it’s alongside two helpful proteins, transferrin and lactoferrin, that help increase absorption.  Transferrin and lactoferrin both act as a shuttle system for iron to get to baby’s bloodstream.  Although breast milk has low levels of iron, this transportation system explains how the supply and delivery of iron is very efficient.

Iron Absorbability from Breast milk, Formula, and Infant Cereal**
Breast milk: 50–70 percent
Iron-fortified dairy formula: 3–12 percent
Iron-fortified soy formula: 1–7 percent
Iron-fortified cereal: 4–10 percent
Cow’s milk: 10 percent
 
Worried parents who feed their baby cereal for the iron benefit, may feel relief in knowing that if their baby is having a reaction, don’t like it or suffers constipation, it’s okay to stop feeding cereal. The absorption rate of iron from cereal is low and may not be providing their baby with enough to meet their requirements.
 
I believe that high levels of beneficial or good bacteria in the digestive system (probiotics of Lactobacillus acidophilus and Bifidobacterium) should allow better absorption of iron.  Bad bacteria, that lives in all of us, consumes iron from food; when more good bacteria (probiotics) crowds it out, iron should be more readily available for our body.

Probiotics are simple enough to give, have many more health benefits for your baby, including boosting the immune system, possibly reducing the chance of developing of allergies, and may help to reduce gassiness and colic-like symptoms. I’ve recommended it for hundreds of babies, and I believe that they’re all the better for it. 

Do you have a specific question about iron? Leave me a question in the comments below.
 
*Excerpt from Sprout Right – Nutrition from Tummy to Toddler published by Penguin Canada.
**Kelly Bonyata, “Is Iron-Supplementation Necessary?” (May 19, 2006), http://www.kellymom.com/nutrition/vitamins/iron.html