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Getting Enough Iron During Pregnancy

Rachel O'Reilly

Iron is one of those buzzword nutrients that almost every woman knows about. Groups at highest risk for iron deficiency include teenage girls, women of childbearing age, pregnant women, children under 2 years of age, and the elderly. According to the World Health Organization, iron deficiency affects a large number of children and women in developing countries and is the only nutrient deficiency that is also significantly prevalent in industrialized countries.

Some degree of iron deficiency occurs in 35-58% of healthy women of childbearing age. But why does this occur? Mostly due to inadequate dietary intake, blood loss, lack of iron absorption/utilization, increased demand by the body (such as during pregnancy), or a combination of all these factors.

Iron deficiency anemia is one of the common nutrient anemias that can occur during pregnancy (others are a deficiency of folic acid and B12). Symptoms include:

  • Extreme fatigue

  • Dizziness

  • Shortness of breath

  • Paleness of skin, fingernail beds, and mucous membranes

  • Loss of appetite (especially past the first trimester)

  • Heart palpitations

  • Gastrointestinal disturbances such as constipation and abdominal pain

  • Frequent colds or infections

Iron’s role in the body

Iron plays an important role in transporting oxygen from the lungs to the body’s tissues, and carbon dioxide from the tissues to the lungs. For this reason, sufficient iron availability allows for optimal oxygenation of fetal tissue. Additionally, iron is a key enzyme in metabolism and DNA synthesis. The body’s need for iron will increase dramatically during pregnancy, as well as lactation, and proper optimal iron levels leads to adequate iron stores for the newborn.

Food Sources of Iron

There are two types of iron, heme and nonheme. Heme iron is found in animal sources, and is the most efficiently absorbed form of iron. Non-heme refers to iron found in plant foods, and is poorly absorbed.

Here’s an example of foods containing bio-available iron (heme):

  • 3 oz clams (cooked) 23.8 mg

  • 3 oz beef liver 5.3 mg

  • 3 oz Sirloin steak 2.9 mg

  • 3 oz shrimp 2.6 mg

  • 3 oz lean ground beef 2.3 mg

  • 3 oz turkey breast 1.3 mg


Other heme iron food sources include:

  • Poultry such as chicken, duck, and turkey

  • Meats such as beef, pork, and lamb

  • Seafood including sardines, anchovies, and oysters


Non-heme food sources: (in plant sources, ~17% of iron is absorbed)

  • 1 cup lentils 6.6 mg

  • 1 cup cooked spinach 6.43 mg

  • 1 cup cooked quinoa 5.3 mg

  • 1 cup kidney beans 5.2 mg

  • 1 cup cooked beet greens 2.74 mg

  • 2 tablespoons sesame seeds 2.62 mg

  • 5 figs, dried 0.85 mg

Other sources include:

  • Blackstrap molasses (also has a lot of sugar, so use sparingly as a sweetener)

  • Nettles (tea)

  • Kelp (seaweed - kombu and dulse)

  • Nutritional yeast  

  • Organic, unsulphured dried fruits including raisins, prunes, black Mission figs, apricots, and cherries)


According to the U.S. Department of Health and Human Services and the National Institutes of Health, the recommended dietary allowance (RDA) of iron during pregnancy is 27mg, and 9-10 mg during lactation.  Keep in mind that the RDA is a guideline that was originally created in 1941 and was designed to reduce the rates of severe nutritional deficiency disease, such as scurvy. In other words, consider the RDA the minimum amount necessary, and these amounts will not take your individual need into consideration. To check your individual iron status, talk to your healthcare provider; they will be able to run a CBC test, or complete blood count, and interpret the results for your needs.

Can I get all my iron needs from food?

Even for women who eat a healthy, whole foods diet, and have reasonable iron stores prior to conception, supplementing (via your prenatal vitamin, not as a single supplement) will ensure sufficient iron levels during pregnancy, as well as for a good length of time postpartum. Supplementation may also be helpful in protecting against iron deficiency in subsequent pregnancies . Always talk to your health care provider and/or midwife before supplementing.


Honey Iron Syrup



Black Mission figs

Dried dark cherries


Carob pod


  1. Mix equal parts of each to add up to 1 cup

  2. Place in a 1 quart canning jar

  3. Pour honey to fill and cap the jar

  4. Place into a hot water bath, and heat gently for three hours.

  5. Let sit at room temperature for 1 week

  6. Can strain or use as is

Dose: 1 tablespoon per day, in Nettle herbal tea. To bump up the iron levels even more, use a combination of nettles, yellow dock, and dandelion root.