Iron is important in women’s health
As a woman there are times when you are more at risk of not having enough iron, such as during your period, or when you might need extra iron, e.g. during pregnancy.
You may also need to think about the iron levels of your children at certain times, especially during growth spurts and when your daughter starts menstruating (often called periods). So, whatever stage of life you are in, iron should be an important part of it.1
Iron and menstruation
The onset of menstruation, results in regular monthly periods that are a huge milestone in a girl’s life, and is an important part of what it means to be a woman.
Aside from the monthly inconvenience, a period puts quite a strain on the body and its iron stores.1
During your period you lose blood, which contains iron.1 This is one of the principal reasons for increased iron demand in women of reproductive age.1 This loss of blood means that women need up to twice as much iron from their diet as men.1 If the amount of iron in your diet is not enough to match the amount of iron lost through your period, you could become iron deficient, which can lead to iron deficiency anaemia (IDA).1
Heavy menstrual bleeding (HMB) and iron deficiency (ID)
Exceptionally heavy periods known as heavy menstrual bleeding, or HMB, affects up to a third of women of reproductive age, and is the most common cause of IDA in the developed world.2
This has an impact on their quality of life, whereby symptoms of IDA cause weakness, fatigue and mood swings to name a few.2
When you start thinking about having a baby there are some things that come to mind – cutting back on alcohol and caffeine and maybe taking a folic acid supplement – but you may also need to keep an eye on your iron levels.1
Why is iron especially important for me now?
If you are thinking of falling pregnant, the amount of iron in your body is vital.
A successful pregnancy requires plenty of iron – for the growth of the placenta, a healthy baby and to protect you against blood loss during delivery.1
Around 40 % of women begin their pregnancy without enough iron.1 Having iron deficiency (ID) before you get pregnant can affect how much your baby grows, meaning they are more likely to have a decreased birth weight.2 In addition, IDA at the start of your pregnancy can increase the chance that you have your baby early.1
There are a lot of things happening in your body before you may know you are pregnant. The placenta begins to grow, and your baby’s organs are almost developed by 8 weeks.3 It is therefore essential that you have a healthy diet from the moment you start trying to get pregnant.
During pregnancy, both you and your baby will need iron, so your doctor or midwife will check your iron levels. However, it is worth knowing the signs of iron deficiency (ID) and how you can maintain your iron levels between appointments. Iron is also important to help you cope with, and enjoy, the early days with your baby.1
It is needed for both physical and mental performance and to help you fight off infections. When you are pregnant you need iron to do all of this and to develop a healthy placenta, to support the growth of your baby and protect you against any blood loss during delivery.1
The placenta is responsible for the transfer of the bulk of substances between you and your growing baby. Oxygen and nutrients from your blood travel through the placenta and into the umbilical cord to be delivered to your baby.2 The transfer of nutrients occurs through blood, and iron is needed for development of this blood.1,2
Extra blood 2x
During your pregnancy you will almost double the amount of blood going around your body. You will need to increase your number of red blood cells by 35 %, and to do this your body needs iron.3
Iron and a healthy pregnancy
During pregnancy it is important to maintain the correct iron levels.3 Having iron deficiency anaemia (IDA) during pregnancy can contribute to your baby being born early (premature) or small (low birth weight).1,4
There are some factors that may put you at a higher risk of having ID or developing IDA:1
- If you had low iron levels before you were pregnant
- If you have other children, especially if they are close in age
- If you are having twins, or more
If you have ID or IDA during pregnancy you are likely to still have ID or IDA after giving birth, and less able to cope with any blood loss during delivery. Having low haemoglobin levels after birth can make it harder to look after your baby.1,5 Learn more about delivery and the early days.
The good news is there is a preferable solution for pregnant woman – FERRIMED® . It is clinically proven to be effective in the treatment of IDA in pregnant women.6 It doesn’t interfere with other medicines or food and is well tolerated with limited potential for side effects.6,7 Unlike other iron supplements, FERRIMED® contains ferric iron, which allows the body to absorb only the iron it needs.7 So for expectant moms, trust FERRIMED® to supplement your iron needs, by preventing or treating IDA in order to optimise the health of your baby.6
Iron and a healthy baby
Iron is needed for all organs to work properly, but especially when they are growing.4 A growing baby first uses iron that it gets from the mother to make red blood cells.1 If there is not enough iron in a baby’s body, it can affect the growth of their heart, muscles and brain.1,4 A baby’s immune system will also be affected if there is inadequate iron available.4 Iron is very important for a healthy brain development.1
Iron is not only necessary for growth in the womb, but also for growth after birth. Your baby uses the iron stored before birth to grow.1 A healthy, full-term baby will have enough iron to keep it growing normally until it is 4-6 months old.1,4
As your body returns to normal, there will be a change in the amount of iron your body will require.3 Even after a normal birth there is a chance you could have low iron.5
Am I at risk?
Iron deficiency (ID) after giving birth is very common.8 Almost a quarter of women are anaemic one week after a normal delivery.5 Having a caesarean can also increase your risk of IDA as a result of blood loss during the delivery.5 If you had IDA during your pregnancy you are likely to still have low iron levels after giving birth.5 Other factors that may increase your chance of having IDA after delivery include:
- If you have other children5
- If you had a caesarean section5
- If you had forceps or vacuum delivery9
- If you lost a lot of blood during labour or just after giving birth10
- If your baby was premature, or very late9
- If you had twins (or more!)5
- If you were overweight or obese before getting pregnant10
- If you are a vegetarian5
Why is iron still important?
To cope with the demands of a new-born baby your body needs all the help it can get – and that includes iron. ID and IDA after birth can negatively affect your quality of life, by:
- Affecting your mood and emotional well-being5,11
- Increasing number of infections 5
- Causing fatigue10
- Causing insufficient milk syndrome12
- Reducing the quality of your milk13
If you think you may suffering from low iron levels the first thing to do is talk to your doctor and get your iron levels checked. Remember to mention any difficulties you had during the birth and the amount of blood you have lost since getting home. If you are feeling particularly distressed, exhausted or having problems looking after your baby don’t be afraid to say so.
The earlier iron deficiency is diagnosed, the earlier it can be treated.
Once the initial baby haze has lifted and you are settling into your role as a mother, the importance of iron has a new focus – your child. As important as iron was during pregnancy, it continues to be a vital part of keeping you, and your children, healthy.
Are my periods unusually heavy?
It may be hard to know if your periods are worse or heavier than your friends’ and difficult to explain to your doctor what an impact they have on your life.
The questions below may help you judge how heavy your periods are, and give you a starting point for a conversation with your doctor.3
- Do you need to use double sanitary protection?
- Do you sometimes leak through your clothes or onto your bedding?
- Do you pass large blood clots?
If you answered yes to two or more of the above questions you may have HMB. 3 Talk to your doctor as they may be able to offer you treatment to ease some of these symptoms. If you are losing a lot of blood, you should check your iron stores as you may be at risk of ID and IDA.1,2
Iron and Your Baby
As your baby grows it needs iron to develop. Iron deficiency (ID) is the most common nutritional deficiency affecting infants.22
This is because their iron needs are greater since they grow so quickly, and have limited dietary sources of iron.1
Some factors which can contribute to your baby having ID, or developing iron deficiency anaemia (IDA) are:2
- If you were iron deficient during your pregnancy
- If you smoked during your pregnancy
- If you have diabetes
- If your baby was premature
- If you exclusively breastfeed for more than 4-6 months
Iron and the first six months
During the final trimester of your pregnancy, your baby had the chance to store iron.3 After birth, your baby uses this iron to allow it to keep growing.2,4 These stores are vital because the amount of iron required after four months often exceeds that found in breastmilk,3,4 and your baby’s gut is still developing so it is not yet ready to absorb iron from food.5 After 4-6 months your baby will have used up their stores of iron, so they will need to start getting iron from their diet.3 If your baby was delivered early they may not have had as much time to store iron before they were born as they needed.3
Iron for growth, learning and behaviour
As your baby’s iron stores decrease after 4-6 months, the amount of iron it needs from their diet increases to 11 mg/day.3 After they turn 1 years old, their growth slows down, so their iron requirements drop to 7 mg/day.3
Like their physical growth, your baby’s brain is also growing and developing rapidly. In fact, your baby’s brain is growing so fast that it doubles in size in the first year, and is almost the size of an adult brain by the time they are two5.
Iron is vital for a developing brain. The part of the brain that is important for learning and memory, the hippocampus, is very sensitive to low iron levels, and not having enough iron can prevent it from developing properly.5
ID can affect many areas of your child’s development, including their coordination, social and emotional skills and IQ. 1 Making sure your child has enough iron, and plenty opportunities for learning, will help to give them the best start in life.6
The good news is there is a solution for your growing baby. FERRIMED® is available in a pleasant tasting syrup that may be used from birth, and is clinically proven to be effective in the treatment of ID and IDA7 It does not interact with other medicines or food and is well tolerated with limited potential for side effects.7-9 Unlike other iron supplements, FERRIMED® contains ferric iron which allows the body to absorb only the iron it needs.8,9 Trust FERRIMED® to supplement your growing child’s needs by preventing or treating ID / IDA.7
Feeding and Weaning
Just as your baby puts extra demands on you for iron during pregnancy, as it continues to grow, so does its need for iron.2
After about 6 months, it is important that your baby gets iron from their diet to maintain their iron status.2
Iron and breastfeeding
If you are breastfeeding, you need to make sure you have enough iron to produce quality breastmilk.2,10 Anaemia, which could be due to ID, increases your chance of suffering from insufficient milk syndrome.2,11 This can mean your baby doesn’t gain weight properly, wants to feed regularly and weans at an earlier age.11 Anaemia can also affect the nutrients of breastmilk, as well as the substances that are needed for your baby’s immune system.10
Iron and weaning
At around 4-6 months, your baby begins to eat foods rich in iron, and the amount of iron it needs from their diet increases to 11 mg/day.2,3 After they turn 1 years old, their growth slows down, so their iron requirements drop to 7 mg/day.3
If your baby was full-term and you are breastfeeding, it is recommended that, starting at 4 months, you give them an iron supplement of 1 mg for every kg of their body weight, every day, until they are eating enough iron-rich foods.3
The teenage years are full of change as your children’s minds and bodies prepare for adulthood. All of this growth and change needs iron.12
Girls need the most iron
ID is more common in girls than in boys, simply because their need for iron is greater. As their bodies are growing and need more iron, girls also start losing iron on a regular basis with the start of their menstrual cycles (periods). The amount of blood lost during a period varies between girls, and is the main factor determining the amount of iron your daughter needs.12,13
Iron and growing boys
A teenage boy may be emptying out the fridge, but what he is eating is important. Boys need to provide fuel for a bigger change in size than a teenage girl. Growth spurts are accompanied by an increase in the amount of blood flowing through their body as well as an increase in lean muscle mass.12
Iron and diet
There is an increased number of overweight children today than ever before. Overweight teenagers are twice as likely to be iron deficient than those who are a normal weight. Girls are at a particularly high risk of ID if they are overweight as their bodies tend to grow faster and mature earlier than girls who are not overweight, making it even harder to get enough iron to meet their needs.14
Iron for learning and sport
Iron is important for learning, and low iron levels affect learning and behaviour before IDA has even developed.14
Iron is utilised by the body for oxygen transport and energy production, and it is therefore essential to athletic performance.15 Sport is a great way to keep fit and busy. However, a lot of exercise may have an effect on your iron stores, and insufficient iron stores (ID) has a negative effect on the amount oxygen that is transported and utilized by your body, negatively affecting athletic performance.15
Making sure teenagers follow a healthy diet and consume enough iron can help them fulfill their academic potential, and allow them to perform at their best on the sports field.
- Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci 2014;19(2):164-174.
- Liu Z, Doan Q V, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health 2007;10(3):183-194.
- Centers for Disease Control and Prevention. Blood Disorders in Women. Heavy Menstrual Bleeding. [online] 2016 Nov 28 [cited 2017 Sep 15]. Available from: URL: https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html.
- Geisser P. Safety and Efficacy of Iron(III)-hydroxide Polymaltose Complex. Arzneimittel-Forschung 2007;57(6a):439-52.
- Borbolla JF, Cicero RE, Dibildox M, Sotres D, Gutiérrez R. Iron hydroxide polymaltose complex vs iron sulphate in the treatment of iron deficiency anaemia in infants. Revista Mexicana de Pediatria 2000;57(2):63-67.
- Yasa B, Agaoglu L, Unuvar E. Efficacy, Tolerability, and Acceptability of Iron Hydroxide Polymaltose Complex versus Ferrous Sulfate: A Randomized Trial in Pediatric Patients with Iron Deficiency Anemia. Int J Pediatr 2011;2011:1-6.
- Breymann C. Iron deficiency anemia in pregnancy. Expert Rev Obstet Gynecol 2013;8(6):587-596.
- Ronnenberg AG, Wood RJ, Wang X, Xing H, Chen C, Chen D, et al. Preconception Hemoglobin and Ferritin Concentrations Are Associated with Pregnancy Outcome in a Prospective Cohort of Chinese Women. J Nutr 2004;134(10):2586-2591.
- Viteri FE. Iron endowment at birth: maternal iron status and other influences. Nutr Rev 2011;69(Suppl 1):S3-S16.
- Naidu S, Louw VJ, Surbek D. New frontiers in the treatment of iron deficiency during pregnancy and postpartum period. South African Women’s Health Issue 2017:30-34
- Desforges M, Sibley CP. Placental nutrient supply and fetal growth. Int J Dev Biol 2010;54(2-3):377-390.
- Bothwell TH. Iron requirements in pregnancy and strategies to meet them. Am J Clin Nutr 2000;72(Suppl):257S-264S.
- Rao R, Georgieff MK. Iron in fetal and neonatal nutrition. Semin Fetal Neonatal Med 2007;12(1):54-63.
- Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol 2011;90(11):1247-1253.
- Ortiz R, Toblli JE, Romero JD, Monterrosa B, Frer C, Macagno E, et al. Efficacy and safety of oral iron(III) polymaltose complex versus ferrous sulfate in pregnant women with iron-deficiency anemia: a multicenter, randomized, controlled study. J Matern Fetal Neonatal Med 2011;24:1-6.
- Breymann C, Gliga F, Bejenariu C, Strizhova N. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. Int J Gynaecol Obstet 2008;101(1):67-73.
- Bergmann RL, Richter R, Bergmann KE, Dudenhausen JW. Prevalence and risk factors for early postpartum anemia. Eur J Obstet Gynecol Reprod Biol 2010;150(2):126-131.
- Bodnar LM, Cogswell ME, McDonald T. Have we forgotten the significance of postpartum iron deficiency? Am J Obstet Gynecol 2005;193:36-44.
- Corwin EJ, Murray-Kolb LE, Beard JL.Low Hemoglobin Level Is a Risk Factor for Postpartum Depression. J Nutr 2003;133:4139-4142.
- Henly SJ, Anderson CM, Avery MD, Hills-Bonczyk SG, Potter S, Duckett LJ. Anemia and insufficient milk in first-time mothers. Birth 1995;22(2):86-92.
- França EL, Silva VA, Volpato RMJ, Silva PA, Brune MFSS, Honorio-França AC.Maternal anemia induces changes in immunological and nutritional components of breast milk. J Matern Fetal Neonatal Med 2013;26(12):1223-1227.
- Lozoff B, Beard J, Connor J, Felt B, Georgieff M. Long-lasting Neural and Behavioural effects of iron-deficiency in infancy. Nutr Rev 2006;64(5 Pt 2):S34-S91.
- Baker RD, Greer FR. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics 2010;126(5):1040-1050.
- Radlowski EC, Johnson RW. Perinatal iron deficiency and neurocognitive development. Front Hum Neurosci 2013;7:1-11.
- Lozoff B, Smith J, Clark K, Perales C. Home intervention improves cognitive and social-emotional scores in iron-deficient anemic infants. Pediatrics 2010;126(4):e884-e894.
- Beard JL. Iron requirements in adolescent females. J Nutr 2000;130(2S Suppl):440S-442S.
- Zimmermann M, Hurrell R. Nutritional iron deficiency. Lancet 2007;370:511-520.
- Nead KG. Overweight Children and Adolescents: A Risk Group for Iron Deficiency. Pediatrics 2004;114(1):104-108.
- Peeling P, Dawson B, Goodman C, Landers G, Trinder D. Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones. Eur J Appl Physiol 2008;103(4):381-391.