Helpful information about iron-deficiency (anemia)

Iron-deficiency anemia is easily diagnosed and treated — and very common in females, especially those of childbearing age. The World Health Organization estimates that more than 42% of pregnant women and 30% of nonpregnant women and suffer from this condition.

Why do so many women of childbearing age have iron-deficiency anemia?

Women who are of childbearing age are at high risk for the condition because of the blood lost during monthly periods. If you have a heavy period, you might be at high risk for this condition. Women who are pregnant are also at high risk for the condition because their bodies are in need of even more iron than usual due to their increased blood volume and the iron and hemoglobin needed for a baby’s growth.

A number of other conditions and risk factors can lead to iron-deficiency anemia. Individuals who don’t consume enough iron — found in foods like meat, leafy greens, eggs, and iron-fortified foods — could be at risk. People who suffer blood loss for other reasons — such as ulcers or hernias — or even frequent blood donors can also be at risk. And because iron is absorbed by the body in the small intestine, individuals with disorders that affect the small intestine’s ability to absorb such nutrients can be at risk too.

What are some of the symptoms of anemia? And how is it diagnosed and treated?

Mild anemia usually goes unnoticed as some of the common symptoms of iron-deficiency anemia can be easily attributed to other issues or overlooked. But when the condition does worsen, common symptoms may include:

• Fatigue or lack of energy
• Generalized weakness
• Pale or yellow skin
• Headache, lightheadedness, or dizziness
• Pounding in the ears
• Shortness of breath
• Rapid heartbeat or chest pain
• Cold hands and feet
• Brittle nails
• Hair loss
• Sore tongue
• Poor appetite
• Pica, unusual cravings for non-nutritive substances (like ice, dirt, or starch)

Your healthcare provider can run blood tests to diagnose iron-deficiency anemia. Because the condition is often under-diagnosed, being your own healthcare advocate can go a long way. If you’re suffering from any of these symptoms, ask your provider if they think such tests are warranted.

Once diagnosed, your provider will work to understand the underlying cause of the condition. Fortunately, for many, anemia can easily be treated with over-the-counter iron supplements or dietary changes. Many people do start to feel better after a few weeks, and your healthcare provider will likely have you retake the same blood tests a month or so after starting treatment to see if your iron levels are improving.

What can iron-deficiency anemia lead to?

If iron-deficiency anemia is left untreated, it can cause a number of complications such as heart problems and a greater susceptibility to infection.

In pregnant women, the condition is linked to premature births, babies with low birth weight, and greater blood loss after birth. Luckily, blood tests at initial prenatal healthcare appointments include blood tests that will look for signs of anemia. Based on these test results, for many women their prenatal care may very well include iron supplements.

Read more

• Foods to fix iron-deficiency anemia
• Why preventive care is essential for better health

Sources:

• AJ Friedman et al. “Iron deficiency anemia in women: A practical guide to detection, diagnosis, and treatment.” Obstetrical & Gynecological Survey. 70(5): 342-53. May 2015. Retrieved August 28 2017. https://www.ncbi.nlm.nih.gov/pubmed/25974731.
• Mayo Clinic Staff. “Iron deficiency anemia.” Mayo Clinic. Mayo Foundation for Medical Education and Research, November 11 2016. Retrieved August 28 2017. http://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/home/ovc-20266507.
• “Iron-Deficiency Anemia.” American Society of Hematology. American Society of Hematology. Retrieved August 28 2017. http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx.
• “What Is Iron-Deficiency Anemia?” National Institutes of Health: National Heart, Lung, and Blood Institute. U.S. Department of Health and Human Services. March 26 2014. Retrieved August 28 2017. http://www.apa.org/helpcenter/emotional-support.aspx.

Your diet during pregnancy can dictate the course of both your health and Baby’s. Proper nutrition will promote good health, while poor nutrition could result in lots of different complications, depending on whether you’re getting too much or too little of something.

Nutrition enormously contributes to the body’s function. Since Baby taps directly into what you eat and drink to feed them and keep them growing big and strong, it’s important to be extra diligent about getting all of the recommended daily allowance (RDA) of the nutrients you need during pregnancy.

Taking a daily prenatal vitamin is a good start, but may not contain all of the vitamins and minerals that you need to ensure a healthy pregnancy for both you and Baby— most of the nutritional burden will come from your diet. Moms-to-be who track their nutrition have a much better sense of whether they are eating healthily or not, making adjustments as needed to better promote baby’s development and even combat pregnancy symptoms.

How Ovia can help

With Ovia, you can track the different food groups you eat to ensure that your getting all the nutritional value that you and Baby need, as well as your water intake and your prenatal vitamin regimen. Tracking your nutritional intake with Ovia can help us let you know when you should make an adjustment in your diet to better promote Baby’s healthy growth and development, or if a change may relieve some of your symptoms.

Getting all of the vitamins and minerals you need to stay comfortable and healthy can be a tough job, but it’s very possible and very important to do so. Tracking what you eat can help you best understand how your nutrition affects your pregnancy and your baby to ensure that Baby is developing as they should be.

Reviewed by the Ovia Health Clinical Team

Read more

• Prenatal vitamins: what to look for
• Fruits and vegetables during pregnancy

Sources

• “Nutrition During Pregnancy: FAQ001.” ACOG. American College of Obstetricians and Gynecologists, 4/15/2015. Web.
• American College of Obstetricians and Gynecologists. “ACOG Practice Bulletin No. 95: anemia in pregnancy.” Obstet Gynecol. 112(1):201-7. Web. 7/8/2015.

Every parent wants to make sure that they are as healthy as possible, and one of the best ways to ensure that is by following proper, pregnancy-specific nutrition guidelines. Even those who eat a tremendously well-balanced diet need some supplementation of vitamins and minerals, so all pregnant people are strongly encouraged to take a daily prenatal vitamin, which contains a variety of critical nutrients. Here’s a general idea of what to look for:

Folic acid

This synthetic form of folate is found naturally in foods like beans, nuts, and spinach. The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women get 600 micrograms (mcg) of folic acid each day. Since it can be hard to get that much folate just from food alone, ACOG also recommends that pregnant women take a daily prenatal vitamin with at least 400 mcg of folic acid (or 4 mg for those who are high-risk for neural tube defects), to help cell and neural tube development. Most prenatal vitamins, however, may have closer to 800 mcg. Although you can buy prenatal vitamins that contain “folate,” folic acid is the only supplement that has been researched and shown to reduce the incidence of neural tube defects.

Iron

ACOG recommends that pregnant women get 27 mg of iron a day in their prenatal vitamin intake to help with blood development and oxygen transport. Iron can sometimes lead to constipation, which can be treated with over-the-counter stool softeners. People with iron-deficiency anemia may need additional iron, so talk to your health provider for more information.

Calcium

The Mayo Clinic suggests that a prenatal vitamin should contain at least 250 mg of calcium to help a fetus develop bones, and to prevent you from developing osteoporosis. Pregnant people should aim to consume 1000mg of calcium each day through foods like dairy, cooked leafy green vegetables, and some fish. 

Vitamin D

ACOG recommends that pregnant people get between 200-400 IUs (international units) of vitamin D in their prenatal, as it helps with healthy bone growth. All women should aim for at least 600 IU of vitamin D per day, and possibly more if you do not get much exposure to sunlight. This is one simple vitamin where testing to get a personal baseline level can be helpful. Higher levels of supplementation are safe and indicated when vitamin D deficiency is present.

Vitamin B6

The Mayo Clinic advises that a prenatal vitamin should contain at least 2 mg of vitamin B6. Vitamin B6 is sometimes also prescribed to help combat pregnancy nausea.

Vitamin C

Though often overlooked in the pregnancy nutrient world, ACOG advises pregnant women to get at least 85 mg of vitamin C in their prenatal vitamin to help build a developing baby’s bones and muscles, and keep the mother’s immune system running strong.

Choline

An emerging nutrient, most prenatals now contain choline – which is tough to consume through diet alone. 450 mg per day is a typical recommendation.

DHA

Although many prenatal vitamins don’t contain docosahexaenoic acid (DHA, an Omega-3 fatty acid), DHA can be important for nervous system development, so most healthcare providers would recommend taking 200-300 mg a day if you’re unable to eat enough through dietary sources.

You should talk to your provider about any other supplementation you’re considering, and you should also avoid additional vitamin A supplements, as excess can be harmful in pregnancy. It can be tough to choose a prenatal when there are so many brands available with lots of flashy advertising and claims of effectiveness. Remember that “natural” is just a marketing term, and only vitamins with a USP checkmark are tested to verify that the ingredients and dosage levels are consistent with their label. When in doubt, your OB provider can always help with personalized suggestions.

Reviewed by the Ovia Health Clinical Team

Read more

• DHA during pregnancy
• Folic acid during pregnancy: building baby’s brain

Sources

• AK Sfakianaki. “Prenatal vitamins: A review of the literature on benefits and risks of various nutrient supplements.” Formulary Journal. ModernMedicine Network, January 31 2013. Retrieved July 1 2020.https://www.formularywatch.com/view/prenatal-vitamins-review-literature-benefits-and-risks-various-nutrient-supplements.
• Mayo Clinic Staff. “Prenatal vitamins: Why they matter, how to choose.” Mayo Clinic. Mayo Clinic, May 1 2020. Retrieved July 1 2020. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945.
• “Nutrition During Pregnancy: FAQ001.” The American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, June 2020. Retrieved July 1 2020. https://www.acog.org/patient-resources/faqs/pregnancy/nutrition-during-pregnancy.

We aren’t going to lie – after so many years of looking out for yourself first and foremost, it can be tough adjusting to the new lifestyle, and the fact that you haven’t even met the most important person in your world yet (although Baby is staying cozy right under your nose)!

Whether you were trying for years, or they is a bit of a surprise, it’s very important to understand what is on the horizon, and how your life will change now that you’re pregnant.

What happens next after the positive test?

A home pregnancy test is the way a lot of women find out the wonderful news, either before or after a missed period. Although these tests are for the most part reliable, it’s best to call your healthcare provider to have him or her confirm the pregnancy with a blood test. Much like your home pregnancy test did, your provider will search your blood for the level of hCG, a hormone only produced in significant quantities during pregnancy, to make sure. Following this, your healthcare provider will schedule your next appointment.

Your healthcare provider can be your most valuable resource from conception to delivery, so feel free to ask him or her any questions you might have about your body, your baby, or anything else.

Prenatal vitamin

Many women who are trying to conceive will already be on a prenatal vitamin that provides all of the daily nutrients they’ll need (you still need food!), but those who are not should begin a regimen as soon as possible. Prenatals contain vitamins and nutrients like folic acid, iron, and Vitamin B to help you stay as healthy as possible, and to best facilitate Baby’s development.

Kicking the habits

Smoking and drinking aren’t the best ideas for Baby‘s health, so adjusting to some restrictions may be difficult for some moms, particularly those for whom pregnancy was a bit of a surprise.

It can be really tough, but newly pregnant moms need to understand how much smoking, excess alcohol, and other things can affect the pregnancy. Engaging in these behaviors during pregnancy makes you more likely to miscarry, have a complicated pregnancy, or have a baby with birth defects or developmental disorders, so cutting out or down on these substances is probably just about the most important thing you can do for Baby’s health during these first few days or weeks of pregnancy.

It’s also best to limit your caffeine intake to a cup of coffee or tea a day, and to avoid eating fish high in mercury like tilefish, swordfish, mackerel, and shark. You should also avoid non-steamed deli meat and soft cheeses.

Happy and healthy

Of course it’s important for every man and woman to stay healthy, but this need just increases when you’ve got a baby to take care of too! Pregnant moms need to be very mindful of their activity, nutrition, sleep, blood pressure, and more to ensure that Baby is developing in the best ecosystem possible.

• Activity: Moms-to-be must be very diligent about getting enough exercise, as staying active will not only help you keep your weight gains to a healthy level, but can also help you manage your symptoms, and strengthen your body for labor.
• Nutrition: Even though prenatal vitamins contain lots of vitamins and nutrients you need, it’s important to reinforce this nutritional need through healthy eating. Pregnant women should do their best to eat plenty of fresh fruits, veggies, and meats, and avoid eating overly fatty or processed foods, as the body works best with only natural fuels.
• Sleep: Getting the right amount of ZZZs is imperative during pregnancy, as it allows your body to recover to the strength it needs to help baby develop healthily, and can help you manage your toughest symptoms.
• Blood pressure: Abnormal blood pressure, whether high or low, can both be dangerous for you and Baby during pregnancy, so it’s very important to monitor your BP readings so you’ll know that all is well.

Read, read, read

If this is your first pregnancy, you might not be totally informed about what’s about to happen during these next nine months. Read as many resources as you can, whether books, magazines, or online (just make sure the author is reputable!) about pregnancy. Even if you’re a veteran in the pregnancy game, it never hurts to brush up on your information.

Reviewed by the Ovia Health Clinical Team

One of the best ways to ensure a healthy nutritional balance during pregnancy is by following proper, pregnancy-specific nutrition guidelines. Even those women who eat a tremendously well-balanced diet need some supplementation of vitamins and minerals, however, so all pregnant moms are strongly encouraged to take a daily prenatal vitamin that contains a variety of helpful and healthy nutrients. Women should try to find a prenatal that includes all of the following.

Folic acid

This is the synthetic form of folate, found in prenatal vitamins and fortified grains. The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women get at least 400 micrograms of folic acid (4 mg for those who are high-risk), which helps cell and neural tube development. Most prenatal vitamins, however, will have closer to 800 mcg.

Iron

ACOG recommends that pregnant women get 27 mg of iron a day in their prenatal vitamin, to help with blood development and oxygen transport. Iron can sometimes lead to constipation, which can be treated with OTC stool softeners.

Calcium

The Mayo Clinic suggests that a prenatal vitamin contain at least 250 mg of calcium to help a fetus’ bones, and prevent you from developing osteoporosis.

Vitamin D

The Cleveland Clinic recommends that pregnant women get between 200-400 IUs of Vitamin D in their prenatal, as it helps with healthy bone growth.

Vitamin B6

The Mayo Clinic advises that a prenatal vitamin should contain at least 2 mg of Vitamin B.

Vitamin C

Though often overlooked in the pregnancy nutrient world, The Mayo Clinic advises pregnant women to get at least 50 mg of Vitamin C in their prenatal vitamin to help build a developing baby’s bones, and keep the mother’s immune system running strong.

Copper

2 mg of copper is recommended by The Mayo Clinic in a prenatal vitamin as copper helps build a baby’s heart, red blood cells, and nervous system.

Zinc

The Mayo Clinic recommends that moms-to-be get 15 mg/day of zinc from their prenatal vitamin to help with cell development and the immune system.

DHA

Although many prenatal vitamins don’t contain docosahexaenoic acid (DHA, an Omega-3 fatty acid), DHA can be incredibly important for nervous system development, so most healthcare providers would recommend taking a prenatal that includes DHA, most of which contain about 200 mg.

You should talk to your provider about any other supplementation you’re considering, and should also avoid additional Vitamin A supplements as an excess is proven to be dangerous.

Reviewed by the Ovia Health Clinical Team

Read more

• Routine prenatal tests
• Nutrition in pregnancy

Sources

• AK Sfakianaki. “Prenatal vitamins: A review of the literature on benefits and risks of various nutrient supplements.” Formulary Journal. ModernMedicine Network. Web. 1/31/2013.
• Mayo Clinic Staff. “Prenatal vitamins: Why they matter, how to choose.” Mayo Clinic. Mayo Clinic, 5/13/2015. Web.
• University of California- Davis Health System. “Women who start prenatal vitamins early are less likely to have children with autism, study finds.” ScienceDaily. ScienceDaily, 5/25/2011. Web.
• “Nutrition During Pregnancy: FAQ001.” ACOG. American College of Obstetricians and Gynecologists, 4/15/2015. Web.

Who might progesterone be a good fit for?

Studies show that weekly progesterone treatments may help reduce the risk of preterm birth for those who have certain risk factors, like a short cervix.

What about if you have a history of preterm birth?

Those who have had spontaneous preterm deliveries of single babies in the past are especially at risk for preterm delivery. Some research suggested that progesterone treatment was helpful for those with a history of prior preterm birth, and that getting weekly progesterone injections would lower the risk of preterm labor. However, the PROLONG study published in 2020 found that weekly progesterone injections did not have a significant benefit for those with a history of preterm birth.

Because the evidence is mixed for those with a history of preterm birth, talk through the possible benefits and risks of progesterone treatment with your healthcare provider.

How does it work?

Progesterone works by preventing the contractions that kickstart labor. This means that even in cases where progesterone treatments don’t prevent preterm labor, they may delay labor significantly, giving babies longer to develop in the womb. Babies who are considered to be “late preterm” – babies born between 34 and 36 weeks gestation – have a lower risk of more dangerous health complications, and the closer to term a pregnancy gets, the better the odds are.

Progesterone isn’t an effective treatment for those carrying twins or multiples, and may not be right for those who have personal histories of certain health conditions. If you’re concerned about your risk for preterm labor, talk to your provider about possible prevention strategies.

Learn more about preterm labor

Read more

• The power of preparing for preterm birth
• Risk factors for preterm labor and birth

Sources

• Vincenzo Berghella. “Cervical insufficiency.” UpToDate. Wolters Kluwer, December 5 2017. Retrieved December 19 2017. https://www.uptodate.com/contents/cervical-insufficiency.
• Mary L. Gavin. “When do pregnant women need progesterone shots?” KidsHealth. The Nemours Foundation, November 2016. Retrieved December 19 2017. http://kidshealth.org/en/parents/progesterone-shot.html.
• S.S. Hassan. “Vaginal progesterone reduces the rate of preterm birth in women with sonographical short cervix: a multicenter, randomized, double-blind, placebo-controlled trial.” Ultrasound in Obstetrics and Gynecology. 38(1): 18-31. July 2011. Retrieved December 20 2017. https://www.ncbi.nlm.nih.gov/pubmed/21472815.
• Paul J. Meis, et al. “Prevention of Recurrent Preterm Delivery by 17 Alpha Hydroxyprogesterone Caproate.” New England Journal of Medicine. 2003; 348:2379-2385. June 12 2003. Retrieved December 20 2017. http://www.nejm.org/doi/full/10.1056/NEJMoa035140.
• M.S. To, J. Miletin, J. Semberova, S. Daly. “Is routine tranvaginal cervical length measurement cost-effective in a population where the risk of spontaneous preterm birth is low?” Acta Obstetrica Gynecologica Scandinavica. 95(12): December 2016. Retrieved December 19 2017. https://www.ncbi.nlm.nih.gov/pubmed/27623283.
• “Preterm birth fact sheet.” World Health Organization. World Health Organization, November 2017. Retrieved December 20 2017. http://www.who.int/mediacentre/factsheets/fs363/en/.
• “Progesterone treatment to help prevent preterm birth.” March of Dimes. March of Dimes, August 2014. Retrieved December 19 2017. https://www.marchofdimes.org/complications/progesterone-treatment-to-help-prevent-premature-birth.aspx.
• M.S. To, et al. “Cervical assessment at the routine 23-week scan: standardizing techniques.” Ultrasound in Obstetrics & Gynecology. 17(3): 217-9. March 2001. Retrieved December 19 2017. https://www.ncbi.nlm.nih.gov/pubmed/11309170.
• Cerner Multum. “Progesterone vaginal.” University of Michigan. Regents of the University of Michigan, March 13 2015. Retrieved December 19 2017. http://www.uofmhealth.org/health-library/d00550t1.

Jennifer Heinen, MS, RDN, LDN Founder, Nourish for Life

Eat first thing in the morning

Eat small, frequent meals throughout the day

Skip the fatty foods

Try foods that fight nausea

Choose bland yet nutritious, whole foods

Stay hydrated

Take your vitamins at night

Consider Vitamin B6

Go for a brisk walk or get up and stretch

Read more

• Nausea during pregnancy: from typical morning sickness to hyperemesis gravidarum
• Essential nutrients to prioritize during pregnancy

Sources

• “Morning Sickness: Nausea and Vomiting of Pregnancy.” ACOG. FAQ126The American College of Obstetricians and Gynecologists, Dec 2015. www.acog.org/-/media/For-Patients/faq126.pdf.
• Noel M Lee and Sumona Saha. “Nausea and Vomiting of Pregnancy.” Gastroenterol Clin North Am. 40(2): 309–vii. Web. Jun 2011.

• Protein: Protein is an important building block for most of the things little bodies need so they can grow – muscles, blood, internal organs, and bones
• Folate: Folate is an MVP during pregnancy and beyond because it’s needed for making DNA and for helping cells divide.
• Calcium: Calcium is pretty well-known for developing strong, healthy bones, and with the rate that babies and toddlers (and their bones!) grow, that calcium is definitely needed. Calcium is also needed for that pearly-white smile your little one will have once they gets all their teeth by around age two and a half.
• Iron: Iron is needed for making red blood cells, which carry oxygen all through the body.
• Healthy fats: Fats have a bad reputation, but the healthy ones are important for absorbing nutrients, making hormones, regulating body temperature, and cell growth.
• And many more: From carbs and fiber to the A-Z of vitamins the body needs, to the countless undiscovered micronutrients which may be an important part of nutrition, there is a whole rainbow of nutrients out there to help your little one grow as strong and healthy as possible.

The goal of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is to make sure that all children in the U.S. get the same access to these important nutrients, and more families are eligible for this benefit than you might think – in 2014, almost 62% of all infants in the U.S. were eligible for WIC. To see if your family might be eligible for WIC benefits, tap the button below to visit their website.

Reviewed by the Ovia Health Clinical Team

Read more

• Essential nutrients to prioritize during pregnancy
• How prenatal vitamins support conception