During the last half of pregnancy, your body makes more red blood cells in order to supply enough for you and your baby. Every red blood cell uses iron as its core. Iron cannot be made by your body and must be absorbed from the foods you eat.
Although iron is found in many foods, it is hard to absorb, making it difficult for your body to get enough to meet its needs during pregnancy. When you don't have enough iron in your diet, you make fewer red blood cells, which is called anemia. Iron deficiency anemia is very common and is easy to correct.
Your body also needs a nutrient called folate to make healthy blood cells. Folate is easily absorbed and found in most green vegetables.
Causes of Anemia
- Poor intake of iron- and folate-rich foods
- Increased destruction of red blood cells that can occasionally occur during illness
Anemia Signs and Symptoms
Often, women with anemia don't have specific symptoms. If anemia is severe, you may feel tired and weak.
Preventing Anemia
- Eat iron-rich foods such as meat, chicken, fish, eggs, dried beans and fortified grains. The form of iron in meat products, called heme, is more easily absorbed than the iron in vegetables. If you are anemic and you ordinarily eat meat, increasing the amount of meat you consume is the easiest way to increase the iron your body receives.
- Eat foods high in folic acid, such as dried beans, dark green leafy vegetables, wheat germ and orange juice.
- Eat foods high in vitamin C, such as citrus fruits and fresh, raw vegetables.
- Cooking with cast iron pots can add up to 80 percent more iron to your food.
- Take your prenatal multivitamin and mineral pill which contains extra folate.
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Iron Supplements
Because it is difficult to get enough iron from your diet, you may need to take an iron supplement. There usually is enough iron in your prenatal vitamin to prevent anemia, but your provider may prescribe an extra iron pill if you are anemic.
If the iron tablet upsets your stomach, take it with a small amount of food. Do not take your iron tablet with dairy products or calcium supplements.
Iron-Rich Foods
The recommended dietary allowance (RDA) of iron during pregnancy is 30 milligrams. Here are some foods rich in iron.
Foods that provide .5 to 1.5 milligrams of iron:
- Chicken, 3 ounces
- Green peas, 1/2 cup
- Tomato juice, 6 ounces
- Broccoli, 1/2 cup
- Brussels sprouts, 1/2 cup cooked
- Whole wheat bread, 1 slice
- Dried apricots, 5 halves
- Raspberries, 1 cup
- Strawberries, 1 cup
Foods that provide 1.6 to 3 milligrams of iron:
- Sirloin steak, 3 ounces
- Roast beef, 3 ounces
- Lean hamburger, 3 ounces
- Baked potato with skin
- Kidney beans, 1/2 cup cooked
- Lima beans, 1/2 cup cooked
- Navy beans, 1/2 cup cooked
- Oatmeal, 1 cup cooked
- Raisins, 1/2 cup
Foods that provide 3 to 12 milligrams of iron:
- Clams, 4 large or 9 small
- Oysters, 6 medium
- Spinach, 1/2 cup cooked
- Fortified cereal, 1 cup
Additional sources of iron:
- All kinds of liver (except fish) — however, liver should not be eaten more than once a week
- Lean beef, veal, pork or lamb
- Greens, all kinds
- Beets
- Sauerkraut
- Tofu
- Lentils
- Soy bean flour
- Enriched pastas
- Unrefined sugars, such as molasses
It’s always important to eat a balanced diet — and it’s even more important when you’re pregnant because what you eat is the main source of nutrients for your baby. However, many women don’t get enough iron, folate, calcium, vitamin D, or protein. So when you are pregnant, it is important for you to increase the amounts of foods you eat with these nutrients.
Most women can meet their increased needs with a healthy diet that includes plenty of fruits, vegetables, whole grains, and proteins. According to the American College of Obstetricians and Gynecologists (ACOG), you should try to eat a variety of foods from these basic food groups. If you do, you are likely to get all the nutrients you need for a healthy pregnancy.
Key Nutrients You Need
According to ACOG, you and your baby need these key nutrients for a healthy pregnancy:
Calcium
Helps to build strong bones and teeth. Main sources include milk, cheese, yogurt, and sardines. During pregnancy you need 1,000 milligrams (mg) daily.
Iron
Helps red blood cells deliver oxygen to your baby. Sources include lean red meat, dried beans, peas, and iron-fortified cereals. During pregnancy you need 27 mg daily.
Vitamin A
You need this vitamin for healthy skin, eyesight, and bone growth. Carrots, dark, leafy greens, and sweet potatoes are good sources. During pregnancy you need 770 micrograms daily.
Vitamin C
Promotes healthy gums, teeth, and bones, and helps your body absorb iron. Good sources include citrus fruit, broccoli, tomatoes, and strawberries. During pregnancy you need 85 mg daily.
Vitamin D
Aids your body in the absorption of calcium to help build your baby’s bones and teeth. Sources include exposure to sunlight, fortified milk, and fatty fish, such as salmon. During pregnancy you need 600 international units (IUs) daily.
Vitamin B6
Helps form red blood cells and helps your body use protein, fat, and carbohydrates. You can find vitamin B6 in beef, liver, pork, whole-grain cereals, and bananas. During pregnancy you need 1.9 mg daily.
Vitamin B12
Helps form red blood cells and maintains your nervous system. You can find this vitamin only in animal products. Good sources include liver, meat, fish, poultry, and milk. During pregnancy you need 2.6 micrograms daily.
Folate (Folic Acid)
A B vitamin important in the production of blood and protein, it also reduces the risk of neural tube defects (a birth defect of the brain and spinal cord). You can find folate in green, leafy vegetables, liver, orange juice, legumes (beans, peas, lentils), and nuts.
You must get at least 400 micrograms of folate daily before pregnancy and during the first 12 weeks of pregnancy to reduce the risk of neural tube defects. During pregnancy, doctors recommend you get 600 micrograms daily.
Weight Gain
Weight gain is important during your pregnancy and something you and your doctor will monitor for nine months until you give birth. However, gaining too much or too little weight can contribute to problems during your pregnancy for both you and your baby.
Just because you are eating for two doesn’t mean you should eat twice the amount of food. If you are a healthy weight before your pregnancy, you only need to eat an average of about 300 extra calories a day.
Recent recommendations by the Institute of Medicine for pregnancy weight gain begin your pre-pregnancy body mass index (BMI).
| BMI < 18.5: underweight | 28-40 lbs | Not enough data |
| BMI: 18.5-24.9: healthy weight | 25-35 lbs | 37-54 lbs |
| BMI: 25-29.9: overweight | 15-25 lbs | 31-50 lbs |
| BMI: >30: obese | 11-20 lbs | 25-42 lbs |
| Adapted from IOM guidelines, 2009 |
Multiple Births
If you are expecting more than one baby, you should discuss what and how much to eat with your health care provider. Your nutrient and calorie needs are higher than those of women carrying one baby.
Prenatal Vitamins
Vitamin and mineral supplements cannot replace a healthy diet. Most doctors recommend that pregnant women take a prenatal vitamin and mineral supplement every day in addition to eating a healthy diet.
Taking a supplement ensures that you and your baby get enough important nutrients like folic acid and iron. But don't overdo it — taking too much can be harmful for you and your baby.
Alcohol, Caffeine, and Fish
- Pregnant women and women who may become pregnant should not drink alcohol. Drinks containing alcohol include beer, wine, liquor, mixed drinks, and malt beverages.
Even moderate drinking during pregnancy can cause behavioral or developmental problems for a baby. Heavy drinking during pregnancy can result in serious problems for the baby, including malformation and intellectual disability.
- While it’s unclear whether or not high caffeine intake leads to miscarriage, it appears moderate caffeine intake (about two 8-ounce cups of coffee) does not.
Still, it’s probably a good idea to limit caffeine in your diet during your pregnancy. Too much caffeine can interfere with sleep, contribute to nausea, and lead to dehydration.
- Fish can be a great source of protein, omega-3 fatty acids, and other healthy nutrients. But pregnant women should take care to avoid certain kinds of fish because they contain high levels of mercury, which can harm a growing baby. Fish you should avoid include shark, swordfish, king mackerel, and tilefish.