Anaemia in Pregnancy: Iron-Rich Diet and Treatment

Anaemia means your blood has fewer red blood cells, or less haemoglobin, than it should, so less oxygen reaches your body. In pregnancy it is most often caused by too little iron, and it is common: WHO estimated that about 37 percent of pregnant women worldwide were anaemic in 2019.

The good news is that it is simple to check and usually easy to treat with iron-rich food and, when your doctor advises, iron tablets. This guide covers symptoms, diet, treatment and India's national programme.

Why Anaemia Is More Likely in Pregnancy

During pregnancy your body makes more blood to support the baby, so it needs more iron. If your diet does not supply enough, or your iron stores were already low, anaemia follows. The NHS says that pregnancy and heavy periods are very common causes of iron deficiency anaemia.

Other causes, listed by WHO, include a lack of folate or vitamin B12, infections such as malaria, intestinal worms, and inherited blood conditions such as thalassaemia and sickle cell disorders. This is why your doctor may do more than prescribe iron if tests show something else.

Symptoms to Look For

Mild anaemia may cause no symptoms, which is why blood tests are part of antenatal care. When it does cause symptoms, they include:

• Tiredness and low energy beyond normal pregnancy tiredness
• Shortness of breath or a pounding heartbeat
• Pale skin or gums
• Dizziness, especially on standing
• Headaches and cold hands and feet
• Craving non-food items such as ice, chalk or soil (called pica)
• Hair loss, a sore tongue or brittle nails

Many of these overlap with ordinary pregnancy, so only a blood test can confirm anaemia. Read about the tests done at each visit in our guide to pregnancy check-ups month by month.

Why It Matters for You and the Baby

WHO says anaemia in pregnancy is linked to premature birth, low birth weight and, in severe cases, maternal death. The NHS adds that untreated anaemia can raise the risk of complications before and after birth. Treating it early lowers these risks, so please do not ignore tiredness or put off the blood test.

Iron-Rich Foods in an Indian Diet

The NHS lists the following foods as good iron sources, and many have familiar Indian equivalents:

• Pulses and beans: dal, rajma, chana, lobia and other lentils.
• Dark-green leafy vegetables: spinach (palak), fenugreek (methi), amaranth and gongura are everyday examples.
• Dried fruit: raisins, apricots and prunes.
• Fortified cereals and bread, where available.
• Meat and eggs for those who eat them. Avoid liver during pregnancy, as the NHS advises.

Tip: add something rich in vitamin C, such as lemon, orange, guava or amla, to the same meal. WHO says vitamin C helps the body absorb iron.

WHO and the NHS also say that tea, coffee, milk and dairy, and high-bran or wholegrain foods can reduce iron absorption when taken at the same time. You do not need to stop them, but have your tea or coffee between meals rather than with them.

India's Anaemia Mukt Bharat Programme

India's National Health Mission runs the Anemia Mukt Bharat programme with six interventions. For pregnant women, the programme gives one iron and folic acid tablet daily from the fourth month of pregnancy, for at least 180 days, and again for 180 days after delivery. The government red tablet has 60 mg of elemental iron and 500 mcg of folic acid. It also provides deworming in the second trimester, anaemia testing with haemoglobin meters at sub-centres and health centres, and advice on iron-, protein- and vitamin C-rich foods.

If you are given tablets at a government health centre, take them as advised and keep your check-up dates. Our article on folic acid and prenatal vitamins explains how the different supplements fit together.

How Anaemia Is Treated

• Diagnosis: a full blood count test, with other tests if your doctor suspects another cause.
• Iron tablets: your doctor will prescribe the type and amount. The NHS says treatment usually lasts about 6 months, because the body needs time to rebuild its stores. Repeat blood tests check that your levels are recovering.
• Taking the tablets: with or soon after food can reduce side effects, and a glass of orange juice may help absorption.
• Side effects: constipation or diarrhoea, stomach pain, heartburn, nausea and darker stools. Keep taking them unless your doctor changes the plan.
• Safety: keep iron tablets out of the reach of children, as an overdose is dangerous.

When to be cautious: do not start iron tablets, or increase them, without your doctor's advice. Supplements should be taken only when a health professional recommends them, as WHO also notes.

Preventing Anaemia After Delivery

Iron needs stay high after birth, particularly if you lost blood in delivery or are breastfeeding. Continue your tablets as advised and keep eating iron-rich meals. See postpartum recovery for more on recovery.

A Sample Day of Iron-Smart Eating

There is no perfect menu, but this pattern follows the advice above and uses everyday food.

• Breakfast: idli or upma with a pulse-based chutney or sambar, followed by an orange or guava.
• Lunch: rice or roti with dal, a leafy vegetable curry and a squeeze of lemon.
• Snack: a handful of raisins or dried fruit, or boiled chickpeas.
• Dinner: roti or rice with another pulse or egg, fish or meat if you eat them, and a vegetable.
• Tea or coffee: have it between meals, not alongside.

Iron tablets and this food pattern work together; food alone may not be enough once your doctor has found anaemia.

When to See a Doctor

See a doctor promptly if you feel very weak, breathless at rest, faint or dizzy, have fast breathing or a racing heartbeat, or look very pale. These can mean severe anaemia and need same-day care.

Talk to a Doctor

Haemoglobin checks are part of antenatal check-ups at Chaitanya Hospital in Kadapa. Book an appointment or call +91 944 103 0587. This article is for general awareness and is not a substitute for a doctor's advice.