Iron deficiency has been identified as the most prevalent nutritional deficiency in the world.1

Causes of Iron Deficiency

Iron deficiency is known to affect:1

What are the 3 main causes of iron deficiency?

Who needs more iron?

The World Health Organization estimates that around 30-40% of pregnant women are iron deficient. Whilst starting a family is a wonderful new chapter in your life, it is also a time when you need to take extra care of yourself and your baby.

Why do you need more iron?

You need iron to make haemoglobin which transports oxygen throughout your body. When pregnant, you need to provide your baby with oxygen and blood, so the demand for iron goes up. Increasing your iron supply is a vital step towards ensuring mum and baby stay healthy.

What happens if you don’t have enough iron?

Some of these risks are:

  • Postpartum anaemia
  • Premature deliveries
  • Low birth weight
  • Delays in cognitive development and learning

Iron deficiency is a treatable condition, and your doctor will advise you on the risks of iron deficiency during pregnancy.

Factors that may increase a pregnant woman’s risk of having iron deficiency anaemia

Heavy and prolonged menstrual bleeding is a commonly reported gynaecological complaint. It can be very inhibitive and disruptive, affecting your daily activities.

Why do you need more iron?

If your period goes on for more than 7 days and you need to change your pad or tampon at least every two hours, chances are you have heavy menstrual bleeding. You may be losing more than 80ml of blood every month.

What happens if you don’t have enough iron?

  • Depleted levels of iron through continuous heavy bleeding can lead to an iron deficiency.
  • Excessive blood loss may make you feel tired and drained, with low energy levels. Your productivity at work will decrease.
  • It can also have a negative effect on your state of mind, social relationships, family life and levels of intimacy.

What are the possible causes of heavy menstrual bleeding?

  • Fibroids – These are noncancerous growths that develop in or around the womb, and can be the cause of heavy or painful periods.
  • Polyps – Noncancerous growths in the lining of the womb or cervix.
  • Adenomyosis – This is a condition where tissue from the womb lining gets embedded in the wall of the womb.
  • Endometriosis – This is when the tissue that lines the womb is found outside of the womb, for example in the ovaries or fallopian tubes.
  • Endometrial cancer – This is a cancer that begins in the uterus and is characterised by abnormal bleeding. It is also known as uterine cancer.

When you have your periods, you may need up to 2x the amount of iron than usual.10

Postpartum anaemia caused by inadequate amounts of iron and/or bleeding post-delivery is a common condition, affecting around 27% of postpartum women. Losing in excess of 500ml of blood during vaginal or caesarean delivery is considered postpartum haemorrhage.

Why do you need more iron?

In severe cases of postpartum anaemia, your survival, health and ability to care for your baby after childbirth can be adversely affected. As iron deficiency anaemia or postpartum anaemia may last for many months after giving birth, it is important you take in extra amounts of iron during this time.

What happens if you don’t have enough iron?

  • You may feel extremely tired and weak.
  • This can lead to reduced milk production.
  • Postnatal depression is also a possibility.
  • Your baby could have low stores of iron.

What are the possible causes of postpartum anaemia?

  • Low iron intake before or during pregnancy.
  • Significant blood loss during delivery can deplete your body’s iron reserve and lead to anaemia after delivery.

Iron is a vital nutrient for healthy growth and development in infants and children. If your child's diet lacks iron, he or she might develop a condition called iron deficiency.

Why do you need more iron?

Iron plays an essential role in your child’s physical and mental development, including oxygen transport throughout the body, DNA synthesis and muscle metabolism. Less iron means less oxygen circulation, which may make your child tired. A lack of iron can also lead to slowed growth, a poor appetite, rapid breathing, behavioural problems and frequent infections caused by low immunity. Iron is vital for better thinking and cognitive development.

What happens if you don’t have enough iron?

  • Untreated iron deficiency can affect a child's growth and development.
  • Especially if the child is under 2 years old, severe cases of iron deficiency may lead to significant and irreversible effects on brain development.
  • As a result, this may cause negative consequences in learning and school performance later in life.

Who is at high risk?

  • Babies born prematurely or with a low birth weight.
  • Babies who drink cow’s or goat’s milk before they turn one.
  • Breast-fed babies who are not given accompanying foods containing iron after six months.
  • Babies who drink formula that isn’t fortified with iron.
  • Children who have health conditions including chronic infections or restricted diets.
  • Children who don’t eat enough iron-rich food.

Why is your body not getting enough iron?

1. Because your diet is not balanced10

Following a vegetarian or vegan diet may lead to less iron in your body.

This is because heme iron (iron from animal products) which comes from meat, poultry and seafood is better absorbed by your body than iron from plant-based foods.

Non-heme iron (iron from plant-based foods) comes from dairy, eggs, all plant-based foods including fruits and vegetables, and fortified plant-based foods such as bread, cereals, and breakfast bars. Non-heme iron is not so easily absorbed because this process may be influenced by other meal components that inhibit iron absorption.

Vegetarians need 2x the amount of iron in their diet than non-vegetarians.4

2. Because your body can’t absorb iron the way it needs to15-16

Intestinal disorders such as coeliac disease can make it difficult for your body to absorb iron from the food you eat.

If you have inflammatory bowel disease, the lining of your small intestine could be inflamed, leading to problems with iron absorption.

  1. World Health Organization. WHO guidance helps detect iron deficiency and protect brain development. Available at: https://www.who.int/news-room/detail/20-04-2020-who-guidance-helps-detect-iron-deficiency-and-protect-brain-development. Accessed: April 2020.
  2. Loy, S.L., Lim, L.M., Chan, S. et al. Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study. BMC Public Health 19, 397 (2019). https://doi.org/10.1186/s12889-019-6736-y.
  3. National Health Services. Iron deficiency anaemia in pregnancy. Information for patients. Available at: https://www.ouh.nhs.uk/patient-guide/leaflets/files/14412Panaemia.pdf. Accessed: April 2020.
  4. Siu AL, on behalf of the U.S. Preventive Services Task Force. Screening for Iron Deficiency Anemia and Iron Supplementation in Pregnant Women to Improve Maternal Health and Birth Outcomes: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163:529–536. doi: https://doi.org/10.7326/M15-1707.
  5. Schummers L, Hutcheon JA, Hernandez-Diaz S, et al. Association of Short Interpregnancy Interval With Pregnancy Outcomes According to Maternal Age. JAMA Intern Med. 2018;178(12):1661–1670. doi:10.1001/jamainternmed.2018.4696.
  6. Sriprasert I, Pakrashi T, Kimble T, Archer DF. Heavy menstrual bleeding diagnosis and medical management. Contracept Reprod Med. 2017;2:20. Published 2017 Jul 24. doi:10.1186/s40834-017-0047-4.
  7. Kocaoz S, Cirpan R, Degirmencioglu AZ. The prevalence and impacts heavy menstrual bleeding on anemia, fatigue and quality of life in women of reproductive age. Pak J Med Sci. 2019;35(2):365‐370. doi:10.12669/pjms.35.2.644.
  8. National Health Service. Overview. Heavy periods. Available at: https://www.nhs.uk/conditions/heavy-periods/. Accessed: April 2020.
  9. Mayo Clinic. Endometrial Cancer. Available at: https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461#:~:text=Endometrial%20cancer%20is%20a%20type,is%20sometimes%20called%20uterine%20cancer. Accessed: April 2020.
  10. Institute of Medicine 2006. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC: The National Academies Press. https://doi.org/10.17226/11537.
  11. Markova V, Norgaard A, Jorgensen KJ, Langhoff-Roos J. Treatment for women with postpartum iron deficiency anaemia. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD010861. DOI: 10.1002/14651858.CD010861.pub2.
  12. Bodnar LM, Scanlon KS, Freedman DS, Siega-Riz AM, Cogswell ME. High prevalence of postpartum anemia among low-income women in the United States. Am J Obstet Gynecol. 2001;185(2):438-443. doi:10.1067/mob.2001.115996
  13. Wormer KC, Jamil RT, Bryant SB. Acute Postpartum Hemorrhage. [Updated 2019 Oct 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499988/.
  14. Mayo Clinic. Children’s Health. Iron deficiency in children: Prevention tips for parents. Available at: https://newsnetwork.mayoclinic.org/discussion/iron-deficiency-in-children-prevention-tips-for-parents/. Accessed: April 2020.
  15. World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO. Available at: https://www.who.int/publications-detail/9789240000124. Accessed: April 2020.
  16. Nielsen OH, Soendergaard C, Vikner ME, Weiss G. Rational Management of Iron-Deficiency Anaemia in Inflammatory Bowel Disease. Nutrients. 2018;10(1):82. Published 2018 Jan 13. doi:10.3390/nu10010082.