Saturday, October 23, 2010

More on Iron Deficiency and Postpartum Anemia - Prevention

Each cell in the body, from the brain to the heart and the bones, requires oxygen to be healthy and function. The body transports oxygen to the cells by piggybacking oxygen on the iron in red blood cells. But what happens if there is not enough blood? Not enough iron to deliver the oxygen? If a person is anemic?

Low iron levels do not automatically spell anemia. There is a long, sliding grade from low iron levels to wholesale anemia as a condition requiring medical treatment. However, even a mild degree of iron deficiency can create undesirable symptoms. When the body is deprived of oxygen, cells turn down the volume on their energy use. An iron-deficient person may feel tired, look pale, and could come down with a cold or flu more frequently than other people. However, these symptoms come on slowly, and may go unnoticed.

Iron deficiency can stem from a range of causes. Any on-going internal bleeding, for instance, from an ulcer, from hemorrhoids, from cancer, or from other disease can lead to blood loss and iron deficiency. Lack of certain nutrients such as iron, vitamin B12, and folic acid can also lead to anemia. These nutrients may be lacking in one’s diet but can also result of an inability to absorb these nutrients from food.

Here is good news. Anemia has been decreasing in the US since the early 1990s. Less happily, however, the kind of anemia linked to too little iron is as widespread as ever, and this is important for women to know, for iron deficiency is found mainly among menstruating girls and pregnant women. Through menstruation, blood and iron is lost each month. In pregnancy, a woman’s body ‘donates’ its stores of iron to the baby.

Low iron levels can factor into common problems after birth, including low milk supply, fatigue, and depression. When a mother is depressed, she will naturally enjoy motherhood less, and be less responsive to her baby. The relationship to her newborn baby will suffer. Due to lowered immunity, iron-deficient mothers are more likely to have mastitis, or to come down with a cold or flu. Clearly, iron deficiency in the postpartum should be avoided.

It used to be that ObGyns would meticulously regulate a pregnant woman’s iron levels. The iron supplements they prescribed, however, often led to uncomfortable constipation and bloating. Now it is recognized that the benefits of iron supplementation are not worth the risks of gastrointestinal problems. Studies show that the highest risk for anemia in the postpartum is not low iron levels in pregnancy—except of course in cases where a woman had pre-existing iron deficiency and anemia—but rather by the quantity of blood lost during birth.

Additional risk factors for iron deficiency and anemia are low socioeconomic status and obesity, which often go hand in hand[i]. Here, a lifetime of poor diet and, possibly, inherited body metabolism, conspire to make motherhood a more tiring task—lack of iron and red blood cells makes life feel just that much harder. Clearly, preventing postpartum anemia in all women but especially disadvantaged mothers should be a high, medical priority.

Since anemia in the early postpartum is primarily due to bleeding during childbirth, finding a way to avoid bleeding would logically be the first line of defense. One study shows that although blood loss is greater in caesarian sections than vaginal birth, mothers who have had a c-section suffer less from anemia because they receive blood transfusions[ii]. What to do? Short of giving all mothers blood transfusions?

Talk to any midwife with years of experience, and she’ll have a story or two to tell about Shepherds purse. Traditional midwives like this life saving herb handy, as it is known to dramatically halt the flow of blood. Shepherd’s purse grows freely across the United States, and the aerial parts can be wild harvested, dried and processed into tea or tincture. It can be bought as a bulk herb, packaged in tea bags, as tincture and in capsules.
Every pregnant woman should consider preparing for birth with Shepherd’s purse. Be sure to research the appropriate dosage of the particular form you choose, whether capsule, tincture, tea.

[i] Nead, KG. Halterman, JS. Kaczorowski, JM. "Overweight Children and Adolescents: A Risk Group for Iron Deficiency" Pediatrics 2004;114;104-108
[ii] Bergmann, RL. Richter, R. Bergmann, K. Dudenhausen, J. "Prevalence and risk factors for early postpartum anemia European Journal of Obstetrics and Gynecology and Reproductive" Biology 150 (2010) 126-131

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