Iron deficiency anaemia after birth

This leaflet is for patients with iron deficiency anaemia. It will explain what iron deficiency anaemia is. It will also discuss its causes and possible treatments. If you have any questions please speak to your midwife or doctor. 

What is iron deficiency anaemia?

Anaemia is a condition caused by a reduced amount or much smaller red blood cells. This reduces the amount of haemoglobin in your body. In the UK the most common reason for developing anaemia is not having enough iron, known as iron deficiency anaemia.

Iron deficiency anaemia can affect how you feel. If your iron levels are low, you may not feel able to carry out your normal routine. Symptoms of anaemia include the following.

• Feeling weak and getting tired more easily.

• Feeling dizzy.

• Suffering from low mood, or feeling upset.

• Having headaches.

• Looking pale.

• Feeling out of breath.

• Having heart palpitations (heartbeats that suddenly become more noticeable).

• Having trouble focusing or concentrating.

• Having chest pain.

If you have anaemia, it is important to rest and to listen to your body. Speak with your midwife or doctor if you have any of the above symptoms or feel unwell. You can also contact Maternity Triage for more advice. Their number is at the bottom of this leaflet.

Iron in the body

Iron is in every cell in your body, and it plays many important roles in your overall health. Your body uses iron to make haemoglobin. Haemoglobin is a protein found in red blood cells. It carries oxygen from your lungs around your body. If there is not enough iron in your body, the amount of haemoglobin drops.

Iron helps your muscles store and use oxygen. When this happens, it is harder for your body to get enough oxygen. This can leave you feeling breathless, tired and weak.

It is very common to have iron deficiency anaemia if you have had a higher blood loss or postpartum haemorrhage (PPH) after birth. For more information, please read the Postpartum haemorrhage (PPH) leaflet.

How is anaemia diagnosed?

Anaemia is diagnosed with a simple blood test. Your midwife or doctor may recommend a blood test to check your haemoglobin. This will help them to understand how your body is coping after birth. They may suggest a blood test if:

• your iron levels were already low before birth;

• you had a larger blood loss than expected; or

• you are having symptoms of anaemia.

The blood test will help them decide what treatment (if any) to recommend to you. We understand that some people find blood tests frightening. If you have worries or concerns about this, please speak to your midwife or doctor.

Treatment for iron deficiency anaemia

• Iron supplements

  Your midwife or doctor may recommend that you take iron supplements. When iron levels are low, it can be difficult to get enough iron from your diet alone. Iron supplements should help to get your iron levels back to normal. This will help you start to feel like yourself again.

  Most women / birthing people will not be on multiple doses of iron. If you are, this will only be for a short time. Speak to your midwife or doctor if you have any questions.

  In some cases, there may be some side effects, such as an upset stomach or constipation.

  It is safe to breastfeed whilst taking iron supplements. They do not increase the amount of iron that is in your breast milk.

  Follow these tips to avoid side-effects and to get the most out of your iron supplements.

  • Try taking the iron in smaller doses, more often throughout the day. Or, try taking your prescribed dose of iron every other day. Taking iron one day and then not the next, and so on.

  • Try taking your iron supplement before bed, at least an hour after your last meal.

  • Do not take your iron supplement with calcium, this includes eating or drinking dairy. Some medication also contains calcium (calcium pills or antacids like Gaviscon). Calcium binds to iron and stops your body from absorbing it effectively.

  • Do not drink coffee or tea within an hour of taking iron supplements.

  • Eat high fibre foods, such as fruit and whole grains (such as bran) to prevent constipation. Another option is to take a stool softener, such as lactulose. Speak to your midwife if you suffer from constipation.

  • Try taking iron with a glass of orange juice (vitamin c helps absorption).

  • Drink plenty of fluids.

• IV iron infusion

  If your iron levels are very low, iron supplements may not be enough to increase your body’s iron levels. In this case, you may be offered iron by injection or through a canula (a small plastic tube in your vein). If they recommend this, your midwife or doctor will discuss this with you. For more information, please read the Intravenous (IV) iron infusion leaflet.

• Blood transfusion

  If your iron levels are very low after birth, we may recommend that you have a blood transfusion. It will help to speed-up your recovery and reduce your feelings of weakness and fatigue (extreme tiredness). A blood transfusion is given through a canula (a small plastic tube in your vein).

  It takes time for your body to make new red blood cells to replace the ones you lost during the haemorrhage. A blood transfusion gives your body new blood right away.

  Blood donations in the UK are carefully screened for infections. Blood given to you will be matched to your own blood group, it will be double checked at your bedside by two midwives or doctors. If you have a blood transfusion there is a very small risk of an allergic reaction. Symptoms of this could include:

  • a temperature

  • chills, or

  • a rash.

  Your midwife will carefully monitor your observations to make sure you are well. Chances of getting an infection from a blood transfusion is less than 1 in 1 million. There is a very small risk of other complications after a blood transfusion, such as:

  • a severe allergic reaction;

  • difficulty breathing due to fluid overload; and

  • incompatibility due to red cell antibodies.

  The risks will be explained before you have a transfusion, unless this is not possible. For example, if you need an emergency transfusion. If you have any questions, please speak with your midwife or doctor.

Eating for iron

Even if you are taking iron supplements, your diet is an important source of iron. Some women or birthing people with anaemia say that they were incredibly hungry in the weeks that followed birth. Some will even eat and crave foods they would not normally eat. It is easy to find a list of iron-rich foods online. Some sources are listed at the end of this leaflet.

Here are a few tips to quickly and easily increase the iron content of food you may already be eating.

• If you eat meat, darker meats like beef, lamb, duck or venison have the most iron.

• Some seafood like prawns, oysters and octopus have a lot of iron.

• Eat salads made of spinach instead of lettuce.

• Add pumpkin seeds, chickpeas, and nuts to a salad to make an iron-rich meal.

• Nuts and dried fruits, such as apricots.

• Lentils have more iron than beef. Add lentils to a soup or stew to boost the iron content.

• Try almond butter instead of peanut butter. Two tablespoons of almond butter has as much iron as a serving of chicken.

• Avoid eating dairy (milk, yogurt, cheese) with iron rich foods. The calcium in dairy can make it harder for your body to absorb the iron in the other food.

• To help your body absorb the iron, do not forget to add foods with vitamin C to your meal. Fruits and vegetables containing vitamin C include:

  • kiwi fruit

  • oranges

  • potatoes

  • cauliflower

  • broccoli

  • brussels sprouts

Iron deficiency anaemia or postnatal depression?

The “baby blues” and postnatal depression can affect anyone who has had a baby. Below are some of the symptoms of postnatal depression and iron deficiency anaemia. You will see some overlap in the symptoms for each, as the symptoms can be very similar.

It can be hard to tell what you are feeling, but talking to your midwife can help. They can help and support you if you are suffering from postnatal depression.

Contact details

Contact Maternity Triage on 01227 206737 for help and advice.

If you are more than 42 days after the birth of your baby, call 111 for advice or see your GP. If you are very unwell or have very heavy bleeding call 999.

Contact the Birth Afterthoughts service if you have any unanswered questions about the birth of your baby. Please self-refer here.

If you need help completing the self-referral form, please email the Birth Afterthoughts service. Please ask for help completing a birth afterthoughts referral form in your email.

Further resources

• East Kent Hospitals. Intravenous (IV) iron infusion patient leaflet.

• East Kent Hospitals. Postpartum haemorrhage (PPH) patient leaflet.

• Tommy's. Your mental health after the birth.

• Tommy's. Iron in pregnancy.

[Web sites last accessed 18 June 2026]

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