Breast Milk Iodine Research Articles

Оценка влияния перинатальных факторов и профилактических мероприятий на содержание йода и железа в грудном молоке

Оценка влияния перинатальных факторов и профилактических мероприятий на содержание йода и железа в грудном молоке

Optimization of a New Mass Spectrometry Method for Measurement of Breast Milk Iodine Concentrations and an Assessment of the Effect of Analytic Method and Timing of Within-Feed Sample Collection on Breast Milk Iodine Concentrations.

Breast milk iodine concentration (BMIC) may be an indicator of iodine status during lactation, but there are few data comparing different analytical methods or timing of sampling. The aims of this study were: (i) to optimize a new inductively coupled plasma mass spectrometry (ICP-MS) method; and (ii) to evaluate the effect of analytical method and timing of within-feed sample collection on BMIC. The colorimetric Sandell-Kolthoff method was evaluated with (a) or without (b) alkaline ashing, and ICP-MS was evaluated using a new (129)I isotope ratio approach including Tellurium (Te) for mass bias correction (c) or external standard curve (d). From iodine-sufficient lactating women (n = 97), three samples were collected within one breast-feeding session (fore-, mid-, and hind-feed samples) and BMIC was analyzed using (c) and (d). Iodine recovery from NIST SRM1549a whole milk powder for methods (a)-(d) was 67%, 24%, 105%, and 102%, respectively. Intra- and inter-assay coefficients of variation for ICP-MS comparing (c) and (d) were 1.3% versus 5.6% (p = 0.04) and 1.1% versus 2.4% (p = 0.33). The limit of detection (LOD) was lower for (c) (0.26 μg/kg) than it was for (d) (2.54 μg/kg; p = 0.02). Using (c), the median [95% confidence interval (CI) obtained by bootstrap] BMIC (μg/kg) in foremilk (179 [CI 161-206]) and in mid-feed milk (184 [CI 160-220]) were not significantly different (p = 0.017), but were higher than in hindmilk (175 [CI 153-216]; p < 0.001). In foremilk using (d), BMIC was 199 ([CI 182-257]; p < 0.001 vs. (c)). The variation in BMIC comparing (c) and (d) (13%) was greater than variation within feeding (5%; p < 0.001). Because of poor recoveries, (a) and (b) should not be used to measure BMIC. Compared with (d), (c) has the advantages of higher precision and a lower LOD. In iodine-sufficient women, BMIC shows low variation within a breast-feeding session, so timing of sampling is not a major determinant of BMIC.

Correlation of Iodine content of mother’s milk and urine with their child’s TSH level

Background: Iodine deficiency is still a significant public health problem. In the rural plains of Nepal, it remains a mild-to-moderate public health problem among pregnant and lactating women despite the availability of iodized salt. To date, only limited attention has been paid to breast-milk iodine content despite its importance in the intellectual development of infants.Objectives: (i) To determine iodine content in mother’s urine, mother’s milk and to measure their respective child’s TSH level. (ii) To correlate iodine content of mother’s urine with child’s TSH level and also mother’s milk content with child’s TSH level.Setting and Design: cross sectional study in human using consecutive sampling techniqueMaterials and Methods: Mother’s urinary and milk iodine level was measured by Ammonium Persulfate Digestion Microplate method using Sandell-Kolthoff reaction in a sealing cassette (Hitachi, Japan) and child’s TSH by ELISA commercial Kit from Eliscan (RFCL, India) based on classical sandwich technique.Statistical analysis used: Spearman’s correlation was performed in quantitative variables. A p-value less than 0.05 and 0.001 were considered statistically significant and highly significant respectivelyResults: The median mother’s urine was 174.96 µg/L(97.39-215.43) and their respective median child TSH level was 3.86 mIU/L(2.66-4.80). Median mother’s milk iodine was 129.90 µg/L (94.14-165.94).There was significant negative correlation between mothers’ urinary iodine content and their child’s TSH (r2= -0.391, p = 0.005) and between mother’s urinary iodine and their child’s TSH (r2= -0.471, p = 0.001). There was positive correlation between mother’s milk iodine and mother urinary iodine but not statistically significant ((r2= 0.261, p = 0.067).Conclusion: Mothers urinary iodine, mother’s milk iodine and child TSH are interrelated with each other.Asian Journal of Medical Sciences Vol.7(1) 2015 40-48

Breast Milk Iodine and Iodine Status of Breast-Fed Infants

Background: Breast milk is the only source of iodine for exclusively breast-fed infants. Iodine status of breast-fed infants depends on iodine in breast milk and also number of feeding in 24 hours. Iodine deficiency and iodine excess both have bad impact on infant’s health.Objective: To measure the iodine in breast milk and to evaluate iodine status of their breast-fed infants.Materials and method: This observational analytical study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka with active cooperation of Kumudini Women’s Medical College Hospital, Mirzapur, Tangail involving fifty lactating mothers and their exclusively breast-fed infants. Early morning urine and breast milk samples were collected in dry and clean plastic container free from any chemical contamination. Urinary iodine was used as indicator for assessing iodine status. All statistical analyses were done by using SPSS (statistical programme for social science) 12 version software package for Windows.Results: The median (range) urinary iodine concentration of lactating mothers and their breast-fed infants were 225.25 ?g/L (61.50-530.00) and 225.75 ?g/L (100.50-526.00) respectively. The median (range) breast-milk iodine concentration was 157 ?g/L (54.50-431.50) which was more than three times of recommended minimum concentration (50 ?g/L). Only 2 (4%) lactating mothers had mild biochemical iodine deficiency (UIE, 50-99 ?g/L). There was no biochemical iodine deficiency of breast-fed infants. Iodine in breast milk of lactating mothers was positively correlated with their urinary iodine excretion (p&lt;0.01). Infant’s urinary iodine was positively correlated with iodine concentration in breast milk (p&lt;0.01) and with urinary iodine of lactating mothers (p&lt;0.01).Conclusion: Lactating mothers and their breast-fed infants in this study were iodine sufficient. If iodine content of breast-milk is within normal range, 10-12 numbers of feeding in 24 hours for infants is enough to get sufficient iodine from their mother’s milk.Delta Med Col J. Jul 2015; 3(2): 74-77

Breast Milk Iodine Concentration Correlated with Urinary Iodine Concentration of Infants from Southern Ethiopia

Breast milk from iodine‐sufficient mothers is considered an adequate source of iodine for the exclusively breastfed infant until the age of 6 months. A national policy requiring salt iodization was initiated in Ethiopia in 2011, but reports indicate high variability in salt iodine concentration (SIC) at the community level. Although the recommended household SIC should be 15‐40 ppm, salt from 102 rural households of lactating women in southern Ethiopia ranged from 0 to 39 ppm. Only about 20% of households had SIC &gt;15 ppm. Mean ± SD age of mothers was 23 ± 3.9 y. Maternal BMI was 21.3 ± 2.5 and MUAC was 23.1 ± 1.9 cm. Goiter was observed in 75 of the mothers. Breast milk and urine samples were collected from these mothers and urine samples were collected from their 6 day old infants. Breast milk iodine (BMIC) and urinary iodine (UIC) were analyzed by inductively coupled plasma mass spectrometry (ICP‐MS). Median (Interquartile range) BMIC was 1551 (495, 2487) µg/L. Median maternal UIC was 106 (71, 160), but 47 had UIC below 100 µg/L. Median infant UIC was 212 (109, 348) µg/L. UIC of the mother correlated with BMIC (r=0.26, p&lt; 0.007). BMIC and infant UIC were correlated (r=.34, p&lt;0.0001) as were UIC of mother and infant (r=.63, p &lt;0.0001). UIC of the mother and iodine of the household salt predicted 15% of the variation in BMIC while UIC of the mother and BMIC predicted 41% of the variability in UIC of the infant. Despite the fact that the study population was getting variable amounts of iodine from the recently implemented salt iodization program, BMIC at 6 days after delivery was high. (Supported by Néstle Foundation and Oklahoma Agricultural Experiment Station).

Development of thyroid dysfunction among women with excessive iodine intake – A 3-year follow-up

ObjectivesThyroid dysfunction can be a result of excessive iodine intake, which may have adverse health consequences, particularly for women in fertile age. In 2010, we conducted a cross-sectional study among lactating women with excessive iodine intake in the Saharawi refugee camps in Algeria and found a high prevalence of thyroid dysfunction. Three years later, we conducted a follow-up study to monitor the iodine situation and explore whether thyroid dysfunction still was highly prevalent when the women no longer were post-partum. None of the women were treated for hyper- or hypothyroidism between baseline and follow-up. MethodsIn 2013, we were able to recapture 78 of the 111 women from the baseline. Thyroid hormones and antibodies were measured in serum and thyroid size was assessed by palpation. Urinary iodine concentration (UIC) and drinking water iodine concentration were measured. ResultsThe overall prevalence of thyroid dysfunction and/or positive antibodies was 34.3% and was not significantly changed from baseline. Of the non-pregnant women we reexamined, 17 had hypo- or hyperthyroidism in 2010; among these, 12 women still had abnormal thyroid function at follow-up. In addition, we found 9 new cases with marginally abnormal thyroid function. Women with thyroid dysfunction and/or positive antibodies had significantly higher BMI and thyroglobulin than women with normal thyroid function. We also found that women with high breast milk iodine concentration (BMIC) at baseline had more thyroid dysfunction at follow-up than the women with lower BMIC at baseline. ConclusionsAt follow-up, the prevalence of thyroid dysfunction was still high and had not changed during the 3 years between studies and from a postpartum period. The women still had a high iodine intake indicated by high UIC. Breast milk iodine concentration from baseline predicted thyroid dysfunction at follow-up.

Excessive iodine intake and thyroid dysfunction among lactating Saharawi women

ObjectivesExcessive iodine intake may lead to thyroid dysfunction, which may be particularly harmful during pregnancy and lactation. The main objective was to describe iodine status and the prevalence of thyroid dysfunction among lactating women in areas with high iodine (HI) and very high iodine (VHI) concentrations in drinking water. Design and methodsA cross-sectional survey was performed among 111 lactating women in the Saharawi refugee camps, Algeria. Breast milk iodine concentration (BMIC), urinary iodine concentration (UIC) and the iodine concentration in the most commonly consumed foods/drinks were measured. A 24-h dietary recall was used to estimate iodine intake. Thyroid hormones and antibodies were measured in serum. ResultsMedian UIC, BMIC and iodine intake across both areas was 350μg/L, 479μg/L and 407μg/day, respectively. In multiple regression analyses, we discovered that being from VHI area was associated with higher UIC and BMIC. BMIC was also positively associated with iodine intake. Thyroid dysfunction and/or positive thyroid antibodies were found in 33.3% of the women, of which 18.9% had hypothyroidism and 8.1% had hyperthyroidism and 6.3% had positive antibodies with normal thyroid function. Elevated thyroid antibodies were in total found in 17.1%. We found no difference in distribution of thyroid dysfunction or positive antibodies between HI and VHI areas. BMI, BMIC and elevated thyroglobulin (Tg) predicted abnormal thyroid function tests. ConclusionsThe high prevalence of thyroid dysfunction may be caused by excessive iodine intake over several years.

Maternal Iodine Status Reflects the Iodine Status of their Breast-Fed Infants

Background: Bangladesh is an iodine deficient region and the government of Bangladesh, with assistance of UNICEF had initiated a universal salt iodinization program to provide iodized salt by the middle of 1994. Breast milk is the only source of iodine for exclusively breast-fed infants. Iodine deficiency and iodine excess both have bad impact on infant’s health. Objectives: To assess the iodine status of lactating mothers and their breast-fed infants and to evaluate whether maternal iodine status reflects the iodine status of their breast-fed infants. Material and methods: This observational analytical study was carried out in the department of biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka with active cooperation of Kumudini Women’s Medical College Hospital, Mirzapur, Tangail involving fifty lactating mothers and their exclusively breast-fed infants. Early morning urine and breast milk samples were collected in dry and clean plastic containers free from any chemical contamination. Urinary iodine was used as an indicator for assessing iodine status. All statistical analysis was done by using SPSS (Statistical Program for Social Science) 12 version software package for windows. Results: The median (range) urinary iodine concentration of lactating mothers and their breast-fed infants were 225.25 ?g/L (61.50-530.00) and 225.75?g/L (100.50-526.00). 96% (48) mothers had no biochemical iodine deficiency (UIE ?100?g/L), only 4% (2) mothers had mild biochemical iodine deficiency (UIE, 50-99?g/L). There was no biochemical iodine deficiency of breast-fed infants. The median breast-milk iodine concentration was 157?g/L which was more than three times of recommended minimum concentration (50?g/L). Iodine in breast milk of lactating mothers was positively correlated with their urinary iodine excretion (P&lt;0.01). Infant’s urinary iodine was positively correlated with iodine concentration in breast milk (P&lt;0.01) and also positively correlated with urinary iodine of lactating mothers (P &lt; 0.01). Conclusion: Lactating mothers and their breast-fed infants in this study were iodine sufficient. Iodine status of exclusively breast-fed infants can be determined by the iodine status of their mothers. DOI: http://dx.doi.org/10.3329/pulse.v6i1-2.20283 Pulse Vol.6 January-December 2013 p.6-11

Validation of an optimized method for the determination of iodine in human breast milk by inductively coupled plasma mass spectrometry (ICPMS) after tetramethylammonium hydroxide extraction

In this study a novel method to determine iodine concentrations in human breast milk was developed and validated. The iodine was analyzed by inductively coupled plasma mass spectrometry (ICPMS) following tetramethylammonium hydroxide (TMAH) extraction at 90°C in disposable polypropylene tubes. While similar approaches have been used previously, this method adopted a shorter extraction time (1h vs. 3h) and used antimony (Sb) as the internal standard, which exhibited greater stability in breast milk and milk powder matrices compared to tellurium (Te). Method validation included: defining iodine linearity up to 200μgL−1; confirming recovery of iodine from NIST 1549 milk powder. A recovery of 94–98% was also achieved for the NIST 1549 milk powder and human breast milk samples spiked with sodium iodide and thyroxine (T4) solutions. The method quantitation limit (MQL) for human breast milk was 1.6μgL−1. The intra-assay and inter-assay coefficient of variation for the breast milk samples and NIST powder were <1% and <3.5%, respectively. NIST 1549 milk powder, human breast milk samples and calibration standards spiked with the internal standard were all stable for at least 2.5 months after extraction. The results of the validation process confirmed that this newly developed method provides greater accuracy and precision in the assessment of iodine concentrations in human breast milk than previous methods and therefore offers a more reliable approach for assessing iodine concentrations in human breast milk.

Effects of maternal iodine supplementation during pregnancy and lactation on iodine status and neonatal thyroid-stimulating hormone.

To determine the iodine status in pregnant and lactating women, as well as neonatal thyroid-stimulating hormone (TSH) concentration. Pregnant women cared at our hospital, the University Hospital in Bangkok, had routinely received 200 μg iodine tablet daily since October 2010. Urinary iodine concentrations (UICs) of 1508 pregnant and 87 lactating women and 76 offspring and breast milk iodine concentration (BMIC) (n=57) were measured. Cord serum TSH levels from hypothyroidism screening were analyzed. Median UIC levels of pregnant and lactating women were 170.6 and 138.0 μg l(-1), respectively. Median BMIC and infants' UIC at 2-month postpartum in iodine-supplemented group were higher than the respective values of non-supplemented group. Median cord serum TSH level obtained before iodine supplementation (n=8332) was higher than that obtained after supplementation (n=5181; 7.3 vs 5.2 mU l(-1)). Maternal iodine supplementation improved iodine nutrition in their breast-fed offspring. A trend toward declining in cord serum TSH values after iodine supplementation indicates improvement of iodine status during pregnancy.

Effect of Iodine Loading on the Thyroid Hormone Level of Newborns Living in Kayseri Province

Excessive iodine exposure during the fetal and neonatal periods can lead to neonatal hypothyroidism. This study was conducted to evaluate the level of iodine loading among newborns living in Kayseri province. A total of 59 newborns, who were admitted due to disorders in thyroid hormone levels, were included in the study. Materials and Among the patients who applied with thyroid hormone dysfunction, newborns with a spot urine iodine level ≥ 20 μg/dL were included in the study between the years 2003 and 2013. Free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), thyroglobulin (Tg), breast milk iodine, thyroid ultrasonography, and control measurements of fT3, fT4, TSH, and Tg levels were obtained accordingly from both groups of patients who received or did not receive treatment. The average age of the patients was 15 days with a 36/23 girl to boy ratio. Statistically, no significant difference was noticed between all the girls and boys with respect to all the measured values. The etiologic search showed that out of 59 cases, in 18 cases (30.5%) only the mother and in 19 cases only the newborns (32.2%) had a history of povidone iodine exposure; in 8 cases both mothers and their babies had exposure to povidone iodine (13.6%). In 14 cases (23.7%), the source of iodine loading could not be determined. Levothyroxine (L-thyroxine) treatment was initiated in 56% of the patients (n = 33). Out of 33 patients who were under treatment with L-thyroxine, in 13 cases only the mother had history of povidone iodine exposure; in 12 cases, only the baby had a history of povidone iodine exposure; in 1 case, both mother and her baby had a history of povidone iodine exposure, but the etiology could not be found in 7 cases. The use of antiseptics-containing iodine for mothers before and after birth and for newborns, especially for umbilical cleansing, can lead to iodine loading and hypothyroidism. If transient hypothyroidism develops within this period, then it may not be detected promptly. This can later lead to retardation in psychomotor development and disorder in learning skills during the childhood period.

Iodine Concentrations in Milk and in Urine During Breastfeeding Are Differently Affected by Maternal Fluid Intake

Breastfed infants are dependent on iodine transport into breast milk for production of thyroid hormones. Thyroid hormones are important regulators of brain development. It has been considered whether breast milk iodine concentration (MIC) could be predicted by maternal urinary iodine concentration (UIC), but reports on correlations have been inconsistent. We used urinary creatinine concentration as a proxy for maternal fluid intake and speculated if this might differently influence UIC and MIC. We examined 127 breastfeeding women after the introduction of the mandatory iodine fortification of salt in Denmark. Maternal spot urine and a breast milk sample were obtained at a median of 31 days after delivery (interquartile range: 25-42 days), and the women were asked about intake of iodine containing supplements postpartum. Median UIC was 72 μg/L (46-107 μg/L) and higher in iodine-supplemented mothers (47.2% of participants); 83 μg/L (63-127 μg/L) versus 65 μg/L (40-91 μg/L), p=0.004. Median MIC was 83 μg/L (61-125 μg/L) and also higher in iodine-supplemented mothers; 112 μg/L (80-154 μg/L) versus 72 μg/L (47-87 μg/L), p<0.001. There was a weak correlation between UIC and MIC (r=0.28, p=0.015). A strong correlation was present between UIC and urinary creatinine concentration (r=0.76, p<0.001), whereas urinary creatinine concentration was not correlated to MIC (r=-0.049, p=0.58). When UIC and urinary creatinine were used to estimate 24-h urinary iodine excretion, the correlation between this estimate and breast milk iodine excretion was stronger (r=0.48, p<0.001). Intake of an iodine supplement should be recommended in Danish breastfeeding women. Our results indicate that UIC, but not MIC, depends on maternal fluid intake and that maternal estimated 24-h iodine excretion may be a better indicator of iodine supply to the breastfed infant than UIC.

Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial

Iodine deficiency in infants can damage the developing brain and increase mortality. Present recommendations state that oral iodised oil should be given to breastfeeding mothers to correct iodine deficiency in infancy when iodised salt is not available, and that direct supplementation should be given to infants who are not being breastfed or receiving iodine-fortified complimentary foods. However, there is little evidence for these recommendations. We aimed to assess the safety and efficacy of direct versus indirect supplementation of the infant. We did this double blind, randomised, placebo-controlled trial in Morocco. Healthy breastfeeding mothers and their term newborn babies (aged ≤8 weeks) were block randomised by clinic day to receive either: one dose of 400 mg iodine to the mother and placebo to the infant (indirect infant supplementation), or one dose of about 100 mg iodine to the infant and placebo to the mother (direct infant supplementation). Randomisation was masked to participants and investigators. Coprimary outcomes were: maternal and infant urinary iodine concentrations, breastmilk iodine concentration, maternal and infant thyroid-stimulating hormone (TSH) concentrations, maternal and infant thyroxine (T4) concentrations, and infant growth. These outcomes were measured at baseline, and when infants were aged about 3 months, 6 months, and 9 months, and the two groups were compared using mixed effects models. This study is registered with ClinicalTrials.gov, number NCT01126125. We recruited 241 mother-infant pairs between Feb 25, and Aug 10, 2010, and completed data collection by Aug 6, 2011. At baseline, median urinary iodine concentration was 35 μg/L (IQR 29-40) in mothers and 73 μg/L (29-237) in infants, suggesting iodine deficiency. During the study, maternal urinary iodine concentration (p=0.011), breastmilk iodine concentration (p<0.0001), and infant urinary iodine concentration (p=0.042) were higher in the indirect infant supplementation group than in the direct supplementation group. Maternal TSH (p=0.276) and T4 (p=0.074) concentrations did not differ between the groups over the course of the study, nor did infant TSH (p=0.597) and T4 (p=0.184) concentrations, but the number of infants with thyroid hypofunction was lower (p=0.023) in the indirect supplementation group than the direct supplementation group. The infant groups did not differ in anthropomorphic measures, except that length-for-age Z score was slightly greater in the direct infant supplementation group (p=0.032). At 3 months and 6 months of age, median infant urinary iodine concentration in the indirect infant supplementation group was sufficient (>100 μg/L), whereas infant urinary iodine concentration was sufficient only at 6 months in the direct supplementation group. There were no serious adverse events in either group. In regions of moderate-to-severe iodine deficiency without effective salt iodisation, lactating women who receive one dose of 400 mg iodine as oral iodised oil soon after delivery can provide adequate iodine to their infants through breastmilk for at least 6 months, enabling the infants to achieve euthyroidism. Direct supplementation is less effective in improving infant iodine status. ETH Zurich, Switzerland; the Medicor Foundation, Vaduz, Lichtenstein.

Does Dietary Iodine Regulate Oxidative Stress and Adiponectin Levels in Human Breast Milk?

Little is known about the association between iodine and human milk composition. In this study, we investigated the association between iodine and different markers of oxidative stress and obesity-related hormones in human breast milk. This work is composed of two cross-sectional studies (in lactating women and in the general population), one prospective and one in vitro. In the cross-sectional study in lactating women, the breast milk iodine correlated negatively with superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) activities, and with adiponectin levels. An in vitro culture of human adipocytes with 1 μM potassium iodide (KI, dose similar to the human breast milk iodine concentration) produced a significant decrease in adiponectin, GSH-Px, SOD1, and SOD2 mRNA expression. However, after 2 months of treatment with KI in the prospective study, a positive correlation was found between 24-h urinary iodine and serum adiponectin. Our observations lead to the hypothesis that iodine may be a factor directly involved in the regulation of oxidative stress and adiponectin levels in human breast milk.

Оценка содержания микроэлементов (йода и железа) в грудном молоке

Проведена оценка содержания йода и железа в грудном молоке (n = 88). В исследовании показано, что концентрация йода и железа в материнском молоке у обследованных женщин не соответствует физиологической потребности ребенка грудного возраста. Продемонстрировано, что применение железосодержащих витаминно-минеральных комплексов во время лактации не оказывает значимого влияния на уровень железа в грудном молоке. Содержание йода в молоке матери напрямую зависит от йодной дотации. Показано, что на уровень микронутриентов в грудном молоке не влияет наличие у матери гестационной анемии и зоба, срок родов и место проживания семьи. Сделан вывод о статистически значимом влиянии на уровень йода в грудном молоке сочетанной йодной профилактики (прием матерью во время лактации препаратов калия йодида (200 мкг/сут) на фоне употребления йодированной соли).

Infant iodine supplementation and motor and cognitive development: a randomized controlled trial

The efficacy of two strategies to correct iodine deficiency in infants was tested in a double‐blind, randomized controlled intervention trial using oral iodized oil in a moderate‐to‐severely iodine deficient area in Morocco. Breastfeeding mother‐infant pairs (n=240) enrolled at &lt;1 mo after birth received: 1) 400 mg iodine to the mother and placebo to the infant or; 2) placebo to the mother and 100 mg iodine to the infant. Iodine and thyroid status were measured at baseline, 3, 6, 9 mo and motor and cognitive development were measured at 12 and 18 mo (Bayley Scales of infant development II). Both interventions improved urinary iodine concentrations and thyroid function in infants (p&lt;0.05). Iodine supplementation to the mother improved the median breast milk iodine concentration (P&lt;0.05). At 12 mo the median Psychomotor Development Index (PDI) and Mental Development Index (MDI) in group 1 and 2 were 97 to 95 (PMI) (p = 0.46) and 101 to 105 (MDI) (p = 0.76), respectively. The data at 18 mo are currently being analyzed. Direct and indirect iodine supplementation appears equally effective in improving the iodine status, thyroid status and motor/cognitive development in breastfed infants. This study was funded by the Laboratory of Human Nutrition, ETH Zurich, Switzerland.

KELEBIHAN ASUPAN IODIUM YANG KRONIK PADA IBU MENYUSUI DAN BAYINYA

ABSTRACT Excess or deficiency of iodine are associated with thyroid disorders such as hyperthyroidism and hypothyroidism. In District of Demak, median urinary iodine concentration (UIC) was very high but still no explanation of the causes on thyroid function of the population. To analyze iodine status of lactating mothers and their infant and sources of iodine. Participants were lactating mothers and their infant 500 μg/L was 66.9 percent and 90.8 percent respectively. Median breast milk iodine concentration (BMIC) was 850 μg/L and 4.2 percent had BMIC 6.2 μIU/mL. Meanwhile, none of infants had TSH 34.0 μIU/mL. Mean fT4 of lactating mothers was 1.04+ 0.26 μmol/L. Proportion of fT4 2.0 μmol/L. Mean iodine in household’s salt was 30.0+ 20.8 ppm (range: 7.1-78.3 ppm). Meanwhile, median iodine in drinking water was 650 μg/L (range: 50-1791 μg/L). Iodine intake of lactating mothers and their infant, from drinking water, was very high. Among lactating mothers, there was a risk of subclinical hyperthyroidism as well as overt hyperthyroidism. In contrary, there was a risk of hypothyroidism of infants 500 μg/L adalah 66,9 persen dan 90,8 persen. Median kadar iodium ASI adalah 850 μg/L dan sebanyak 4,2 persen mempunyi iodium ASI 6,2 μIU/mL. Sementara itu, tidak ada bayi mempunyai TSH 34,0 μIU/mL. Rata-rata fT4 ibu menyusui adalah 1,04+0,26 μmol/L. Proporsi fT4 2,0 μmol/L. Rata-rata iodium garam rumah tangga adalah 30,0+20,8 ppm (rentang: 7,1- 78,3 ppm). Sementara itu, median iodium air minum adalah 650 μg/L (rentang: 50-1791 μg/L). Asupan iodium ibu menyusui dan bayinya, dari air minum, adalah sangat tinggi. Pada ibu menyusui ada risiko hipertiroidisme subklinik maupun hipertiroidisme. Sebaliknya, ada risiko hipotiroidisme pada bayi umur < 6 bulan. [Penel Gizi Makan 2013, 36(2):103-112] Kata kunci: kelebihan iodium, status iodium, ibu menyusui, bayi, garam, air

Iodine Supplementation During Pregnancy and Lactation

DIETARY IODINE INTAKE IS OBLIGATORY FOR THE PROduction of thyroid hormones. Despite substantial public health advances over the past 3 decades, iodine deficiency currently affects 1.92 billion people globally. Dietary iodine requirements are increased during pregnancy due to increased thyroid hormone production, increased renal iodine losses, and fetal iodine requirements. Dietary requirements remain increased in lactation due to the concentration of iodine in breast milk. Adverse effects of iodine deficiency in pregnancy, when the deficiency leads to severe decreases in maternal thyroxine (T4), include maternal and fetal goiter, cretinism, intellectual impairments, neonatal hypothyroidism, and increased pregnancy loss and infant mortality. Decreases in maternal T4 associated with even mild iodine deficiency may have adverse effects on the cognitive function of offspring, and iodine deficiency remains the leading cause of preventable intellectual disability worldwide.

Breastmilk Iodine Concentrations Following Acute Dietary Iodine Intake

Breastmilk iodine levels may vary temporally in response to recent changes in dietary iodine intake. We assessed the effect of and time to peak breastmilk iodine levels after potassium iodine ingestion, which has never been studied and is important toward interpretation of studies of breastmilk iodine measurements. Sixteen healthy lactating Boston-area women with no known thyroid disease were each given 600 μg oral potassium iodide (KI) (456 μg iodine) after an overnight fast. Iodine was measured in breastmilk and urine at baseline and hourly for 8 hours following iodine intake. All dietary iodine ingested during the study period was also measured. Mean age of mothers was 30.2±4.1 (SD) years. Median (interquartile range [IQR]) baseline breastmilk and urine iodine levels were 45.5 μg/L (IQR 34.5-169.0) and 67.5 μg/L (IQR 57.5-140.0), respectively. Following 600 μg KI administration, median increase in breastmilk iodine levels above baseline was 280.5 μg/L (IQR 71.5-338.0), and median peak breastmilk iodine concentration was 354 μg/L (IQR 315-495). Median time to peak breastmilk iodine levels following KI administration was 6 hours (IQR 5-7). Dietary iodine sources provided an additional 36-685 μg iodine intake during the 8-hour study. Following ingestion of 600 μg KI, there is a measurable rise in breastmilk iodine concentrations, with peak levels occurring at 6 hours. These findings strongly suggest that breastmilk iodine concentrations should be interpreted in relation to recent iodine intake.

Breastmilk Iodine Concentrations Following Acute Dietary Iodine Intake

Breastmilk Iodine Concentrations Following Acute Dietary Iodine Intake