Skip to main content Accessibility help
×
Home
Hostname: page-component-564cf476b6-mgm4h Total loading time: 0.231 Render date: 2021-06-19T08:50:47.002Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

Iodine status of postpartum women and their infants aged 3, 6 and 12 months: Mother and Infant Nutrition Investigation (MINI)

Published online by Cambridge University Press:  16 April 2021

Ying Jin
Affiliation:
School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
Jane Coad
Affiliation:
Nutrition Science, School of Food and Advanced Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North 4474, New Zealand
Sheila A. Skeaff
Affiliation:
Department of Human Nutrition, University of Otago, Dunedin, New Zealand
Shao (Jo) Zhou
Affiliation:
School of Agriculture, Food and Wine, Faculty of Sciences & Robinson Research Institute, University of Adelaide, Adelaide, Australia
Louise Brough
Affiliation:
Nutrition Science, School of Food and Advanced Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North 4474, New Zealand
Corresponding
E-mail address:

Abstract

To alleviate the re-emergence of iodine deficiency in New Zealand, two strategies, the mandatory fortification of bread with iodised salt (2009) and a government-subsidised iodine supplement for breast-feeding women (2010), were introduced. Few studies have investigated mother and infant iodine status during the first postpartum year; this study aimed to describe iodine status of mothers and infants at 3, 6 and 12 months postpartum (3MPP, 6MPP and 12MPP, respectively). Partitioning of iodine excretion between urine and breast milk of exclusive breast-feeding (EBF) women at 3MPP was determined. In total, eighty-seven mother–infant pairs participated in the study. Maternal and infant spot urinary iodine concentration (UIC) and breast milk iodine concentration (BMIC) were determined. The percentage of women who took iodine-containing supplements decreased from 46 % at 3MPP to 6 % at 12MPP. Maternal median UIC (MUIC) at 3MPP (82 (46, 157) µg/l), 6MPP (85 (43, 134) µg/l) and 12MPP (95 (51, 169) µg/l) were <100 µg/l. The use of iodine-containing supplements increased MUIC and BMIC only at 3MPP. Median BMIC at all time points were below 75 µg/l. Infant MUIC at 3MPP (115 (69, 182) µg/l) and 6MPP (120 (60, 196) µg/l) were below 125 µg/l. Among EBF women at 3MPP, an increased partitioning of iodine into breast milk (highest proportion 60 %) was shown at lower iodine intakes, along with a reduced fractional iodine excretion in urine (lowest proportion 40 %), indicating a protective mechanism for breastfed infants’ iodine status. In conclusion, this cohort of postpartum women was iodine-deficient. Iodine status of their breastfed infants was suboptimal. Lactating women who do not consume iodine-rich foods and those who become pregnant again should take iodine-containing supplements.

Type
Full Papers
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below.

References

World Health Organization, UNICEF & ICCIDD (2007) Assessment of iodine deficiency disorders and monitoring their elimination. https://apps.who.int/iris/bitstream/handle/10665/43781/9789241595827_eng.pdf (accessed November 2020).Google Scholar
Bougma, K, Aboud, FE, Harding, KB, et al. (2013) Iodine and mental development of children 5 years old and under: a systematic review and meta-analysis. Nutrients 5, 13841416.CrossRefGoogle ScholarPubMed
Semba, RD & Delange, F (2001) Iodine in human milk: perspectives for infant health. Nutr Rev 59, 269278.CrossRefGoogle ScholarPubMed
Dold, S, Zimmermann, MB, Aboussad, A, et al. (2017) Breast milk iodine concentration is a more accurate biomarker of iodine status than urinary iodine concentration in exclusively breastfeeding women. J Nutr 147, 528537.CrossRefGoogle ScholarPubMed
World Health Organization Breastfeeding recommendations. https://www.who.int/health-topics/breastfeeding#tab=tab_2 (assessed November 2020).Google Scholar
Eastman, C, Ma, G & Li, M (2019) Optimal assessment and quantification of iodine nutrition in pregnancy and lactation: laboratory and clinical methods, controversies and future directions. Nutrients 11, 2378.CrossRefGoogle ScholarPubMed
Eltom, A, Eltom, M, Elnagar, B, et al. (2000) Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women. Eur J Clin Nutr 54, 429433.CrossRefGoogle ScholarPubMed
Thomson, CD, Packer, MA, Butler, JA, et al. (2001) Urinary selenium and iodine during pregnancy and lactation. J Trace Elem Med Biol 14, 210217.CrossRefGoogle ScholarPubMed
Andersson, M, Aeberli, I, Wüst, N, et al. (2010) The Swiss iodized salt program provides adequate iodine for school children and pregnant women, but weaning infants not receiving iodine-containing complementary foods as well as their mothers are iodine deficient. J Clin Endocrinol Metab 95, 52175224.CrossRefGoogle Scholar
Aakre, I, Morseth, MS, Dahl, L, et al. (2021) Iodine status during pregnancy and at 6 weeks, 6, 12 and 18 months post-partum. Matern Child Nutr 17, e13050.CrossRefGoogle ScholarPubMed
Manousou, S, Augustin, H, Eggertsen, R, et al. (2021) Inadequate iodine intake in lactating women in Sweden: a pilot 1-year, prospective, observational study. Acta Obstet Gynecol Scand 100, 4857.CrossRefGoogle ScholarPubMed
Thomson, CD (2004) Selenium and iodine intakes and status in New Zealand and Australia. Br J Nutr 91, 661672.CrossRefGoogle ScholarPubMed
Skeaff, SA, Thomson, CD & Gibson, RS (2002) Mild iodine deficiency in a sample of New Zealand schoolchildren. Eur J Clin Nutr 56, 11691175.CrossRefGoogle Scholar
Thomson, B (2009) Levels of Iodine in New Zealand Retail Salt. Prepared as Part of a New Zealand Food Safety Authority Contract for Scientific Services. https://www.mpi.govt.nz/dmsdocument/22690/direct#:˜:text=Iodisedsaltisdefinedby,)(FSANZ%2C2009) (accessed March 2021)Google Scholar
Ershow, AG, Skeaff, SA, Merkel, JM, et al. (2018) Development of databases on iodine in foods and dietary supplements. Nutrients 10, 120.CrossRefGoogle ScholarPubMed
Ministry for Primary Industries (2014) Update report on the dietary iodine intake of Zealand children following fortification of bread with iodine. https://www.mpi.govt.nz/dmsdocument/4596/direct (accessed November 2020).Google Scholar
Jin, Y, Coad, J, Zhou, SJ, et al. (2020) Use of iodine supplements by breastfeeding mothers is associated with better maternal and infant iodine status. Biol Trace Elem Res (In the Press).CrossRefGoogle Scholar
Pearson, A, Gibbs, M, Lau, K, et al. (2016) New Zealand Total Diet Study. https://apo.org.au/sites/default/files/resource-files/2018–05/apo-nid173731.pdf (accessed November 2020).Google Scholar
The New Zealand Institute for Plant and Food Research and New Zealand Ministry of Health (2018) New Zealand Food Composition Data. Mistry of Health. https://www.foodcomposition.co.nz/ (accessed October 2020).Google Scholar
Thomson, CD, Colls, AJ, Conaglen, JV, et al. (1997) Iodine status of New Zealand residents as assessed by urinary iodide excretion and thyroid hormones. Br J Nutr 78, 901912.CrossRefGoogle ScholarPubMed
Skeaff, SA, Ferguson, EL, McKenzie, JE, et al. (2005) Are breast-fed infants and toddlers in New Zealand at risk of iodine deficiency? Nutrition 21, 325331.CrossRefGoogle ScholarPubMed
Skeaff, SA & Lonsdale-Cooper, E (2012) Mandatory fortification of bread with iodised salt modestly improves iodine status in schoolchildren. Br J Nutr 190, 11091113.Google Scholar
Jones, E, Mclean, R, Davies, B, et al. (2016) Adequate iodine status in New Zealand school children post-fortification of bread with iodised salt. Nutrients 8, 298.CrossRefGoogle ScholarPubMed
Edmonds, J, McLean, R, Williams, S, et al. (2015) Urinary iodine concentration of New Zealand adults improves with mandatory fortification of bread with iodised salt but not to predicted levels. Eur J Nutr 25, 12011212.Google Scholar
Ministry for Primary Industries (2016) Mandatory Iodine Fortification in New Zealand : Supplement to the Australian Institute of Health and Welfare 2016 Report- Monitoring the Health Impacts of Mandatory Folic Acid and Iodine Fortification. https://www.aihw.gov.au/reports/food-nutrition/folic-acid-iodine-fortification-aus-nz-supplement/contents/table-of-contents (accessed November 2020).Google Scholar
New Zealand Ministry of Health (2011) Supplement (Tablet) to Take When Pregnant or Breastfeeding. https://www.healthed.govt.nz/system/files/resource-files/HE4147%20Folic%20acid%20and%20iodine.pdf (accessed November 2020).Google Scholar
Brough, L, Jin, Y, Shukri, NH, et al. (2015) Iodine intake and status during pregnancy and lactation before and after government initiatives to improve iodine status, in Palmerston North, New Zealand: a pilot study. Matern Child Nutr 11, 646655.CrossRefGoogle ScholarPubMed
Azizi, F & Smyth, P (2009) Breastfeeding and maternal and infant iodine nutrition. Clin Endocrinol 70, 803809.CrossRefGoogle ScholarPubMed
Vannoort, RW & Thomson, BM (2005) 2003/04 New Zealand Total Diet Survey - Agricultural Compound Residues, Selected Contaminants and Nutrients. New Zealand Food Safety Authority. https://www.mpi.govt.nz/dmsdocument/22189/direct (accessed November 2017).Google Scholar
Vannoort, RW & Thomson, BM (2009) New Zealand Total Diet Study: Agricultural Compound Residues, Selected Contaminant and Nutrient Elements. Ministry of Agriculture and Forestry. https://www.mpi.govt.nz/dmsdocument/4004/direct (accessed November 2020).Google Scholar
Jin, Y, Coad, J, Zhou, SJ, et al. (2020) Mother and Infant Nutrition Investigation in New Zealand (MINI Project): protocol for an observational longitudinal cohort study. JMIR Res Protoc 9, e18560.CrossRefGoogle ScholarPubMed
Faul, F, Erdfelder, E, Buchner, A, et al. (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41, 11491160.CrossRefGoogle ScholarPubMed
da Costa, THM, Haisma, H, Wells, JCK, et al. (2010) How much human milk do infants consume? data from 12 countries using a standardized stable isotope methodology. J Nutr 140, 22272232.CrossRefGoogle ScholarPubMed
Fecher, P, Goldmann, I & Nagengast, A (1998) Determination of iodine in food samples by inductively coupled plasma mass spectrometry after alkaline extraction. J Anal Spectrom 13, 977982.CrossRefGoogle Scholar
WHO World Health Organization (2007) AnthroPlus for Personal Computers. Manual: software for Assessing Growth of the World’s Children. Geneva: WHO.Google Scholar
De Onis, M & Blössner, M (1997) WHO Global Database on Child Growth and Malnutrition. Geneva: WHO.Google Scholar
De Onis, M, Onyango, A, Borghi, E, et al. (2006) WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age:Methods and Development. https://www.who.int/publications/i/item/924154693X (accessed November 2006).Google Scholar
National Academy of Science Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. http://www.nap.edu/catalog/10026.html (accessed November 2020).Google Scholar
Dold, S, Zimmermann, MB, Baumgartner, J, et al. (2016) A dose-response crossover iodine balance study to determine iodine requirements in early infancy. Am J Clin Nutr 104, 620628.CrossRefGoogle ScholarPubMed
New Zealand Ministry of Health (2006) Nutrient Reference Values for Australia and New Zealand. Vol 085. Commonwealth of Australia. https://www.nrv.gov.au/ (accessed March 2021).Google Scholar
Axford, S, Charlton, K, Yeatman, H, et al. (2011) Improved iodine status in breastfeeding women following mandatory fortification. Aust N Z J Public Health 35, 579580.CrossRefGoogle ScholarPubMed
Bouhouch, RR, Bouhouch, S, Cherkaoui, M, et al. (2014) Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: A double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2, 197209.CrossRefGoogle ScholarPubMed
Ellsworth, L, Mccaffery, H, Harman, E, et al. (2020) Breast milk iodine concentration is associated with infant growth, independent of maternal weight. Nutrients 12, 113.CrossRefGoogle ScholarPubMed
Velasco, I, Bath, SC & Rayman, MP (2018) Iodine as essential nutrient during the first 1000 days of life. Nutrients 10, 116.CrossRefGoogle ScholarPubMed
Mulrine, HM, Skeaff, SA, Ferguson, EL, et al. (2010) Breast-milk iodine concentration declines over the first 6 mo postpartum in iodine-deficient women. Am J Clin Nutr 92, 849856.CrossRefGoogle ScholarPubMed
Dror, DK & Allen, LH (2018) Iodine in human milk: a systematic review. Adv Nutr 9, 278S294S.CrossRefGoogle ScholarPubMed
Institute of Medicine (IOM) (2000) DRI Dietary Reference Intakes: applications in Dietary Assessment. Washington, DC: National Academies Press.Google Scholar
Delange, F (2007) Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition. Public Health Nutr 10, 15711580.CrossRefGoogle ScholarPubMed
Huynh, D, Condo, D, Gibson, R, et al. (2017) Iodine status of postpartum women and their infants in Australia after the introduction of mandatory iodine fortification. Br J Nutr 117, 16561662.CrossRefGoogle ScholarPubMed
Vermiglio, F, Presti, L, Battiato, S, et al. (1992) Enhaneed iodine concentrating capacity by the mammary gland in iodine defieient lactating women of an endemie goiter region in Sieily. J Endocrinol Invest 15, 137142.CrossRefGoogle Scholar
Konig, F, Andersson, M, Hotz, K, et al. (2011) Ten repeat collections for urinary iodine from spot samples or 24-hour samples are needed to reliably estimate individual iodine status in women. J Nutr 141, 20492054.CrossRefGoogle ScholarPubMed
Li, M & Eastman, CJ (2010) Neonatal TSH screening: is it a sensitive and reliable tool for monitoring iodine status in populations? Best Pract Res Clin Endocrinol Metab 24, 6375.CrossRefGoogle ScholarPubMed
Statistics New Zealand (2018) Household Income and Housing-Cost Statistics: year Ended June 2016. https://www.stats.govt.nz/information-releases/household-income-and-housing-cost-statistics-year-ended-june-2017 (accessed October 2020).Google Scholar

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Iodine status of postpartum women and their infants aged 3, 6 and 12 months: Mother and Infant Nutrition Investigation (MINI)
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Iodine status of postpartum women and their infants aged 3, 6 and 12 months: Mother and Infant Nutrition Investigation (MINI)
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Iodine status of postpartum women and their infants aged 3, 6 and 12 months: Mother and Infant Nutrition Investigation (MINI)
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *