The results are thus compatible with the international recommendation that lactating women and infants younger than two years of age who reside in iodine-sufficient countries do not require iodine supplementation
BACKGROUND Iodine , an essential micronutrient , plays a critical role in normal growth and development , especially during the first two years of life .
This systematic review and meta- analysis is among the first to evaluate breast-milk iodine concentrations and infant iodine status in countries characterized by iodine sufficiency or deficiency .
Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial.
BACKGROUND 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 aim ed to assess the safety and efficacy of direct versus indirect supplementation of the infant . METHODS We did this double blind , r and omised , placebo-controlled trial in Morocco . Healthy breastfeeding mothers and their term newborn babies ( aged ≤8 weeks ) were block r and omised 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 ) . R and omisation was masked to participants and investigators . Co primary 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 Clinical Trials.gov , number NCT01126125 . FINDINGS 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 . INTERPRETATION 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 . FUNDING ETH Zurich , Switzerl and ; the Medicor Foundation , Vaduz , Lichtenstein
The results are thus compatible with the international recommendation that lactating women and infants younger than two years of age who reside in iodine-sufficient countries do not require iodine supplementation
BACKGROUND Iodine , an essential micronutrient , plays a critical role in normal growth and development , especially during the first two years of life .
This systematic review and meta- analysis is among the first to evaluate breast-milk iodine concentrations and infant iodine status in countries characterized by iodine sufficiency or deficiency .