Comparison of two sources of iodine delivery on breast milk iodine and maternal and infant urinary iodine concentrations in southern Ethiopia: A randomized trial

Abstract

Iodine deficiency during pregnancy and lactation could expose the infant to severe iodine deficiency disorders. A randomized supplementation trial among rural lactating women was conducted in Sidama zone, southern Ethiopia, to compare the methods of iodine delivery on breast milk iodine, and on maternal and infant urinary iodine concentrations. Women were randomly assigned either to receive 225 μg iodine as potassium iodide capsule daily for 6 months or 450 g of appropriately iodized salt (30–40 μg I as KIO3/g of salt) weekly for household consumption for 6 months. Breast milk iodine concentration (BMIC) and maternal and infant urinary iodine concentration (UIC) were measured at baseline and at 6 months. The women did not differ in BMIC and UIC, and infants did not differ in UIC in a time by treatment interaction. Median (IQR, interquartile range, IQR) BMIC at baseline was 154 [43, 252] μg/L and at 6 months was 105 [36, 198] μg/L, maternal UIC at baseline was 107 [71, 161] μg/L and at 6 months was 130 [80, 208] μg/L; infant UIC at baseline was 218 [108, 356] μg/L and at 6 months was 222 [117, 369] μg/L. Significant correlations among the three variables were obtained in both groups at both times. We conclude that for lactating women an adequate amount of appropriately iodized salt (30–40 μg I/g) had similar effects as a daily supplement of 225 μg I on BMIC and on maternal and infant UIC.

Development of a biochemical marker to detect current breast milk intake

“…A strength of this approach is that the sample collection method is easy, painless, and non‐invasive, very important characteristics for use in paediatric settings. We found urine collection into a nappy with cotton wool balls to be acceptable to parents and efficient, as has been described by others (Ahmad et al, ; Gebreegziabher & Stoecker, ). This method of sample collection would work for clinical and research purposes if a successful assay system to differentiate breastfeeding from formula feeding was established.…”

Iodine supplementation of lactating women and assessment of infant visual information processing and maternal and infant thyroid function: A randomized trial

“…The current study was conducted in 2013, following the rapid implementation of a salt iodization program in 2012. Presumably as the result of the program implementation, our study population showed higher UIC and BMIC than previous studies [12].…”

“…A larger relative decline of thyroid volume was observed in the younger compared to older females from a site where iodine deficiency was moderate [11]. In our study, women supplemented with adequately iodized salt had breast milk iodine concentrations that were not different from women who received a daily capsule containing 225 ug iodine; infant urinary iodine concentrations also were not significantly different based on source of maternal iodine supplement [12].…”

“…The area was known for severe iodine deficiency prior to national implementation of salt iodization in 2012 [15–17]. Breast feeding behavior, household salt use, and compliance of subjects was reported in our previously published manuscript [12]. This study is registered with ClinicalTrials.gov, number NCT03889431.…”

“…Prior to beginning supplementation, baseline data were collected from both mothers and infants. Collection and analysis of breast milk and urine has been described in our previous paper [12]. Maternal blood samples were collected using a disposable 10 cc syringe coated with lithium heparin with a 21 gauge needle (Sarstedt, Inc., Newton, N.C.).…”