Advertisement

Biological Trace Element Research

, Volume 186, Issue 1, pp 106–113 | Cite as

High Urinary Iodine Concentration Among Breastfed Infants and the Factors Associated with Iodine Content in Breast Milk

  • Oraporn Dumrongwongsiri
  • Suthida Chatvutinun
  • Phanphen Phoonlabdacha
  • Areeporn Sangcakul
  • La-or Chailurkit
  • Atitaya Siripinyanond
  • Umaporn Suthutvoravut
  • Nalinee Chongviriyaphan
Article
  • 171 Downloads

Abstract

Iodine deficiency in infants leads to delayed growth and development. Some studies have reported iodine deficiency among infants and lactating women. We assessed iodine status in infants and lactating women, as well as the iodine content in breast milk. A cross-sectional study enrolled mother-infant pairs (infants aged 4–6 months), who visited Well Child Clinic at Ramathibodi Hospital, Bangkok, Thailand. Infants were classified by feeding type as breastfed (BF), mixed breastfed and formula-fed (MF), and formula-fed (FF). Demographic and perinatal data were collected. The urinary iodine concentration (UIC) of infants and lactating women, and breast milk iodine concentration (BMIC) were analyzed. Seventy-one infants were enrolled. The median UIC of infants was 282 mcg/L. Breastfed infants had higher median UIC than formula-fed infants (553 vs. 192 mcg/L; p = 0.002). Forty-eight percent of infants had a UIC more than 300 mcg/L. The median UIC and BMIC of lactating women were 149 and 255 mcg/L, respectively. Among the BF group, the infant UIC was correlated with maternal UIC (rs = 0.857, p = 0.014). Multiple linear regression showed the BMIC to be associated with maternal UIC (β = 4.03, 95% CI [1.34, 6.71]) and maternal weight (β = 8.26, 95%CI [2.76, 13.77]). Iodine nutrition among our study population was adequate. The median UIC of infants and lactating mothers were 282 and 149 mcg/L, respectively. Breastfed infants had a significantly higher median UIC than formula-fed infants. The BMIC was associated with maternal UIC and maternal weight.

Keywords

Iodine status Breastfed infants Urinary iodine concentration Breast milk iodine concentration Breastfeeding 

Notes

Acknowledgements

We express our sincere thanks to all participants in our study, healthcare personnel at the well child clinic and lactation clinic of the Faculty of Medicine of Ramathibodi Hospital for their cooperation. We are grateful to Professor Pat Mahachoklertwattana for his suggestions on the manuscript, and Miss UmapornUdomsubpayakul for her assistance in statistical analyses. We thank Arshad Makhdum, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding information

This study was funded by the Development Potential of Thai People Project, Faculty of Medicine, Ramathibodi Hospital, Mahidol University.

Compliance with Ethical Standards

The study protocol was approved by the Committee of Human Rights Related to Research Involving Human Subjects, Faculty of Medicine of Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (protocol number 01-54-01). All mothers provided written inform consent before enrollment. All procedures performed in the study were in accordance with the ethical standards of the committee and with the 1964 Helsinki declaration.

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Andersson M, Karumbunathan V, Zimmermann MB (2012) Global iodine status in 2011 and trends over the past decade. J Nutr 142(4):744–750.  https://doi.org/10.3945/jn.111.149393 CrossRefPubMedGoogle Scholar
  2. 2.
    Li M, Eastman CJ (2012) The changing epidemiology of iodine deficiency. Nat Rev Endocrinol 8(7):434–440.  https://doi.org/10.1038/nrendo.2012.43 CrossRefPubMedGoogle Scholar
  3. 3.
    Pearce EN, Andersson M, Zimmermann MB (2013) Global iodine nutrition: where do we stand in 2013? Thyroid 23(5):523–528.  https://doi.org/10.1089/thy.2013.0128 CrossRefPubMedGoogle Scholar
  4. 4.
    Zimmermann MB (2012) The effects of iodine deficiency in pregnancy and infancy. Paediatr Perinat Epidemiol 26(Suppl 1):108–117.  https://doi.org/10.1111/j.1365-3016.2012.01275.x CrossRefPubMedGoogle Scholar
  5. 5.
    Gowachirapant S, Winichagoon P, Wyss L, Tong B, Baumgartner J, Melse-Boonstra A, Zimmermann MB (2009) Urinary iodine concentrations indicate iodine deficiency in pregnant Thai women but iodine sufficiency in their school-aged children. J Nutr 139(6):1169–1172.  https://doi.org/10.3945/jn.108.100438 CrossRefPubMedGoogle Scholar
  6. 6.
    WHO/UNICEF/ICCIDD (2007) Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. GenevaGoogle Scholar
  7. 7.
    Pongpaew P, Supawan V, Tungtrongchitr R, Phonrat B, Vudhivai N, Chantaranipapong Y, Kitjaroentham A, Jintaridhi P, Intarakhao C, Mahaweerawat U, Saowakhontha S, Schelp FP (1999) Urinary iodine excretion as a predictor of the iodine content of breast milk. J Med Assoc Thail 82(3):284–289Google Scholar
  8. 8.
    International Council of the Control of Iodine Deficiency Disorder (2009) Tracking process toward sustainable elimination of iodine deficiency disorders in Thailand. In: BangkokGoogle Scholar
  9. 9.
    Kramer MS, Kukuma R (2002) The optimal duration of exclusive breastfeeding. A systematic review. World Health Organization, GenevaGoogle Scholar
  10. 10.
    Azizi F, Smyth P (2009) Breastfeeding and maternal and infant iodine nutrition. Clin Endocrinol 70(5):803–809CrossRefGoogle Scholar
  11. 11.
    Dunn JT, Crutchfield HE, Gutekunst R, Dunn AD (1993) Two simple methods for measuring iodine in urine. Thyroid 3(2):119–123CrossRefGoogle Scholar
  12. 12.
    Johnson LA, Ford HC, Doran J, Richardson VF (1990) A survey of the iodide concentration of human milk. N Z Med J 103(896):393–394PubMedGoogle Scholar
  13. 13.
    Leung AM, Braverman LE, He X, Heeren T, Pearce EN (2012) Breastmilk iodine concentrations following acute dietary iodine intake. Thyroid 22(11):1176–1180CrossRefGoogle Scholar
  14. 14.
    Semba RD, Delange F (2001) Iodine in human milk: perspectives for infant health. Nutr Rev 59(8 Pt 1):269–278PubMedGoogle Scholar
  15. 15.
    Bratter P, Blasco IN, Negretti de Bratter VE, Raab A (1998) Speciation as an analytical aid in trace element research in infant nutrition. Analyst 123(5):821–826CrossRefGoogle Scholar
  16. 16.
    Dorea JG (2002) Iodine nutrition and breast feeding. J Trace Elem Med Biol 16(4):207–220.  https://doi.org/10.1016/s0946-672x(02)80047-5 CrossRefPubMedGoogle Scholar
  17. 17.
    Delange F (2007) Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition. Public Health Nutr 10(12a):1571–1580.  https://doi.org/10.1017/s1368980007360941 CrossRefPubMedGoogle Scholar
  18. 18.
    Delange F, de Benoist B, Burgi H (2002) Determining median urinary iodine concentration that indicates adequate iodine intake at population level. Bull World Health Organ 80(8):633–636PubMedPubMedCentralGoogle Scholar
  19. 19.
    Osei J, Baumgartner J, Rothman M, Matsungo TM, Covic N, Faber M, Smuts CM (2016) Iodine status and associations with feeding practices and psychomotor milestone development in six-month-old South African infants. Matern Child Nutr 13.  https://doi.org/10.1111/mcn.12408 CrossRefGoogle Scholar
  20. 20.
    Gordon JH, Leung AM, Hale AR, Pearce EN, Braverman LE, He X, Belfort MB, Nelson SM, Brown RS (2014) No difference in urinary iodine concentrations between Boston-area breastfed and formula-fed infants. Thyroid 24(8):1309–1313.  https://doi.org/10.1089/thy.2014.0026 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Sukkhojaiwaratkul D, Mahachoklertwattana P, Poomthavorn P, Panburana P, Chailurkit LO, Khlairit P, Pongratanakul S (2014) Effects of maternal iodine supplementation during pregnancy and lactation on iodine status and neonatal thyroid-stimulating hormone. J Perinatol 34(8):594–598.  https://doi.org/10.1038/jp.2014.62 CrossRefPubMedGoogle Scholar
  22. 22.
    Andersson M, Aeberli I, Wust N, Piacenza AM, Bucher T, Henschen I, Haldimann M, Zimmermann MB (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(12):5217–5224.  https://doi.org/10.1210/jc.2010-0975 CrossRefPubMedGoogle Scholar
  23. 23.
    de Lima LF, Barbosa F Jr, Navarro AM (2013) Excess iodinuria in infants and its relation to the iodine in maternal milk. J Trace Elem Med Biol 27(3):221–225.  https://doi.org/10.1016/j.jtemb.2013.01.003 CrossRefPubMedGoogle Scholar
  24. 24.
    Wang Y, Zhang Z, Ge P, Wang Y, Wang S (2009) Iodine status and thyroid function of pregnant, lactating women and infants (0–1 yr) residing in areas with an effective Universal Salt Iodization program. Asia Pac J Clin Nutr 18(1):34–40PubMedGoogle Scholar
  25. 25.
    Osei J, Andersson M, Reijden OV, Dold S, Smuts CM, Baumgartner J (2016) Breast-milk iodine concentrations, iodine status, and thyroid function of breastfed infants aged 2–4 months and their mothers residing in a South African township. J Clin Res Pediatr Endocrinol 8(4):381–391.  https://doi.org/10.4274/jcrpe.2720 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Mekrungcharas T, Kasemsup R (2014) Breast milk iodine concentrations in lactating mothers at Queen Sirikit National Institute of Child Health. J Med Assoc Thail 97(Suppl 6):S115–S119Google Scholar
  27. 27.
    Bazrafshan HR, Mohammadian S, Ordookhani A, Abedini A, Davoudy R, Pearce EN, Hedayati M, Azizi F, Braverman LE (2005) An assessment of urinary and breast milk iodine concentrations in lactating mothers from Gorgan, Iran, 2003. Thyroid 15(10):1165–1168.  https://doi.org/10.1089/thy.2005.15.1165 CrossRefPubMedGoogle Scholar
  28. 28.
    Ordookhani A, Pearce EN, Hedayati M, Mirmiran P, Salimi S, Azizi F, Braverman LE (2007) Assessment of thyroid function and urinary and breast milk iodine concentrations in healthy newborns and their mothers in Tehran. Clin Endocrinol 67(2):175–179.  https://doi.org/10.1111/j.1365-2265.2007.02857.x CrossRefGoogle Scholar
  29. 29.
    Dold S, Zimmermann MB, Aboussad A, Cherkaoui M, Jia Q, Jukic T, Kusic Z, Quirino A, Sang Z, San Luis TO, Vandea E, Andersson M (2017) Breast milk iodine concentration is a more accurate biomarker of iodine status than urinary iodine concentration in exclusively breastfeeding women. J Nutr 147(4):528–537.  https://doi.org/10.3945/jn.116.242560 CrossRefPubMedGoogle Scholar
  30. 30.
    Henjum S, Kjellevold M, Ulak M, Chandyo RK, Shrestha PS, Froyland L, Strydom EE, Dhansay MA, Strand TA (2016) Iodine concentration in breastmilk and urine among lactating women of Bhaktapur, Nepal. Nutrients 8(5).  https://doi.org/10.3390/nu8050255 CrossRefGoogle Scholar
  31. 31.
    Jorgensen A, O'Leary P, James I, Skeaff S, Sherriff J (2016) Assessment of breast milk iodine concentrations in lactating women in Western Australia. Nutrients 8(11).  https://doi.org/10.3390/nu8110699 CrossRefGoogle Scholar
  32. 32.
    Zimmermann MB (2013) Iodine deficiency and excess in children: worldwide status in 2013. Endocr Pract 19(5):839–846.  https://doi.org/10.4158/ep13180.ra CrossRefPubMedGoogle Scholar
  33. 33.
    Rillema JA, Hill MA (2003) Prolactin regulation of the pendrin-iodide transporter in the mammary gland. Am J Physiol Endocrinol Metab 284(1):E25–E28.  https://doi.org/10.1152/ajpendo.00383.2002 CrossRefPubMedGoogle Scholar
  34. 34.
    Andersen SL, Moller M, Laurberg P (2014) Iodine concentrations in milk and in urine during breastfeeding are differently affected by maternal fluid intake. Thyroid 24(4):764–772.  https://doi.org/10.1089/thy.2013.0541 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Oraporn Dumrongwongsiri
    • 1
  • Suthida Chatvutinun
    • 2
  • Phanphen Phoonlabdacha
    • 1
  • Areeporn Sangcakul
    • 3
  • La-or Chailurkit
    • 4
  • Atitaya Siripinyanond
    • 5
  • Umaporn Suthutvoravut
    • 1
  • Nalinee Chongviriyaphan
    • 1
  1. 1.Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
  2. 2.Pediatrics Nursing Division, Nursing Service Department, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
  3. 3.Department of Pathology, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
  4. 4.Department of Medicine, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
  5. 5.Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of ScienceMahidol UniversityBangkokThailand

Personalised recommendations