The Basics
What is Iodine?
Taken by mouth to prevent and treat iodine deficiency and its consequences.
Brand names for Iodine
Na
How Iodine is classified
Anti-Infective Agents – Local, Antibacterial Agents
Iodine During Pregnancy
Iodine pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Iodine while pregnant
N/A
Taking Iodine While Breastfeeding
What are recommendations for lactation if you're taking Iodine?
Iodine is an essential trace nutrient for all infants that a normal component of breastmilk. Infant requirements are estimated to be 15 mcg/kg daily in fullterm infants and 30 mcg/kg daily in premature infants.[1] Systematic reviews and studies on iodine nutrition found that iodine in breastmilk is adequate in iodine-sufficient countries, but in countries with iodine fortification of foods, many mothers did not obtain adequate iodine and that additional supplementation was desirable.[2][3][4][5] In iodine-deficient areas, supplementation of breastfeeding mothers with iodine appears to be more effective than direct supplementation of the infant in reducing infant iodine deficiency.[6] The American Thyroid Association recommends that breastfeeding women should supplement their diet with a daily oral supplement that contains 150 mcg of iodine, but sustained iodine intake while breastfeeding that exceeds 500 to 1100 mcg daily should be avoided.[7] A survey in the United States between 2011 and 2014 found that only 19% of lactating women used a dietary supplement that contained iodine.[8] The use of excessive amounts of iodine in the mother near term and during breastfeeding (e.g., seaweed soup) can increase breastmilk iodine levels and cause transient hypothyroidism in breastfed infants. The absorption of iodine can be marked after application to open wounds or mucous membranes. Exposure of mothers to unnecessary iodine who are or will be breastfeeding should be avoided or minimized to the extent possible by avoiding its use on maternal mucous membranes (e.g., vaginal use, wound therapy), avoiding prolonged contact time, avoiding repeated applications, and applying it to the smallest possible surface areas of the body. It is possible that maternal exposure to iodine near term could interfere with thyroid studies done as a part of newborn screening tests.
Maternal / infant drug levels
Iodine is an essential trace nutrient for all infants that a normal component of breastmilk. Infant requirements are estimated to be 15 mcg/kg daily in fullterm infants and 30 mcg/kg daily in premature infants.[1] Systematic reviews and studies on iodine nutrition found that iodine in breastmilk is adequate in iodine-sufficient countries, but in countries with iodine fortification of foods, many mothers did not obtain adequate iodine and that additional supplementation was desirable.[2][3][4][5] In iodine-deficient areas, supplementation of breastfeeding mothers with iodine appears to be more effective than direct supplementation of the infant in reducing infant iodine deficiency.[6] The American Thyroid Association recommends that breastfeeding women should supplement their diet with a daily oral supplement that contains 150 mcg of iodine, but sustained iodine intake while breastfeeding that exceeds 500 to 1100 mcg daily should be avoided.[7] A survey in the United States between 2011 and 2014 found that only 19% of lactating women used a dietary supplement that contained iodine.[8] The use of excessive amounts of iodine in the mother near term and during breastfeeding (e.g., seaweed soup) can increase breastmilk iodine levels and cause transient hypothyroidism in breastfed infants. The absorption of iodine can be marked after application to open wounds or mucous membranes. Exposure of mothers to unnecessary iodine who are or will be breastfeeding should be avoided or minimized to the extent possible by avoiding its use on maternal mucous membranes (e.g., vaginal use, wound therapy), avoiding prolonged contact time, avoiding repeated applications, and applying it to the smallest possible surface areas of the body. It is possible that maternal exposure to iodine near term could interfere with thyroid studies done as a part of newborn screening tests.
Possible effects of Iodine on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Iodine
(Skin Disinfection) Chlorhexidine, Benzalkonium Chloride.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Ares S, Quero J, de Escobar GM. Iodine balance, iatrogenic excess, and thyroid dysfunction in premature newborns. Semin Perinatol. 2008;32:407-12. PMID: 19007678
2. Nazeri P, Mirmiran P, Shiva N et al. Iodine nutrition status in lactating mothers residing in countries with mandatory and voluntary iodine fortification program: An updated systematic review. Thyroid. 2015;25:611-20. PMID: 25811835
3. Nazeri P, Kabir A, Dalili H et al. Breast-milk iodine concentrations and iodine levels of infants according to the iodine status of the country of residence: A systematic review and meta-analysis. Thyroid. 2018;28:124-38. PMID: 29334343
4. Farebrother J, Zimmermann MB, Abdallah F et al. Effect of excess iodine intake from iodized salt and/or groundwater iodine on thyroid function in nonpregnant and pregnant women, infants, and children: A multicenter study in East Africa. Thyroid. 2018;28:1198-210. PMID: 30019625
5. Nazeri P, Tahmasebinejad Z, Mehrabi Y et al. Lactating mothers and infants residing in an area with an effective salt iodization program have no need for iodine supplements: Results from a double-blind, placebo-controlled, randomized controlled trial. Thyroid. 2018;28:1547-58. PMID: 30272528
6. Bouhouch RR, Bouhouch S, Cherkaoui M et al. Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2014;2:197-209. PMID: 24622750
7. Alexander EK, Pearce EN, Brent GA et al. 2016 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid. 2017;27:315-89. PMID: 28056690
8. Gupta PM, Gahche JJ, Herrick KA et al. Use of iodine-containing dietary supplements remains low among women of reproductive age in the United States: NHANES 2011-2014. Nutrients. 2018;10:422. PMID: 29596306
9. Dror DK, Allen LH. Iodine in human milk: A systematic review. Adv Nutr. 2018;9 (Suppl 1):347S-57S. PMID: 29846524
10. Gushurst CA, Mueller JA, Green JA, Sedor F. Breast milk iodide: Reassessment in the 1980s. Pediatrics. 1984;73:354-7. PMID: 6546615
11. Pearce EN, Leung AM, Blount BC et al. Breast milk iodine and perchlorate concentrations in lactating Boston-area women. J Clin Endocrinol Metab. 2007;92:1673-7. PMID: 17311853
12. Dold S, Baumgartner J, Zeder C et al. 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. Thyroid. 2016;26:287-95. PMID: 26563466
13. Kirk AB, Martinelango PK, Tian K et al. Perchlorate and iodide in dairy and breast milk. Environ Sci Technol. 2005;39:2011-7. PMID: 15871231
14. Kirk AB, Dyke JV, Martin CF, Dasgupta PK. Temporal patterns in perchlorate, thiocyanate, and iodide excretion in human milk. Environ Health Perspect. 2007;115:182-6. PMID: 17384762
15. Kwit NT, Hatcher RA. Excretion of drugs in milk. Am J Dis Child. 1935;49:900-4.
16. Casteels K, Punt S, Bramswig J. Transient neonatal hypothyroidism during breastfeeding after post-natal maternal topical iodine treatment. Eur J Pediatr. 2000;159:716-7. PMID: 11014479
17. Smith VC, Svoren BM, Wolfsdorf JI. Hypothyroidism in a breast-fed preterm infant resulting from maternal topical iodine exposure. J Pediatr. 2006;149:566-7. PMID: 17011335
18. Chung HR, Shin CH, Yang SW et al. Subclinical hypothyroidism in Korean preterm infants associated with high levels of iodine in breast milk. J Clin Endocrinol Metab. 2009;94:4444-7. PMID: 19808851
19. Kurtoglu S, Akin L, Akin MA, Coban D. Iodine overload and severe hypothyroidism in two neonates. J Clin Res Pediatr Endocrinol. 2009;1:275-7. DOI: doi:10.4274/jcrpe.v1i6.275
20. Emder PJ, Jack MM. Iodine-induced neonatal hypothyroidism secondary to maternal seaweed consumption: A common practice in some Asian cultures to promote breast milk supply. J Paediatr Child Health. 2011;47:750-2. PMID: 21276114
21. Gonzalez-Iglesias H, de la Flor St Remy RR, Lopez-Sastre J et al. Efficiency of iodine supplementation, as potassium iodide, during lactation: A study in neonates and their mothers. Food Chem. 2012;133:859-65.
22. Leung A, Braverman LE, He X et al. Breastmilk iodine concentrations following acute dietary iodine intake. Thyroid. 2012;22:1176-80. PMID: 22830631
23. Sukkhojaiwaratkul D, Mahachoklertwattana P, Poomthavorn P et al. Effects of maternal iodine supplementation during pregnancy and lactation on iodine status and neonatal thyroid-stimulating hormone. J Perinatol. 2014;34:594-8. PMID: 24743135
24. Nazeri P, Mirmiran P, Tahmasebinejad Z et al. The effects of iodine fortified milk on the iodine status of lactating mothers and infants in an area with a successful salt iodization program: A randomized controlled trial. Nutrients. 2017;9:E180. PMID: 28241419
25. Gebreegziabher T, Stoecker BJ. Comparison of two sources of iodine delivery on breast milk iodine and maternal and infant urinary iodine concentrations in southern Ethiopia: A randomized trial. Food Sci Nutr. 2017;5:921-8. PMID: 28748081
26. Hamada K, Mizokami T, Maruta T et al. Effects of inorganic iodine therapy administered to lactating mothers with Graves disease on infant thyroid function. J Endocr Soc. 2017;1:1293-300. PMID: 29264454
27. Stoutjesdijk E, Schaafsma A, Dijck-Brouwer DAJ et al. Iodine status during pregnancy and lactation: a pilot study in the Netherlands. Neth J Med. 2018;76:210-217. PMID: 30019676
28. Dumrongwongsiri O, Chatvutinun S, Phoonlabdacha P et al. High urinary iodine concentration among breastfed infants and the factors associated with iodine content in breast milk. Biol Trace Elem Res. 2018;186:106-13. PMID: 29549532
29. Hulse T. Transient neonatal hypothyroidism resulting from maternal ingestion of a traditional Korean seaweed soup. Horm Res Paediatr. 2012;78 (Suppl 1):127-8. Abstract. DOI: doi:10.1159/000343182
30. Hamby T, Kunnel N, Dallas JS et al. Maternal iodine excess: An uncommon cause of acquired neonatal hypothyroidism. J Pediatr Endocrinol Metab. 2018;31:1061-4. PMID: 30052521
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
