Sensitive Midwifery - Issue 44 - October 2019

When it comes to iodine intake, there’s a lot of food for thought, writes Sensitive Midwifery’s Kelly Norwood-Young. Iodine in maternity care I odine is a micronutrient required by the human body for normal thyroid function. Common sources are iodised salt, grains (including bread), dairy products, saltwater fish and seafood, kelp and other sea vegetables. Although it is possible to get enough iodine from food, many people are unknowingly deficient in iodine, and pregnant women (who need a higher intake of the trace mineral) are more susceptible to this deficiency. Breastfed babies, too, will only receive enough iodine if their mothers are getting enough. And yet, in maternity care especially, ensuring adequate intake through iodised salt or supplementation is not as simple as it seems, since there are also significant risks to consuming too much iodine. The dangers of deficiency Iodine deficiency disorders a ff ect more than 2.2 billion individuals worldwide (38% of the world’s population). Across all age groups, severe or prolonged iodine deficiency can result in goitre (swelling in the neck due to an enlargement of the thyroid gland), hypothyroidism (which a ff ects thyroid hormone production), as well as many other health challenges. Even a mild deficiency can cause slowed metabolism, fatigue, weight gain, sore muscles, dry skin and brittle nails. Pregnant women require even higher amounts of iodine, which, as the World Health Organization (WHO) notes, is ‘essential for the production of maternal and fetal thyroid hormones that regulate the development of the fetal brain and nervous system’. Insu ffi cient iodine intake during pregnancy has been linked to congenital abnormalities, perinatal and infant mortality, impaired mental function, and cretinism. Numerous studies have noted how maternal iodine deficiency can a ff ect brain development adversely. One 2004 study suggested that mild iodine deficiency in mothers may also be associated with attention-deficit and hyperactivity disorders in o ff spring, while another more recent study (2013) found that pregnant mothers who were deficient in iodine were more likely to have children with learning di ffi culties and lower IQ scores. Importantly, research has shown that prenatal iodine deficiency has been identified as the leading cause of preventable brain damage worldwide. Women with adequate intrathyroidal iodine stores are able to adapt easily to the increased demand for thyroid hormone during gestation, with total Dimensions Continued on page 31 30 eSensitive Midwifery Magazine Issue 44