Goals & ObjectivesGoals:

Increase knowledge of WIC staff regarding the importance of iodine supplementation for pregnant and breastfeeding women.

WIC staff can assign Risk 427.4 correctly and discuss iodine supplementation with participants.

Objectives: Upon completion of this in-service, WIC staff will be able to:Explain the reasons for iodine supplementation for pregnant

and breastfeeding women.Demonstrate their knowledge of iodine supplementation by

reading nutrition labels and identifying iodine-containing prenatal vitamins.

Iodine: What do you know about it?Essential trace mineralHelps with thyroid function

Where is it?Table salt – iodized since the 1920’sSeafood and seaweedSmall amounts found in:

GrainsDairyMeat

Iodine and Public HealthAdded to salt in the 1920’sOne of the first food fortifications designed to prevent

a common health issue (goiter) Later found iodine prevented certain birth defects

(cretinism)

Why are we worried about iodine?

What can happen if you don’t get enough?Deficiency is rare in U.S.Iodine Deficiency Disorders (IDDs)Increased number of miscarriages,

stillbirths, and birth defectsDepends on developmental

stage and severity of deficiency

How much do we need?Adults & adolescents:

150 micrograms /day (Micrograms is abbreviated mcg or µg)

Pregnant or Breastfeeding Women:

250-500 mcg/day

Pregnancy & breastfeedingIncreased need during pregnancy and

breastfeeding because mothers are the sole source of iodine for their babies.

How much iodine is in salt?One teaspoon of iodized salt contains 400 mcg of

iodine Americans get lots of sodium, most of which comes

from processed foods not iodized salt.Don’t encourage moms to eat more salt, rather

encourage them to consider buying iodized salt when they shop.

Prenatal Vitamins

Take before or early in pregnancy First half of pregnancy especially critical

Recommend a vitamin that contains 150 mcg of iodine during pregnancy and breastfeeding

Not all prenatal multivitamins contain iodineReview labels before making recommendations

What does this mean?DO NOT increase salt intake

When adding salt to food, consider using iodized formsVitamins should supplement food

About 150 mcg from supplementsCombine with foods to reach 250-500 mcg/day

Risk 427.4 is Inadequate Supplementation of Iron, Iodine, or Folic Acid.

In TWIST the supplementation question for women reads “Are you taking a vitamin with iron or iron supplement?”

Ask if they are taking a prenatal vitamin.If no – assign the riskIf yes – ask if it contains iron, folic acid and iodine

If they don’t know – do not assign risk and refer to their health care provider.

If it does not contain any of the 3 nutrients – assign risk If it contains all 3 nutrients – do not assign risk

Assigning Risk 427.4