Poor knowledge and dietary practices related to iodine in breastfeeding mothers a year after introduction of mandatory fortification

Abstract

Aim: Public health has refocused attention on low iodine status of vulnerable groups. The purpose of this research was to identify knowledge and dietary practices related to iodine nutrition in breastfeeding women in the Illawarra region following introduction of the mandatory iodine fortification programme. Methods: A cross‐sectional study was undertaken at four early childhood centres. Sixty mothers in their first six months of breastfeeding completed a short knowledge questionnaire, an iodine‐specific food frequency questionnaire, and reported use of nutritional supplements. Results: The women were generally limited in their ability to identify good dietary sources of iodine such as milk and bread but 45 women (75%) correctly identified seafood as a good source. There was some confusion in identifying health problems associated with insufficient iodine intake. Mean reported iodine intake was 146 mg/day (standard deviation: 58 mg; range: 43–342 mg); 48 women (80%) had intakes below the estimated average requirement of 190 mg/day. After allowance was made for fortification of bread, mean iodine intake significantly increased to 182 mg/day (P < 0.001) and the number of women having intakes below the estimated average requirement decreased to 36 (60%). Milk was the highest contributor to iodine intake, on average representing 62% of total iodine consumed. Only 27 (45%) mothers reported consuming supplements that contained iodine. Conclusion: The combination of inadequate knowledge regarding iodine and the limited use of iodine supplements highlights a potential public health issue of concern. However, mandatory fortification may be overcoming this knowledge and behaviour deficit.

Health knowledge and iodine intake in pregnancy

“…Inadequate iodine supplementation has also been found in other Australian studies of pregnant and breastfeeding women . Similarly, poor knowledge about iodine in pregnancy and dietary sources of iodine has been previously demonstrated in Australian pregnant and lactating women . This study showed that most pregnant women were aware of the importance of folate compared with iodine.…”

“…A review by Charlton et al . also found that pregnant and lactating women were better informed about folate and other dietary issues related to pregnancy than iodine . Previous studies indicate that many Australian pregnant and lactating women feel that they had not received sufficient information regarding iodine for their pregnancy …”

Dietary Iodine Intake of the Australian Population after Introduction of a Mandatory Iodine Fortification Programme

“…As well as fortified bread, we identified that other major sources of iodine for the total Australian population in 2011–2013 included milk products and dishes (26%), non-alcoholic beverages (15%) and cereal based products and dishes (12%). Despite being rich in iodine, fish and seafood contributed only minimally to total iodine intake due to low reported consumption, as has been reported by other studies [23,34]. Previous studies in pregnant Australian women identified that dairy foods were a major contributor to total iodine intake (57%–62%), followed by bread and cereals (19%–21%) with minor contributions from fish and seafood (3%–8%) [14,23].…”

Understanding food and nutrition‐related behaviours: Putting together the pieces of the puzzle

“…Other individual factors have been consistently shown to be associated with eating behaviours including nutrition knowledge and self‐efficacy 19 . Research by Axford et al 20 . highlights the importance of nutrition knowledge in the area of iodine.…”

“…18 Other individual factors have been consistently shown to be associated with eating behaviours including nutrition knowledge and self-efficacy. 19 Research by Axford et al 20 highlights the importance of nutrition knowledge in the area of iodine. They demonstrated that even among a well-educated sample of breastfeeding women, knowledge relating to iodine, such as its importance to health, good sources of iodine and the need for supplements during lactation, was poor.…”