1. IODINE WHAT’S IN YOUR SUPPLEMENT? ADAPTED FROM THE OREGON WIC PROGRAM

2. Goals & Objectives Goals: Increase knowledge of WIC staff regarding the importance of iodine supplementation for pregnant and breastfeeding women. WIC staff can assign Risk 427D correctly and discuss iodine supplementation with participants. Objectives: Upon completion of this in-service, 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.

3. Essential trace mineral Helps with thyroid function Prevents goiter in women Prevents certain birth defects in infant, including: Mental retardation Speech and hearing deficits Motor skill impairments ADHD Iodine: What do you know about it?

4. Table salt – iodized since the 1920’s Seafood and seaweed Naturally found in soil Small amounts found in: Grains Dairy Meat Where is it?

5. Added to salt in the 1920’s Among first foods fortified to prevent a common health issue (goiter) Later found iodine prevented certain birth defects (cretinism) Iodine and Public Health

6. Why are we worried about iodine?

7. Deficiency is rare in U.S. Iodine Deficiency Disorders (IDDs) Increased number of miscarriages, stillbirths, and birth defects Depends on developmental stage and severity of deficiency What can happen if you don’t get enough?

8. Adults & adolescents: 150 micrograms /day (Micrograms is abbreviated mcg or µg ) Pregnant or Breastfeeding Women: 250-500 mcg/day How much do we need?

9. Increased need during pregnancy and breastfeeding because mothers are the sole source of iodine for their babies Pregnancy & breastfeeding

10. One teaspoon of iodized salt contains 400 mcg of iodine Americans get lots of sodium, primarily 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. How much iodine is in salt?

11. The American Thyroid Association recommends that pregnant and breastfeeding women take prenatal vitamins with 150 mcg of iodine per day. Recommendations for Iodine

12. 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 iodine Review labels before making recommendations

13. DO NOT increase salt intake When adding salt to food, consider using iodized forms Vitamins should supplement food About 150 mcg from supplements Combine with foods to reach 250-500 mcg/day What does this mean?

14. Risk 427D is Inadequate Vitamin/Mineral Supplementation. In HuBERT the question about supplemention for women reads “What type of vitamins, minerals, herbal supplements or teas are you taking?” When assessing the supplement for iodine: If none – assign the risk If 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 427D

15. Questions?