title: Low iodine content in the diets of hospitalized preterm infants.
abstract: BACKGROUND
  Iodine is critical for normal thyroid hormone synthesis and brain development during infancy, and preterm infants are particularly vulnerable to the effects of both iodine deficiency and excess. Use of iodine-containing skin antiseptics in intensive care nurseries has declined substantially in recent years, but whether the current dietary iodine intake meets the requirement for hospitalized preterm infants is unknown.
  
  
  OBJECTIVE
  The aim of the study was to measure the iodine content of enteral and parenteral nutrition products commonly used for hospitalized preterm infants and estimate the daily iodine intake for a hypothetical 1-kg infant.
  
  
  METHODS
  We used mass spectrometry to measure the iodine concentration of seven preterm infant formulas, 10 samples of pooled donor human milk, two human milk fortifiers (HMF) and other enteral supplements, and a parenteral amino acid solution and soy-based lipid emulsion. We calculated the iodine provided by typical diets based on 150 ml/kg · d of formula, donor human milk with or without HMF, and parenteral nutrition.
  
  
  RESULTS
  Preterm formula provided 16.4-28.5 μg/d of iodine, whereas unfortified donor human milk provided only 5.0-17.6 μg/d. Adding two servings (six packets) of Similac HMF to human milk increased iodine intake by 11.7 μg/d, whereas adding two servings of Enfamil HMF increased iodine intake by only 0.9 μg/d. The other enteral supplements contained almost no iodine, nor did a parenteral nutrition-based diet.
  
  
  CONCLUSIONS
  Typical enteral diets for hospitalized preterm infants, particularly those based on donor human milk, provide less than the recommended 30 μg/d of iodine, and parenteral nutrition provides almost no iodine. Additional iodine fortification should be considered.
authors.affiliation: Division of Newborn Medicine, Hunnewell 438, Children's Hospital Boston, 300 Longwood Avenue, Boston, Massachusetts 02115, USA. mandy.belfort@childrens.harvard.edu
authors.forename: Mandy B
authors.initials: MB
authors.lastname: Belfort
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Pearce
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Braverman
authors.forename: Xuemei
authors.initials: X
authors.lastname: He
authors.forename: Rosalind S
authors.initials: RS
authors.lastname: Brown
mesh_terms: D004032:Diet / Q000009:adverse effects*; D005217:Fat Emulsions, Intravenous / Q000737:chemistry; D005526:Food, Formulated / Q000032:analysis*; D005527:Food, Fortified / Q000032:analysis; D006801:Humans; D041943:Infant Formula / Q000737:chemistry*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007455:Iodine / Q000008:administration & dosage* / Q000032:analysis; D008895:Milk, Human / Q000737:chemistry; D009751:Nutritional Requirements; D009753:Nutritive Value; D057947:Parenteral Nutrition Solutions / Q000737:chemistry*
chemical_list: D005217:Fat Emulsions, Intravenous; D057947:Parenteral Nutrition Solutions; D007455:Iodine