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

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: 43342 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.