Iodine During Pregnancy: Are You Getting Enough?

Around the world, 18 million babies are born mentally disabled every year because of maternal iodine deficiency. While iodine deficiency is rare in the U.S., there are a few things you should know to protect your baby.

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Iodine is a mineral found in food — and one of the most important minerals a fetus needs for brain development and physical growth. While our bodies require only the teeny-tiniest amount of it (only 5g over the course of a 70-year lifetime!), that little bit is really important. Iodine deficiency in pregnancy is the most preventable cause of intellectual disability in the world, according to the Centers for Disease Control and Prevention. It's a rare problem in the U.S., but it's a growing problem.

In the past, home-cooked meals with iodized table salt provided adequate iodine in the average American's diet. But iodine content in many of the foods and beverages we consume today is pretty low. The addition of iodine to table salt isn't mandatory in the U.S., and the salt that's used in baked goods, chips and other processed foods isn't iodized either. So with more processed and prepared foods making up our diets, we're getting less iodine. What's more, sea salt isn't iodized either — and many people use sea salt when cooking these days without realizing it doesn't offer the same health benefits as iodized salt.

For these reasons, the American Academy of Pediatrics (AAP) issued new iodine recommendations in 2014 for pregnant and breastfeeding women. The AAP now recommends pregnant and lactating women cook with iodized salt and take a daily supplement with 150 mcg of iodine to reach a total of 290 mcg per day.

WHY IS IODINE IMPORTANT?

During pregnancy, iodine maintains normal function of the thyroid, a gland in the base of your neck that regulates the hormones controlling your metabolism, heart rate, body temperature and other core body functions. Getting enough ensures that your baby develops a healthy and normal thyroid, too. In the rare case a fetus has an underdeveloped thyroid, it can lead to low IQ, developmental delays, deafness, birth defects, cretinism (severely stunted physical and developmental growth) and (in the most extreme cases) death.

Iodine is also key in lactation, as you pass iodine on to your baby through your breast milk. That means the iodine you consume continues to support your baby's thyroid and brain development until your baby begins eating solids.

WHAT ABOUT PRENATAL VITAMINS?

You may get sufficient iodine from your prenatal. But then again, you might not: Recent research has shown that only 15 to 20 percent of pregnant women take a prenatal supplement that contains iodine.

GETTING IODINE IN YOUR DIET

Besides checking the label of your prenatal vitamin to ensure it contains iodine, the best way to ensure you're getting enough is by eating a healthy pregnancy diet. In addition to cooking with salt that says "iodized" on the label (1/4 tsp provides 71 mcg), there are plenty of whole foods that are also natural sources of iodine. A few:

Baked cod (99 mcg in 3 oz)

Plain yogurt, low-fat (75 mcg in 1 cup)

Milk, low-fat (56 mcg in 1 cup)

Fish sticks (54 mcg in 3 oz)

Enriched bread (45 mcg 2 slices)

Shrimp (35 mcg in 3 oz)

Enriched macaroni (27 in 1 cup boiled)

Egg, large (24 mcg in one)

Canned tuna (17 mcg in 3 oz)

Creamed corn (14 mcg in 1/2 cup)

Cheddar cheese (12 mcg in 1 oz)

Dried prunes (13 mcg in five)

Raisin bran cereal (11 mcg in one cup)

Lima beans, boiled (8 mcg in 1/2 cup)

Apple juice (7 mcg in 1 cup)

While seaweed can be a good source of iodine, levels can vary widely — from 16 to 2,984 mcg in a 1-oz serving. As long as you aren't allergic, it's likely OK to include some seaweed occasionally in your diet. But it's best not to take a seaweed supplement, since the amount companies list on labels isn't regulated.

The AAP also recommends that pregnant and breastfeeding women also avoid nitrates, and one reason why is because they can impact your body's ability to absorb iodine. Nitrates are found in processed foods and meats including hot dogs, deli meat and sausages (look for "nitrate-free" on the label to ensure it's not in the foods you're eating).

CAN YOU OVERDO IODINE?

Yes, you can. The National Institutes of Health recommends that you consume no more than 1,100 micrograms of iodine daily; more can cause hypothyroidism and has even been linked to thyroid cancer. So while taking a prenatal supplement containing iodine with 150 mcg is okay, most doctors don't recommend taking a separate iodine supplement, since most start at 500 mcg.

ARE YOU GETTING THE RIGHT AMOUNT?

There is no blood test to check iodine levels. If you're worried, talk about it with your doctor, who may want to do a special 24-hour urine collection test, the best way to test iodine levels in the body. But more than likely, she'll say you're fine.

Cameron ready to give way over ban on in-work benefits for EU migrants

Prime minister signals flexible stance over mooted four-year ban after meeting Polish PM and opposition from other EU states

 

David Cameron discussed his plans for welfare and benefits for EU migrants with the Polish prime minister, Beata Szydło, in Warsaw. Photograph: NurPhoto/Rex Shutterstock

Nicholas Watt, Ian Traynor and Alex Duval Smith

David Cameron is prepared to compromise on his controversial demand that EU migrants should be banned from claiming in-work benefits for four years in the face of overwhelming opposition across Europe.

Amid warnings from Brussels that resistance to the plan is being voiced from all the other 27 EU countries, the Guardian understands that the prime minister accepts he will have to be flexible on the four-year demand to save his EU negotiations.

Cameron will make a final push at an EU summit next week for Europe’s leaders to agree to a legally binding commitment to ban EU migrants from claiming in-work benefits. But British officials now accept that the negative soundings from the “sherpas” – officials who prepare the groundwork ahead of summits – in the other member states wholly reflect the strong views of their national leaders.

The prime minister, who indicated last month that he might be prepared to show some flexibility when he outlined his four-point EU reform plan to the European council president, Donald Tusk, showed he was willing to give ground during a visit to Warsaw. Speaking in Warsaw on Thursday after the new Polish prime minister, Beata Szydło, said she did not “see eye to eye” with the UK over plans to restrict access to in-work benefits, Cameron said he was seeking to find agreement.

Asked at a press conference in Warsaw whether it was time for him to compromise on the benefit ban, Cameron said: “There is real engagement with the agenda that we have set out, a lot of common ground, a lot of agreement on the very significant proposals that we have made. Some of them are difficult and they need further work. Everyone is committed to doing that further work and, I think, reaching agreement.”

EU migrants claiming benefits: questions the government must answer

Cameron is planning to tell fellow EU leaders at a summit in February – the moment when Tusk hopes to reach a resolution on No 10’s reform package – that an agreement must show that his concerns about high levels of EU migration have been addressed.

But the prime minister will indicate that the so-called “fourth basket” in his reform plan, covering welfare and benefits, has multiple elements designed to give the UK better control over migration from the EU. If he can win agreement on most, though not necessarily all, of these proposals he is likely to feel that goal has been achieved.

Rob Oxley, media officer of the Vote Leave group, said of signs that No 10 was prepared to compromise on the four-year ban: “David Cameron’s renegotiation has amounted to a trivial set of demands that won’t bring powers back to the UK and, as the OBR [Office for Budget Responsibility] have admitted, won’t impact immigration flows.

“Smoke and mirrors from No 10 won’t hide the fact that any compromise with intransigent EU leaders would only further water down the renegotiation.”

Will Straw, executive director of Stronger In, said: “British prime ministers from Harold Wilson to Margaret Thatcher to Tony Blair have a strong track record of delivering reforms which benefit Britain and David Cameron is right to continue pursuing the best deal for Britain. Being at the table gives us the best chance of delivering reforms now and into the future.”

Cameron has not ruled out avoiding charges that the four-year ban would be discriminatory by imposing it on UK citizens as well. But this idea, drawn up by No 10 official Max Chambers, is being opposed by Iain Duncan Smith.

The four-year ban was one of nine specific proposals in the immigration section of his letter, including a demand that EU migrants working in the UK should not be allowed to send child benefit to children back home. Tusk has indicated that he might be able to find agreement on child benefit.

The Guardian understands that, in the event of a definitive failure to win agreement on the four-year ban, Cameron would feel able to say he has won substantial concessions if he win agreement in some of the other areas.

The other proposals are:

• Restricting free movement to citizens from future EU member states.

• Tougher and longer re-entry bans for fraudsters and people who collude in sham marriages.

• Addressing the way in which it is easier for an EU citizen to bring a non-EU spouse to Britain than it is for a UK citizen to do the same.

• Stronger powers to deport criminals.

• Addressing recent European court of justice judgments that have been favourable to the UK on free movement.

• Restricting access to social housing.

David Cameron presses for migrant benefit curbs on Romania visit

Cameron is signalling a more flexible approach after Szydło warned him that the “basic principles” of the EU’s rules on freedom of movement must be respected.Poland and other eastern European countries, whose citizens would be hit harder than citizens from wealthier member states, believe the ban breaks the EU’s laws on discrimination. The ban on in-work benefits would require a treaty change because EU citizens are entitled to be treated in the same way as UK citizens in the workplace, including top-ups to their wages through tax credits.

Szydło said: “Of course, there are discussions and issues where we do not see eye to eye today. Among those issues are welfare and benefits.”

But Cameron took heart when Szydło signalled a degree of support for his plans to make it all but impossible for EU migrants to claim out-of-work benefits. She said: “We fully accept the right of the United Kingdom to take sovereign decisions with regard to welfare policy. We want to find a solution that is acceptable to the United Kingdom.”

Cameron is indicating that he is prepared to show flexibility after a constructive dinner on Wednesday night with Szydło, who is from the strongly nationalist and conservative Law and Justice party. Cameron is understood to have found the conversation with Szydło refreshing as they touched on common ground on the need to emphasise that the EU is a collection of sovereign nation states rather than a political union.

Cameron’s thinking emerged as the view crystallises in Brussels that he will need to climb down on the welfare issue if he wants a deal by February. Cameron, according to a senior source in Brussels, “has to adapt his position to reality” on the welfare row. “All the legal experts say this is not feasible,” the source said.