Table 3.
Public health strategies to prevent and control iodine deficiency in lactating women, infants and toddlersa
| Iodine status in the general populationb | Status of salt iodization in population | Recommended strategies | ||
|---|---|---|---|---|
| Lactating women | Infants (age 0-6 mo) | Toddlers (age 7-24 mo) | ||
| Adequate iodine nutrition (≥ 100 µg/L) | Effective and sustained salt iodization | • Maintain salt iodization | • Exclusive breastfeeding | • Maintenance of breastfeedingc |
| • Formula-fed infants should receive formula milk fortified with iodine | • Complementary foods and/or follow-up formula fortified with iodine | |||
| • Iodized salt in complementary foods from age > 12 mo | ||||
| Mild-to-moderate iodine deficiency (20-99 µg/L) | Incomplete coverage of iodized salt | • Improve coverage of iodized salt | • Exclusive breastfeeding | • Maintenance of breastfeedingc |
| • Daily iodine supplementation | • Formula fed infants should receive formula milk fortified with iodine | • Complementary foods and/or follow-up formula, MNP/LNS fortified with iodine | ||
| • Iodized salt in complementary foods from age > 12 mo | ||||
| Severe iodine deficiency (< 20 µg/L) | No or poor coverage of iodized salt | • Introduce salt iodization | • Exclusive breastfeeding | • Maintenance of breastfeedingc |
| • Daily iodine supplementation or single annual oral dose of 400-mg iodized oil | • Formula fed infants should receive formula milk fortified with iodine | • Complementary foods and/or follow-up formula, MNP/LNS fortified with iodine | ||
Abbreviations: LNS, lipid-based nutrient supplements; MNP, micronutrient powders; UIC, urinary iodine concentration.
a Adapted with permission from (21):
b Defined as median UIC in 6- to 12-year-old children (176). Median UIC thresholds for general population/women of reproductive age uncertain (309).
c Continue frequent on-demand breastfeeding until age 2 years or older.