Is Povidone Iodide compatible with breastfeeding? Do we have alternatives for Povidone Iodide?

Povidone Iodide

July 2, 2015 (High Risk)

Disinfectant that contains huge amount (until 12%) of Iodine.

Not absorbed through intact skin of adults. However, it may trespass the inflamed skin, wounds, mucosa surfaces like vagina, in which case can reach concentration in grams in the human serum (1 g = 1,000 milligrams = 1,000,000 micrograms). Normal daily allowance is considered to be as high as 100 to 150 micrograms that increases to 200 – 300 micrograms in pregnancy or nursing period. The latter means less than one third of a milligram.

Iodine is concentrated into breast milk with a level that could reach 20 times higher than the concentration in the blood.

It has been found higher levels of Iodine, altered results of neonatal screening test for thyroid function, and, transient hypothyroidism in infants whose mothers were exposed to Iodine Povidone.

Use should be avoid in the Delivery Room, Operating Room (C-section), Neonatal Units, Toddler admision areas and during the breastfeeding period.

Sporadic or inadvertent use, specially on normal skin, does not require special test or procedures because it does not pose higher risk to the child.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Повидон-йод (Cyrillic)
  • ポビドンヨード (Japanese)

Drug trade names

References

  1. Kurtoglu S, Bastug O, Daar G, Halis H, Korkmaz L, Memur S, Korkut S, Gunes T, Ozturk MA. Effect of Iodine Loading on the Thyroid Hormone Level of Newborns Living in Kayseri Province. Am J Perinatol. 2014Abstract
  2. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  3. Casteels K, Pünt S, Brämswig J. Transient neonatal hypothyroidism during breastfeeding after post-natal maternal topical iodine treatment. Eur J Pediatr. 2000Abstract
  4. Koga Y, Sano H, Kikukawa Y, Ishigouoka T, Kawamura M. Effect on neonatal thyroid function of povidone-iodine used on mothers during perinatal period. J Obstet Gynaecol (Tokyo 1995). 1995Abstract
  5. Arena Ansotegui J, Emparanza Knörr JI, San Millán Vege MJ, Garrido Chércoles A, Eguileor Gurtubai I. [Iodine overload in newborn infants caused by the use of PVP-iodine for perineal preparation of the mother in vaginal delivery]. An Esp Pediatr. 1989Abstract
  6. Rakover Y, Adar H. [Thyroid function disturbances in an infant following maternal topical use of polydine]. Harefuah. 1989Abstract
  7. Delange F, Chanoine JP, Abrassart C, Bourdoux P. Topical iodine, breastfeeding, and neonatal hypothyroidism. Arch Dis Child. 1988Abstract
  8. Chanoine JP, Boulvain M, Bourdoux P, Pardou A, Van Thi HV, Ermans AM, Delange F. Increased recall rate at screening for congenital hypothyroidism in breast fed infants born to iodine overloaded mothers. Arch Dis Child. 1988Abstract
  9. Chanoine JP, Pardou A, Bourdoux P, Delange F. Withdrawal of iodinated disinfectants at delivery decreases the recall rate at neonatal screening for congenital hypothyroidism. Arch Dis Child. 1988Abstract
  10. Danziger Y, Pertzelan A, Mimouni M. Transient congenital hypothyroidism after topical iodine in pregnancy and lactation. Arch Dis Child. 1987Abstract
  11. Postellon DC, Aronow R. Iodine in mother's milk. JAMA. 1982Abstract