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Alert to doctors regarding potential presentation of acquired hypothyroidism in infants due to maternal exposure to high levels of iodine in food.

Further advice is now available for doctors regarding potential presentation of acquired hypothyroidism in infants due to maternal exposure to high levels of iodine in food.

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Alert to doctors regarding potential presentation of acquired hypothyroidism in infants due to maternal exposure to high levels of iodine in food.

Doctors should be aware of the potential for hypothyroidism in infants when their mothers have consumed products containing high levels of iodine during pregnancy or while breast feeding. Relatively short periods of hypothyroidism have the potential to have detrimental long term effects on an infant’s neurological development.

Possible exposure of infants to high levels of iodine through consumption of seaweed containing products.

A cluster of cases diagnosed with thyroid conditions is believed to be associated with the consumption of particular seaweed and products containing seaweed; BonSoy soy milk and Heng Fei Brand Dried Seaweed that were found to contain high levels of iodine and subsequently recalled.

Dishes prepared in particular communities may contain significant quantities of seaweed. This includes soup sometimes consumed by mothers with a Korean or Northern Chinese background in the early post-partum period.

Because iodine is concentrated in breast-milk, breast-fed infants may be exposed to sufficient levels to suppress thyroid function.
Congenital hypothyroidism should be detected by the Guthrie test conducted at birth. Hypothyroidism resulting from exposure to excess iodine in breast-milk may not be indicated on the Guthrie test at birth.

Advice for doctors reviewing infants

The symptoms of hypothyroidism in infants can be non-specific and include:

• Low muscle tone
• Constipation
• Poor feeding
• Jaundice
• Sleepiness/sluggishness
• Hypothermia

If a doctor sees an infant with symptoms consistent with hypothyroidism for which another cause is not evident, they should determine whether the mother has consumed seaweed -containing food products. If there is a history of a symptomatic child’s mother having consumed seaweed products, doctors should consider immediate laboratory investigation of the infant’s thyroid function.

Pre-term infants (<36 weeks gestation) may be at higher risk of developing hypothyroidism as a result of excess iodine consumption by the mother. Sub-clinical hypothyroidism should be considered for pre-term infants where the mother has a history of consuming significant amounts of seaweed products.

Advice regarding the appropriate management and referral of infants with suspected or confirmed hypothyroidism should be discussed with a paediatrician or endocrinologist.

Cases of hypothyroidism in infants that are suspected to be associated with excess maternal iodine intake should be reported to local public health authorities.

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Further information

For further information, please email the Department of Health and Ageing at OzFoodNet@health.gov.au or see http://www.health.gov.au/internet/main/publishing.nsf/Content/recall-soymilk