Requesting iodine supplementation in children on parenteral nutrition

SummaryBackground & aimsIodine supplementation of parenterally fed infants recommended by ESPGHAN is 1 μg/kg/day. To assess nutritional and thyroid status of children on parenteral nutrition (PN) through urinary iodine concentration (UIC).Patients and methodsChildren (1–17 yrs), undergoing PN and receiving an iodine supply of 1 μg/kg/day, were enrolled from 2000 to 2007.ResultsWe observed 15 children (10 males, mean age 76.53 ± 60.4 months) on PN from 14 to 84 weeks (mean 38.5 ± 21.4). Ten were on TPN and five on PPN; nine had short bowel syndrome (SBS) and six had other intestinal diseases requiring PN. Iodine supply in TPN ranged between 1 and 1.6 μg/kg/day (mean 1.1 ± 0.3 μg/kg/day), while in PPN it ranged from 2.3 to 2.8 μg/kg/day (mean 2.6 ± 0.7 μg/kg/day).We found an inverse correlation between duration of PN in months and UIC (P = 0.05). Four weeks after PN onset, UIC < 100 μg/L was found in all SBS patients and 3/6 non-SBS patients (P < 0.05). After 12 weeks, 8/15 (53%) patients had UIC < 50 μg/L, but thyroxine, TSH and thyroid volume remained unchanged.ConclusionsA PN iodine supply of 1 μg/kg/day may be suboptimal. Higher supplies should be evaluated in controlled trials.