Povidone-Iodine

Povidone iodine is a topical antiseptic agent used for the treatment and prevention of wound infections and preoperative preparation of the skin and mucous membranes. It is an iodophor with up to 12% iodine, a complex that gradually releases iodine that acts against bacteria, fungi, viruses, protozoa, cysts and spores. Topical use: cutaneous, buccal and vaginal.

It is not absorbed through intact adult skin, but it is absorbed through inflamed skin, wounds and mucous membranes such as the vaginal mucosa, and can reach the blood plasma in grams (1 gram = 1,000 milligrams = 1,000,000 micrograms). 

The daily requirement of iodine is only 100-150 micrograms and although it rises in pregnancy and lactation to 200-300 micrograms daily, this is less than a third of a milligram. Iodine concentrates in breast milk and reaches levels more than 20 times higher than blood levels that remain for several days. The normal iodine concentration in breast milk is 30 to 500 micrograms/L.

In infants of mothers exposed to topical treatment with iodinated disinfectants there has been elevation of iodine levels in plasma and breast milk; and in the infant: increased ioduria, altered neonatal screening tests for hypothyroidism and transient hypothyroidism. ^{(Kurtoğlu 2014 and 2009, Smith 2006, Casteels 2000, Koga 1995, Arena 1989, Rakover 1989, Chanoine 1988 and 1988, Delange 1988, Danziger 1987)}

Avoid use in delivery areas, operating theatres (caesarean sections), neonatal and infant units and throughout lactation. ^{(WHO 2002, Chanoine 1988)}. During breastfeeding, it is not advisable to use mouthwashes or vaginal irrigations with iodinated products.

If there has been a large exposure to iodine, some authors advise that the mother express and discard milk for one week after discontinuing iodine therapy ^{(Smith 2006)}. If possible, do an analysis of iodine in plasma and breast milk to guide the action.

Occasional application on small wounds, especially on healthy skin, is not dangerous and does not require any analysis in the infant.

Povidone (not iodinated), copovidone or crospovidone, which is used in small quantities as an excipient in some pharmaceutical preparations and artificial tears, has nothing to do with povidone iodine and is compatible with breastfeeding. 

See below the information of this related product:

• Antiseptic, disinfectant iodine (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)