Last update Nov. 7, 2023

Povidone-Iodine

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

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 ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

  • Benzalkonium Chloride (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Chlorhexidine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Povidone-Iodine in other languages or writings:

Tradenames

Main tradenames from several countries containing Povidone-Iodine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
M/P ratio 25 -

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. 2014 Abstract
  2. Kurtoğlu S, Akın L, Akın MA, Çoban D. Iodine overload and severe hypothyroidism in two neonates. J Clin Res Pediatr Endocrinol. 2009;1(6):275-7. Abstract Full text (link to original source)
  3. Smith VC, Svoren BM, Wolfsdorf JI. Hypothyroidism in a breast-fed preterm infant resulting from maternal topical iodine exposure. J Pediatr. 2006 Oct;149(4):566-7. Abstract
  4. 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 Abstract Full text (link to original source) Full text (in our servers)
  5. Casteels K, Pünt S, Brämswig J. Transient neonatal hypothyroidism during breastfeeding after post-natal maternal topical iodine treatment. Eur J Pediatr. 2000 Sep;159(9):716-7. No abstract available. Abstract
  6. 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). 1995 Abstract
  7. 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. 1989 Abstract
  8. Rakover Y, Adar H. [Thyroid function disturbances in an infant following maternal topical use of polydine]. Harefuah. 1989 Abstract
  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. 1988 Abstract Full text (link to original source)
  10. Delange F, Chanoine JP, Abrassart C, Bourdoux P. Topical iodine, breastfeeding, and neonatal hypothyroidism. Arch Dis Child. 1988 Abstract Full text (link to original source)
  11. 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. 1988 Abstract Full text (link to original source)
  12. Danziger Y, Pertzelan A, Mimouni M. Transient congenital hypothyroidism after topical iodine in pregnancy and lactation. Arch Dis Child. 1987 Abstract Full text (link to original source)

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