Have you ever heard about hypothyroidism in infants? If not, let me shed some light on this.
Hypothyroidism is a thyroid disorder when your thyroid does not manage to produce enough thyroid hormones. Sometimes, infants are born with this endocrine disorder. Parents are often worried when such medical conditions are seen right from birth.
The thyroid symptoms in newborns are generally unseeable. A study states that around 1:2000 to 1:4000 newborns suffer from congenital hypothyroidism. It becomes challenging to diagnose hypothyroidism without newborn screening tests.
It becomes problematic if the disorder goes undiagnosed for a long time because thyroid hormones are crucial for a baby's brain development and overall growth.
If you are expecting a baby and want to know about hypothyroidism in infants, then you’re in the right place. The blog has explained congenital hypothyroidism, its causes, symptoms, and diagnosis. So keep reading.
What is congenital hypothyroidism in an Infant?
Congenital hypothyroidism is a disorder that occurs in newborn babies. In this condition, the baby cannot produce enough thyroid hormones, or in uncommon cases, no thyroid hormone at all.
It is necessary to diagnose and treat it on time otherwise, it can result in severe health crises.
What are the causes of congenital hypothyroidism in newborns?
What exactly causes congenital hypothyroidism? There are numerous reasons for hypothyroidism in newborns. Here is the list:
- The thyroid may not grow fully or may be located in the wrong part of the neck. In rare cases, the thyroid gland can be missing.
- The thyroid gland is present, but either it doesn't produce sufficient hormones, or hormones don't work.
- The thyroid gland misses the brain's signal to produce thyroid hormone.
- Sometimes, the mother takes medicine to treat their overactive thyroid during pregnancy. It can cause congenital hypothyroidism, but it is temporary in most cases.
- The mother's body makes certain antibodies that affect the baby's thyroid function.
- If the mother is taking an iodine-deficient diet during pregnancy, it can be a reason for congenital hypothyroidism in the baby.
Which babies are at high risk for congenital hypothyroidism diseases?
A baby with the following is at high risk of getting congenital hypothyroidism:
- With any chromosomal disorder such as Turner syndrome, Down syndrome, or Williams syndrome
- Damaged thyroid gland
- Babies with an autoimmune disorder, likewise type 1 diabetes or celiac disease. These diseases cause several hormone deficiencies also, such as pseudohypoparathyroidism
What are thyroid symptoms in newborns?
You may not see any thyroid symptoms in newborns at first. In case of severe hypothyroidism in infants, you may notice:
- Prolonged Jaundice
- Lethargy (a baby with little or no energy)
- Macroglossia (an enlarged tongue)
- Umbilical Hernia (soft swelling or bulge near the navel)
- Hypothermia (Low body temperature)
- Feeding Difficulty
- Cold or spotted skin
- Poor muscle strength
How to diagnose hypothyroidism in infants?
If you are wondering if thyroid symptoms in newborns are not seeable--how can congenital hypothyroidism be diagnosed? Well, here is the answer.
Newborns undergo a screening test in which a blood sample collected from the baby's heel within 48 hours of birth-- sent for the screening test. The high level of TSH and low T4 or free T4 level indicate positive results for thyroid disorder.
Based on test results, the baby's doctor will collect a blood sample from a vein to verify the diagnosis of congenital hypothyroidism. Other diagnostic tests need to be performed before starting treatment—for instance, thyroid radionuclide uptake and scan, thyroid sonography, or serum thyroglobulin determination test.
Early screening and thyroid therapy can normalize the cognitive development of the newborn.
What is the treatment for congenital hypothyroidism in infants?
Did you know that newborn thyroid levels of free T4 are 2.2 to 5.3 (ng/dL)? The level keeps increasing with baby age.
Once tests are done, results indicate thyroid condition-- doctor recommends thyroid hormone replacement therapy, Levothyroxine. The prescribed dose of Levothyroxine is usually 5 to 15 mcg/kg/day.
Initially, treatment is intravenous, and later on, thyroid medication is mixed with a small amount of water, breast milk, or formula using a dropper or syringe and given to the baby.
To ensure the baby's normal growth, giving thyroid hormone EVERY DAY and keeping an eye on newborn thyroid levels with regular checkups is crucial.
The doctor does periodic thyroid function tests to adjust the thyroid medication properly. In the first six months, thyroid function tests are conducted every 1-2 months and every 3-4 months thereafter. The treatment's ultimate goal is to raise the serum T4 above 130 nmol/L (10 ug/dL) and normalize serum TSH levels in the newborn.
Thyroid medication is just a replacement for thyroid hormones that are missing in the newborn. This medication doesn't cause side effects until the dose is not too high. A pediatric endocrinologist can avoid this by checking blood levels periodically.
What are the possible complications of congenital hypothyroidism?
Thyroid hormones are crucial for a baby's normal growth and development. The deficiency of thyroid hormones can result in:
- Low body temperature
- Neurological issues and mental deficits
- Heart diseases or failure
Wrap it up It is essential to diagnose thyroid diseases at the right time to treat them. If the thyroid disorder in a newborn remains untreated, it can cause serious health issues in the baby.