Neonatal hypothyroidism is decreased thyroid hormone production in a newborn. In very rare cases, no thyroid hormone is produced.
Causes, incidence, and risk factors
Hypothyroidism in the newborn may be caused by:
A missing or poorly developed thyroid gland
A pituitary gland that does not stimulate the thyroid gland
Thyroid hormones that are poorly formed or do not work
A thyroid gland that is not fully developed is the most common defect. Girls are affected twice as often as boys.
Most affected infants have few or no symptoms. This is because their thyroid hormone level is only slightly low. Infants with severe hypothyroidism often have a unique appearance, including:
- Puffy face
- Thick tongue that sticks out
This appearance usually develops as the disease gets worse.
The child may also have:
- Choking episodes
- Dry, brittle hair
- Lack of muscle tone (
- Low hairline
- Poor feeding
- Short height
Signs and tests
A physical exam may show:
- Decreased muscle tone
- Failure to grow
- Hoarse-sounding cry or voice
- Short arms and legs
- Very large soft spots on the skull (fontanelles)
- Wide hands with short fingers
Widely separated skull bones
Blood tests are done to check thyroid function. Other tests may include:
Thyroid scan X-rayof the long bones
Early diagnosis is very important. Most of the effects of hypothyroidism are easy to reverse.
Thyroxine is usually given to treat hypothyroidism. Once the child starts taking this medicine, blood tests are regularly done to make sure thyroid hormone levels are in a normal range.
Getting diagnosed early usually leads to a good outcome. Newborns who are diagnosed and treated in the first month or so usually have normal intelligence.
Untreated mild hypothyroidism can lead to severe
- Intellectual disability
- Growth problems
- Heart problems
Calling your health care provider
Call your health care provider if:
You feel your infant shows signs or symptoms of hypothyroidism
You are pregnant and have been exposed to antithyroid drugs or procedures
If a pregnant women takes radioactive iodine for thyroid cancer, the thyroid gland may be destroyed in the developing fetus. Infants whose mothers have taken such medicines should be observed carefully after birth for signs of hypothyroidism.
Most states require a routine