Updated: December 8, 2020 1:40:59 pm
Kavita (name changed), a 29-year-old woman, recently delivered a beautiful baby girl. She and her husband were overjoyed. But few days after the birth of her baby, Kavita started noticing some changes in the infant. Her baby was suffering from constipation, was less active, her face was a bit puffy and there was something different in the way she cried… could Kavita’s baby be suffering from Congenital Hypothyroidism?
It’s difficult to tell, if a child’s thyroid gland is slowing down the production of its key hormones, which control metabolism and growth.
Low thyroid levels can affect a child’s normal growth and development. It can even interfere with the child’s performance at school.1 Hence, it is important to diagnose and treat Hypothyroidism in children right away.
As parents, here’s what you should know about Hypothyroidism in children.
What is the thyroid gland and what does it do?
The thyroid gland is a small butterfly-shaped gland situated in the lower part of the neck. It produces thyroid hormone which is vital for brain development in babies and normal growth and development in children. 2,3
What is Hypothyroidism and Subclinical Hypothyroidism?
Hypothyroidism occurs when the thyroid gland is underactive and does not make enough thyroid hormone to meet the body’s needs. And when diagnosed at an early stage, it is called Subclinical Hypothyroidism. 2
Can Hypothyroidism occur in children?
Hypothyroidism is the most common thyroid disorder among children. It can occur in children of all age groups, including newborns. Hypothyroidism can be present at birth (a condition called Congenital Hypothyroidism) or it can develop later in childhood (a condition called ‘Acquired’ Hypothyroidism).1,2
‘Congenital’ means present from birth. Congenital Hypothyroidism means the baby was born without the ability to make normal amounts of thyroid hormone. Congenital Hypothyroidism occurs in about 1 in 1130 children.4,5 Girls are twice more likely to be affected than boys.
Causes of Congenital Hypothyroidism in newborns
Congenital Hypothyroidism can be caused due to the following reasons:6,7
- A missing or poorly developed thyroid gland
- An abnormal location of the thyroid gland in the neck
- A pituitary (master) gland that does not signal the thyroid gland to produce the thyroid hormone
- A genetic defect that affects thyroid hormone production
- Too little iodine in the mother’s diet during pregnancy
- Antibodies made by the mother’s body that block the baby’s thyroid function
- Medicines the mother took during pregnancy— such as antithyroid drugs, radioactive iodine
Symptoms of Congenital Hypothyroidism
Most newborns with Congenital Hypothyroidism have no obvious signs or symptoms. Some babies with Hypothyroidism are less active, sleepy, and difficult to feed. But lots of babies have these symptoms without having Hypothyroidism. Reason why, it is so important that all newborns are tested at birth.3
Some babies with Hypothyroidism may have a puffy looking face, prolonged jaundice, low muscle tone, hoarse cry, constipation and bulging navel.3,6
Screening newborns for Hypothyroidism is vital
Untreated Hypothyroidism can result in impaired brain development. In the past, newborns were diagnosed with Hypothyroidism when they were already a few months old. Consequently, some babies had learning disabilities, delayed growth, and mental retardation.3,4
Early diagnosis is crucial — most of the effects of Hypothyroidism are easy to reverse. Babies diagnosed and treated in the first month or so usually have normal intelligence.7
Therefore, it is important to check with your doctor proactively and make sure your baby is screened for Hypothyroidism.
When your child’s thyroid gland stops working despite being normal in the new-born period, it is called ‘Acquired’ Hypothyroidism.2
Causes of Acquired Hypothyroidism
The most common cause of Acquired Hypothyroidism in children is Hashimoto’s thyroiditis. It usually develops after the first few years of life. Hashimoto’s thyroiditis is an autoimmune disorder in which the immune system—which normally should shield the body from invading infections—attacks the thyroid gland cells.2
Children who are at risk for Hypothyroidism
Children with the following conditions are at risk for Hypothyroidism.1,2
- A chromosomal disorder such as Down Syndrome, Williams Syndrome or Turner Syndrome
- An autoimmune disorder such as Type 1 diabetes or celiac disease
- Not enough/too much iodine intake
- Injury to the thyroid gland
- Radiation to the head and neck
- A parent with Hypothyroidism due to Hashimoto’s thyroiditis
Symptoms of Hypothyroidism in children
Hypothyroidism develops slowly over many years, making the symptoms less noticeable. Since the symptoms of Hypothyroidism are so variable and nonspecific, it’s possible for you to either miss them or confuse them with something else.2,8 The only way to know for sure whether your child has Hypothyroidism is to perform a blood test.
The most common and important symptom in children is slowed or delayed growth.1,2
Hence early detection in children is crucial. Discuss with your child’s doctor to diagnose and manage
the condition early.
- In newborns, hypothyroidism is serious and needs early diagnosis and treatment to prevent the onset of brain damage.9
- Early detection and treatment in children is critical for optimising growth and development.10
- University of Rochester Medical Center. Acquired hypothyroidism in children [Internet]. Available at: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=160&contentid=4. Accessed on Sep 2, 2020.
- American Thyroid Association. Hypothyroidism in children and adolescents [Internet]. Available at: https://www.thyroid.org/hypothyroidism-children-adolescents/. Accessed on Sep 2, 2020.
- British Thyroid Foundation. Congenital hypothyroidism [Internet]. Available at: https://www.btf-thyroid.org/congenital-hypothyroidism. Accessed on Sep 2, 2020.
- Children’s of Alabama. Department of Pediatric Endocrinology. A parent’s guide to understanding congenital hypothyroidism [Internet]. Available at: https://www.childrensal.org/workfiles/clinical_services/endocrine/parents_guide.pdf. Accessed on Sep 2, 2020.
- Christopher, R., Rama Devi, A.R., Kabra, M. et al. Newborn Screening for Congenital Hypothyroidism and Congenital Adrenal Hyperplasia. Indian J Pediatr. 2018; 85: 935–940.
- American Thyroid Association. Congenital hypothyroidism [Internet]. Available at: https://www.thyroid.org/wp-content/uploads/patients/brochures/congenital-hypothyroidism-brochure.pdf. Accessed on Sep 2, 2020.
- NIH. U.S. National Library of Medicine. MedlinePlus Medical Encyclopedia. Neonatal hypothyroidism [Internet]. Available at: https://medlineplus.gov/ency/article/001193.htm. Accessed on Sep 2, 2020.
- NHS. Symptoms-Underactive thyroid (hypothyroidism) [Internet]. Available at: https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/symptoms/. Accessed on Aug 15, 2020.
- Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011 Jul;15(Suppl2): S78–81.
- Hanley P, Lord K, Bauer AJ. Thyroid disorders in children and adolescents: a review. JAMA Pediatrics. 2016 Oct 1;170(10):1008-19.
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