A thyroid hormone shortage or reduction that is present from birth is known as congenital hypothyroidism. The development of the thyroid gland or the generation of thyroid hormone can be affected by genetic flaws or a mother’s iodine shortage, which can result in the baby acquiring this disease. Newborn screening tests are typically used to determine congenital hypothyroidism. Hypothyroidism does not typically manifest in children from birth, but it does have symptoms that parents can use to determine whether the condition is present.
One of the most prevalent causes of development retardation worldwide, congenital hypothyroidism affects 1 in every 2,000 to 4,000 babies and is easily cured. Hypothyroidism in babies must be properly diagnosed and treated right away because it might cause mental impairment. It is advised to consult a doctor as soon as possible if your child too gets this illness.
Signs and symptoms of hypothyroidism in infants
The majority of neonates with congenital hypothyroidism do not exhibit any disease-related signs or symptoms. This is due to residual thyroid function or levels of maternal thyroid hormone.
Some of the signs and symptoms that a child with illness may experience are:
- High birth weight
- Increased head circumference
- Lethargy (lack of energy, sleeping a lot, and feeling tired even when waking up)
- slow movements
- crying
- nutritional problems
- Persistent constipation, bloating, or fullness in the stomach
- Tongue enlargement
- dry skin
- Low body temperature
- prolonged jaundice
- Goiter (enlarged thyroid gland)
- Abnormalities in muscle tone
- fat face
- cold body parts
- Thick, coarse hair falling on the forehead
- Enlarged moles or soft spots on the skull
- Umbilical hernia
- Little or no growth
What are the causes of hypothyroidism in children?
Permanent congenital hypothyroidism and transient congenital hypothyroidism are the two main types of congenital hypothyroidism. Children with congenital cardiac defects or Down syndrome are more likely to have congenital hypothyroidism.
Permanent congenital hypothyroidism
The following conditions lead to this kind of hypothyroidism, which calls for lifelong treatment:
- About two-thirds of instances of congenital hypothyroidism are caused by a defect or abnormal development of the thyroid gland, which is the most prevalent cause of this condition. The incorrect positioning of the thyroid gland is the most typical cause of dysgenesis.
- About 10% of instances of congenital hypothyroidism are caused by defects in the synthesis and secretion of thyroid hormone.
- Thyroid hormones are created but do not have the appropriate impact on the body because of flaws in the thyroid hormone transport mechanism.
- this condition with a local origin: This happens when the thyroid gland is able to create thyroid hormones, but the hypothalamus or pituitary gland, both of which are found in the brain, are not able to appropriately direct these hormones.
Transient or temporary congenital hypothyroidism
Transient congenital hypothyroidism, which affects 10 to 20 percent of children with hypothyroidism, is a transient disorder. Infant transitory illness has a number of reasons, however the following are the most significant ones:
Iodine deficiency: Iodine is necessary for the thyroid hormone to be produced. neonatal iodine insufficiency brought on by the mother’s insufficient iodine consumption.
Antibodies: When a woman is pregnant, autoimmune thyroid illnesses like Graves’ disease can cause the development of thyroid hormone receptor blocking antibodies (TRB-Ab). Congenital hypothyroidism could result from the antibodies’ ability to cross the placenta and interfere with the growing baby’s thyroid function. Not all women with autoimmune thyroid illness experience this. Due to the mother’s antibodies spontaneously leaving the baby’s body, this type of congenital hypothyroidism often resolves by one to three months of age.
Fetal Exposure to Medications: Antithyroid drugs used to treat hyperthyroidism have the potential to penetrate the placenta and give birth to a child with hypothyroidism. This particular ailment usually goes away a few days after delivery, and normal thyroid function returns a few weeks later.
Exposure to iodine: This condition can develop if a foetus or child is exposed to extremely high levels of iodine. This kind of iodine exposure happens when people take iodine-containing drugs like amiodarone, which is used to treat irregular heartbeats, or when they use iodine-containing cleaning products, which are used in diagnostic imaging examinations.
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The diagnosis of congenital hypothyroidism frequently involves drawing blood from the newborn’s heel a few days after delivery. Other tests will likely be carried out to confirm that the child has hypothyroidism if the initial examination reveals that the child’s T4 or TSH levels are greater than normal.
Newborns with hypothyroidism are screened through the following tests:
Thyroid stimulating hormone (TSH): In babies, the range of this hormone’s normal concentration is 1.7–9.1 (mU per litre). When this value is exceeded, hypothyroidism is present.
Thyroxine (T4): In babies, this hormone typically ranges between 10 and 20 micrograms per deciliter (micrograms per deciliter). A reading below this number denotes hypothyroidism.
The tests were repeated two to three weeks later if the first findings showed a problem. The thyroid gland must often be examined using imaging studies if the thyroid blood test results are abnormal. and Other tests, such as an electrocardiogram (EKG) to assess the heart or genetic tests, may be required if other disorders, such as heart issues or an atypical facial shape, are present.
Treatment of children with hypothyroidism
A newborn baby’s physical, cognitive, and neurological development may suffer if congenital hypothyroidism is not treated. Because of this, it’s crucial to manage the illness and its symptoms. Medications are the most effective strategy to treat this condition in youngsters.
Take treatment
The most effective technique to replenish thyroid hormone in babies is typically by treatment with levothyroxine (L-throxine or L-T4) tablets or syrup. The dosage, which typically varies from 8 mcg/kg/day to 10-15 mcg/kg/day depending on your child’s weight and drug response, is determined by these factors.
To ensure complete ingestion, this tablet can be crushed and given to a kid after being dissolved in powdered milk. This medication’s therapeutic benefits and safety are the same whether taken as a tablet or syrup.
Thyroid hormone levels should typically stabilise within 10 days of treatment beginning.
Treatment will continue until hormone levels return to normal.
The last word…
Congenital hypothyroidism in children can be treated effectively and early to restore normal growth and development. The aetiology and treatment of congenital hypothyroidism should be discussed with your paediatrician or geneticist. Preventive treatments like appropriate iodine intake or medication alterations to control the mother’s thyroid status may be required in subsequent pregnancies.
