Neonatal hypothyroidism Defination Neonatal hypothyroidism is decreased thyroid hormone production in a newborn. If the baby was born with the condition, it is called congenital hypothyroidism. If it develops soon after birth, it is referred to as hypothyroidism acquired in the newborn period. Causes Hypothyroidism in the newborn may be caused by: – A missing or abnormally developed thyroid gland – Pituitary gland's failure to stimulate the thyroid – Defective or abnormal formation of thyroid hormones End organ resistance to thyroxine Endemic goiter (iodine deficiency) Trans-placental suppression of thyroid by drugs, antibodies, etc Symptoms Symptoms may include: – Puffy-appearing face – Dull look – Thick, protruding tongue – Dry, brittle hair – Coarse Dry skin – Low hairline – Hoarse cry – Jaundice – Poor feeding – Hypotonia – Choking episodes – Lack of muscle tone (floppy infant) – Umblical hernia – Constipation – Sleepiness – Sluggishness – Short stature Diagnosis Blood tests will be done to check thyroid function. Other tests that may be done include: – Thyroid scan – X-ray of the long bones Treatment Early diagnosis is very important. Most of the effects of hypothyroidism are easily reversible. Replacement therapy with thyroxine is the standard treatment of hypothyroidism. Once medication starts, thyroid blood tests are regularly done to make sure levels are within a normal range. Thyroxine is given as a single daily oral dose. Dose is 10 – 15 μg/kg/day in neonates, and 4 μg/kg/day in children. As the child grows, the dosage is adjusted to maintain the serum T4 in the high-normal range.