Diagnosis and treatment of hypothyroidism in infants

The article was professionally consulted by Specialist Doctor I Bui Thi Ha - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital. He has over 11 years of experience working in the field of Pediatrics - Neonatology and has strengths in the field of pediatric cardiopulmonary resuscitation, neonatology, access to diagnosis and treatment, neonatal diseases such as premature birth, neonatal diseases, and neonatal diseases. membranes, respiratory failure, neonatal sepsis.

For infants with hypothyroidism, early diagnosis and treatment within the first 2-3 weeks is very important. If left for a long time, the child may have physical and mental retardation.

Neonatal hypothyroidism is a disease that occurs when the baby's thyroid gland does not produce enough hormones to meet the body's needs. The incidence of neonatal hypothyroidism is between 1 in 3000 and 1 in 4000.
Normally during early pregnancy, the thyroid gland begins to develop at the floor of the brain and then moves down to the lower part of the neck, where it stops growing. But for some reason, the growth and downward movement of the thyroid gland is disrupted, causing the thyroid to be misplaced, or absent. If not detected early and treated promptly, it will have very serious consequences, causing retardation of physical and mental development.
1.1 In the neonatal period Babies have jaundice that lasts longer than usual, the skin color is often lead gray, pale. Babies often sleep a lot, are not flexible with outside noises, cry less, stop sucking or suck less, are not alert when sucking, pass stools, slow to gain weight, cold hands and feet, full tongue often shows the baby's tongue sticking out. go out...

1.2 The period after infancy and early childhood Slow growth physically (slowly in weight gain and height growth) and mentally (inflexible, unable to learn...) compared to normal people.
If children develop hypothyroidism too late, treatment will be less effective due to the mental development sequelae of prolonged and irreversible T4 deficiency.

Babies with hypothyroidism can only be treated and returned to normal when they are detected early and treated promptly within the first 2 weeks after birth.
48 hours after birth, the baby will have a blood sample taken from the heel or the dorsal vein on the back of the hand, soaked in blotting paper to test for TSH and T4. If TSH is high and T4 is low, they will be consulted and referred to an endocrinologist for treatment and monitoring.

Therefore, the sooner the baby is diagnosed with the disease, the higher the ability to recover and develop psycho-physiologically like a normal person.

Because the body lacks the necessary hormone (hormone) T4, which the body cannot make on its own, the endocrinologist will give your child a medicine called L-thyroxine. (also known as synthetic T4).
After 4-5 days of T4 replacement hormone therapy, the baby will have the following changes:
Increased urination. Increased activity: the baby becomes more alert, pays attention to the surroundings, sleeps less, cries a lot. Breastfeed a lot. Skin after a few weeks less gray. Starting to rosy again. If your baby is growing slower than normal, you will see that your baby begins to develop the movements and gestures of a normal baby.
This drug will be used at the appropriate dose prescribed by the endocrinologist based on the results of TSH and T4 tests after taking the drug. T4 hormone is essential for the development of the baby's brain within the first 2 years of age. After 2 years of age, T4 is also needed for the body to grow and mature.

In adults undergoing T4 hormone replacement therapy also lead to the appearance of pathological signs: constipation, poor flexibility, dry skin... Therefore, oral treatment is lifelong and must be An endocrinologist performs regular follow-up visits. Parents must try to make giving their child medication a daily routine to avoid forgetting to take a pill.
Children with hypothyroidism still have a diet like other normal babies. The use of iodine-rich foods is not necessary. Hypothyroidism cannot be cured with diet.
Children with hypothyroidism can still be vaccinated like other normal children, but parents need to consult with an endocrinologist.
Congenital hypothyroidism can be screened and screened by prenatal screening. The Maternity Package of Vinmec International Hospital includes screening tests for congenital hypothyroidism in newborns. Vinmec provides a full range of maternity services with outstanding quality, including prenatal, intrapartum and postpartum examination and monitoring to provide comprehensive care for both mother and baby.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. Besides domestic pediatricians, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.