What is the thyroid gland?
The thyroid is a butterfly-shaped gland in
the front of the neck. The cells in a normal,
healthy thyroid send out hormones,
thyroxine (T4) and triiodothyronine (T3).
The brain sends a message to the thyroid
(thyroid stimulating hormone, TSH) that
controls production of these two hormones.
The thyroid sends them into the
bloodstream. The blood carries these
hormones everywhere in your child’s body.
Thyroid hormones affect almost every tissue
and organ system. They act on a number of
organs to aid in growth, body and brain
growth, and normal metabolism. The
thyroid gland acts like the body’s “gas
pedal” because it affects the rates of growth,
muscle contraction, metabolism, and protein
What is congenital hypothyroidism?
Newborn babies with an absent or an under-
active thyroid gland have congenital (born
with) hypothyroidism (too little thyroid
hormone). Without treatment, these
children would not grow or develop
normally. Early diagnosis and treatment can
prevent these problems. In most cases, the
deficiency in thyroid hormone production
will not go away and the child will require
How is congenital hypothyroidism
There are standard screening tests at birth.
These tests detect almost all cases of
congenital hypothyroidism. These tests
measure one or two hormones, depending on
the state where the baby is born.
T4 is one of the thyroid hormones.
Thyroid Stimulating Hormone (TSH)
is produced by the pituitary gland in
the brain. It tells the thyroid gland to
make thyroid hormones. TSH is used
as the newborn screen in Wisconsin.
Low levels of T4 and high levels of TSH
suggest a diagnosis of congenital
hypothyroidism. Although it is often not
needed or recommended for many babies,
doctors may occasionally decide to do a
thyroid scan or an ultrasound exam. These
tests look at the size and location of the
thyroid or find out if it is missing altogether.
What are the causes of congenital
hypothyroidism that are not inherited?
Underdeveloped thyroid gland.
Missing thyroid gland.
Thyroid gland that developed in the
Problems with the pituitary gland
(most are not inherited, a few rarely
Less commonly, the mother’s
thyroid disease or medicine taken
during pregnancy can cause
What are the causes of congenital
hypothyroidism that can be inherited?
Defects in steps of the process of
making thyroid hormone.
What is the treatment?
Hypothyroidism is treated with a thyroid
replacement pill. It is important for the baby
to get this pill at the same time every day.
Make it part of a routine that works for both
the baby and the caregiver so it is not
forgotten. In most cases, the child will
always need to take this pill, even as an
How does a baby take a pill?
Babies can take the pill crushed in these
liquids: formula, breast milk, or water. The
pill is crushed and given in a small amount
(a few teaspoons) of any of the liquids listed
above in several ways.
A nipple detached from its bottle.
A medicine dropper.
An oral syringe.
It is critical not to use too much liquid.
Never put the medicine in a baby bottle.
The baby might only drink part and not
get enough medicine. The nurse will teach
parents and caregivers how to give the
It is very important that this pill be taken
every day. A growing child will need
different doses of thyroid hormone. As the
child gets bigger, the doses will change.
The doctor will do a blood test to make sure
the dose is the right amount for the child’s
size. The doctor may make changes until
the dose is just right. If you have any
concerns about your child, call your doctor
or nurse. Babies need thyroid hormone for
their brains to develop so remember to give
the medicine every day.
Pediatric Endocrinology: (608) 263-6420
After hours, this number is answered by the
paging operator. Ask for the
endocrinologist on call. Leave your name
and phone number with the area code. The
doctor will call you back.
If you live out of the area, call:
Congenital Hypothyroidism. Hormones and You. The Hormone Foundation. Editors: Brown, Rosalind S MD;
LaFranchi, Stephen MD; Rose, Susan MD.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 3/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7140