Thyroid

When Hugo came home from the hospital he had a scheduled endocrinology appointment. They were going to explain to me the reason for this appointment but in the outbreak of activity leaving the hospital it was never clarified. No matter. When the day of the appointment finally came the nurse asked if I had any questions. I really only had one: Why are we here today? Turns out she didn't really know either so we didn't get any answers until the doctor came in.

Hugo had slightly elevated levels of TSH (Thyroid Stimulating Hormone) which meant his thyroid was not producing enough hormone. It was barely elevated when he left the hospital (Reference range is .80-6.30. Hugo was at 6.50. An infant without any thyroid function will have levels around 500.) but they wanted to follow up to make sure it didn't go higher. I learned the thyroid is responsible for many more things than weight, most importantly brain development. Severe hypothyroidism can cause intellectual disability and developmental delay. They drew blood to retest Hugo and his levels had gone up to 9.50. This was barely high enough that the doctor thought it best to start medication. Because there is no reliable liquid form Hugo would have to take a daily pill.

I was very nervous about getting him to take a pill and felt very pressured that if I failed it could affect his brain development. I read online how others got their baby to take the pill. Some crushed it up and gave it with a bit of milk. Others crushed it up and let the baby gum it off their finger. I was told not to give the pill during or directly after or before a feeding. Calcium and iron can affect the absorption of the medication. I tried to mix it with a small bit of milk and syringed it into his mouth. But a satiated baby between feedings is not motivated to drink. Everything syringed into his mouth and came right back out.

When he was sleeping I went over and poked around his mouth. He opened it a bit and I popped the pill in. Instead of pushing it out he sleepily gummed it and then stopped. I panicked a little. I couldn't get him to open his mouth to see the pill. I called the pharmacist who told me that the pill will indeed dissolve. As a result, we've been using this method for him to get the pill. Now he's even better about taking it when he's awake. We just have to make sure he doesn't push it out with his tongue. His TSH was recently tested again and the levels were below normal this time which meant his medication dose was too high. Now he takes half a pill instead of a whole one. We don't yet know if this is a permanent or temporary condition for Hugo. That the levels were below normal is encouraging that it might be temporary but we'll see as time goes on! Projected time on the medication is 2-3 years.