AAP Guidelines or Suggestions?

Unless you live in Michigan, where the AAP Guidelines on Newborn Screening and Therapy for Congenital Hypothyroidism (CH) are apparently more of a “suggestion” than a guideline.

According to the CDC, congenital hypothyroidism rates have almost doubled in the past 2 decades. The reasons for this increase are unclear, in part due to the lack of follow-up data on children diagnosed with the disorder. There are several issues that need to be addressed before we can understand the reasons for this increase.

  • First, there is significant variation among clinicians regarding testing to confirm a diagnosis after an initial abnormal screening test has occurred;
  • Second, part of the increase may be due to transient hypothyroidism, which can be difficult to differentiate from true, permanent congenital hypothyroidism;
  • Third, screening laboratory methods have changed over time, causing some changes in the rate of hypothyroidism cases identified by some laboratories; and
  • Fourth, epidemiologic studies have identified a higher rate of congenital hypothyroidism among infants of Hispanic ethnicity or infants who were born preterm or with low birthweight

Increases in these demographic and birth characteristics of infants in the United States have also contributed somewhat to the increased rate of hypothyroidism.

So, what can YOU do as a parent or healthcare provider?

“…you should remember that any screening test may yield a FALSE-NEGATIVE result. Therefore, continued vigilance is necessary to recognize the clinical symptoms of a missed diagnosis, such as those for hypothyroidism, including poor feeding, failure to thrive, growth retardation, hypotonia, decreased activity, and constipation.”

For more information, check out: #CDC CH Article