Research Article

Association of unexplained feeding intolerance with congenital hypothyroidism in preterm neonates: a missing link

Aimen Tahir, Rafia Gul, Lubna Asghar, Muhammad Usman

Journal of Islamabad Medical and Dental College · Vol. 14, No. 4 · Pages 366–373 · Published December 20, 2025
DOI: 10.35787/jimdc.v14i4.1444

Feeding Intolerance in Brief

Feeding intolerance is common in premature babies: they cannot tolerate their milk feeds and have a swollen tummy, vomiting or reflux, often with no clear cause. This study asked whether an underactive thyroid from birth (congenital hypothyroidism) might be hiding behind these feeding problems.

Key Points

• A descriptive study of 102 otherwise healthy preterm neonates with unexplained feeding intolerance, in the neonatology department of Fatima Memorial Hospital, Lahore, from May 2023 to April 2024.
• About 37% of the babies (38 of 102) were diagnosed with hypothyroidism. A swollen abdomen, alone or with larger stomach residuals or reflux, was the feeding problem most strongly linked to it.
• Maternal factors (parity, bleeding before delivery and chorioamnionitis) and newborn factors (low 5-minute APGAR scores, jaundice and hemodynamically significant patent ductus arteriosus) were also linked to hypothyroidism.
• The authors conclude that about one in three preterm babies with feeding intolerance had hypothyroidism, so prompt screening and treatment are important.

What This Means for Parents

If your premature baby has feeding intolerance, with a swollen tummy, frequent vomiting or reflux, and the usual tests show no clear cause, ask whether the baby’s thyroid has been checked. In this study about one in three such babies had an underactive thyroid, which is found with a simple blood test and treated with a daily medicine. Treating it early protects your baby’s growth and brain development. Specialist Preemie Care in the NICU and after discharge helps catch problems like this in time.

Feeding IntoleranceCongenital HypothyroidismPremature BabiesAbdominal DistentionRefluxVomitingNICU

Published in the Journal of Islamabad Medical and Dental College, Vol. 14, No. 4 (October–December 2025), Original Articles. PDF shared by the authors.