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Adrenal insufficiency (AI) in a newborn due to hypothalamic-pituitary-adrenal (HPA) axis suppression after maternal glucocorticoid therapy during pregnancy is a rare condition. We report an AI triggered by a nosocomial infection in a premature newborn. The suspected mechanism was the suppression of the HPA axis due to high doses of maternal glucocorticoid treatment during pregnancy. AI was revealed by recurrent hypoglycaemia and mild hyponatraemia during the neonatal period. His twin brother did not develop AI, showing the variable sensitivity of adrenal suppression after exposure to the same glucocorticoid dose. The affected boy was substituted with hydrocortisone until the age of 2 years. At this age, basal morning values for cortisol and Adrenocorticotropic hormone (ACTH) had normalised. The patient also suffers from galactosaemia. We suggest screening for AI, by testing for hypoglycaemia and hyponatraemia, in newborns who were exposed to high doses of maternal methylprednisolone treatment during the pregnancy and to include galactosaemia in national neonatal screening programmes., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

We report a preterm breastfed infant who developed a transient hypothyroidism after his lactating mother had a CT scan with iodinated contrast medium, despite the advised 24 hours' pause in breast feeding. The aetiological assessment did not show any other cause for this hypothyroidism. Transient neonatal hypothyroidism after the use of topical iodine is well known, but it has not been described as a complication of intravenous contrast medium administration to a lactating mother. This case highlights the possibility of transient neonatal hypothyroidism secondary to contrast medium exposure to a lactating mother. When imaging is needed in the lactating mother, a longer break in breast feeding might be needed to prevent transient hypothyroidism in the preterm infant., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)