After Thyroid Surgery: How to Care for Your Child

Thyroidectomy is a surgery to remove part or all of the thyroid gland. Kids with hyperthyroidism, thyroid nodules, or thyroid cancer may need this surgery.

The thyroid is a butterfly-shaped gland in the front of the neck. The thyroid and the hormones it makes are important for growth, development, and metabolism.

The surgeon cut the skin and moved aside neck muscles and nerves to reach the thyroid gland. Because the nerves that control the vocal cords are close to the thyroid, mild hoarseness is common for a couple of days after surgery.

Skin numbness near the incision is also common. Mild swelling should start to improve about 2 days after the procedure. It may be uncomfortable for your child to swallow, but this will get better with time.

The parathyroids are four tiny glands that control the amount of calcium in the blood. These glands lie close to the thyroid and may be damaged during surgery. After surgery, health care providers will check calcium levels in the blood while your child is in the hospital and about 3-4 days after your child goes home.

• The incision will have steri-strips, which is special tape that helps hold the skin together. The steri-strips will fall off on their own. There is no wound dressing.

• It is OK to shower the day after surgery. The wound can get wet — but not soaked — for 1 week. Gently pat the neck with warm, soapy water on a washcloth. 

• Give your child medicines as prescribed by the health care providers:

  • Thyroid hormone supplements replace the hormones lost when the thyroid gland is removed. 

    • Give the thyroid hormone around the same time every day.

    • Give the thyroid hormone on an empty stomach about 30 minutes before your child eats.

  • Calcium supplements are needed until the health care providers are sure that the parathyroid glands have healed. This usually takes 1-2 weeks. 

    • Give calcium with meals.

    • Don’t give calcium and thyroid hormone together.

    • Calcitriol (a form of vitamin D) helps the body absorb calcium. So give vitamin D every day with the calcium.

• Your child should take it easy for the first week after surgery. Most children take up to 1 week out of school, but can return sooner if they feel better and can participate.

• No recess, gym, or sports for 2 weeks after surgery.

• Remind your child to avoid straining (like lifting a heavy schoolbag).

Your child has:

• a rapid increase in neck swelling

• significant bruising or skin color changes around the neck

• discharge from the incision

• a fever above 100.4°F (38°C)

Your child:

• has tingling around the lips or fingers

• has stomach pain or cramps

• feels like the heart is racing, is shaking, or has anxiety

• has a puffy face or swelling of the hands or feet

• is constipated

• feels really cold

Are there different types of thyroid hormone supplements? There are two main types of thyroid hormones. Most children will take levothyroxine after thyroid surgery. Children with thyroid cancer will take a thyroid supplement called liothyronine for a short time while preparing for thyroid cancer treatment.

Will my child need radioactive iodine therapy after thyroid surgery? Children with thyroid cancer may need radioactive iodine therapy. The removed thyroid will be examined after surgery. This lets the health care providers learn more about the type of cancer and decide if radioactive iodine is needed. Your doctors will contact you with the results and make plans for the next steps as soon as possible.