**Question:** Features of hypothyroidism in infancy include the following except-

A. Delayed milestones
B. Normal or increased appetite
C. Normal weight gain
D. Normal or increased sleep

**Core Concept:**
Hypothyroidism in infants is a condition characterized by insufficient thyroid hormone production. The primary symptoms and signs include developmental delay, poor weight gain, and increased sleep.

**Why the Correct Answer is Right:**
Option B, "Normal or increased appetite," is not a typical feature of hypothyroidism in infancy. Infants with hypothyroidism often exhibit decreased activity, reduced feeding, and poor weight gain due to the slowing of the growth rate and reduced energy expenditure.

**Why Each Wrong Option is Incorrect:**
A. Delayed milestones (Correct, delayed milestones are a common feature of hypothyroidism in infants)
C. Normal weight gain (Incorrect, infants with hypothyroidism usually experience poor weight gain)
D. Normal or increased sleep (Incorrect, hypothyroid infants commonly present with increased sleep or excessive sleepiness)

**Clinical Pearl / High-Yield Fact:**
Early diagnosis and treatment of hypothyroidism in infants are crucial for normal growth, development, and overall health. Thyroid function tests should be considered in infants with suspected developmental delay or suboptimal growth.

**Correct Answer:**
B. Normal or increased appetite