Hymie was born with Down Syndrome, which is more common among teenage pregnancies like Karen's. Unwanted by Karen, Hymie is put up for adoption for money. Because of his sexual activity with Karen, Lip assumes that he is the father of Hymie. Lip, with the aid of Mandy, records a video for the unborn child. However, after Hymie is born, it is revealed that his father is a teenage Asian boy. Upon seeing that the baby is Asian, Lip is angered and destroys the recording and presumably tells the two expecting parents, although it is not clear, that Hymie has Down Syndrome. The expecting mother rejects the baby in tears and the baby is left in the hospital.
Sheila kidnaps Hymie from the hospital shortly after he is born. She and Jody take care of him as their own. Leading to the episode in which an exhausted Sheila accidentally leaves Hymie on the top of a trash can. Realizing that she left the baby outside, she frantically runs outside and retrieves Hymie. Leaving her to wonder if she can take care of a new born.
Later in the show, Karen reveals to Hymie's father, Timmy Wong, and grandmother, Mrs. Wong, that Sheila is caring for the baby. Mrs. Wong is adamant that she take Hymie to live with his father. Sheila consents after Mrs. Wong agrees to let Sheila visit. In a later episode, it is revealed that Karen had contacted Mrs. Wong and asked her to take the baby stating that Sheila is not sane enough to care for him. After Karen's accident, she and Jody take Hymie to live with them in Arizona.