What causes hypocalcemia in newborns?

What causes hypocalcemia in newborns?

Neonatal hypocalcemia usually occurs within the first 2 days of life and is most often caused by prematurity, being small for gestational age, maternal diabetes or hyperparathyroidism, and perinatal asphyxia. Neonates may have hypotonia, tachycardia, tachypnea, apnea, poor feeding, jitteriness, tetany, and/or seizures.

What causes hypophosphatemia?

Hypophosphatemia is a serum phosphate concentration < 2.5 mg/dL (0.81 mmol/L). Causes include alcohol use disorder, burns, starvation, and diuretic use. Clinical features include muscle weakness, respiratory failure, and heart failure; seizures and coma can occur. Diagnosis is by serum phosphate concentration.

What is neonatal refeeding syndrome?

Background: Refeeding Syndrome (RS) is characterized by a combination of fluid and electrolyte disorders that can occur in both children and adults when enteral or parenteral nutrition is initiated after a period of starvation or malnutrition (Pulcini 2016, Skipper 2012, Boateng 2010, Mehanna 2008, Kraft 2005).

What is sodium phosphate used for in neonates?

The use of NaGP in neonatal PN prevents calcium and phosphorus precipitation, hence increasing their supply to preterm infants in meeting their growth requirement.

How is neonate hypocalcemia treated?

Hypocalcemia associated with hyperphosphatemia is treated by giving the infants a low phosphorous formula or human milk and adding calcium supplements to the milk. Infants with vitamin D deficiency are treated with oral Vitamin D analogs (dihydrotachysterol and calcitriol).

What are symptoms of hypocalcemia in newborn?

Symptoms and signs of neonatal hypocalcemia rarely occur unless total serum calcium is < 7 mg/dL (< 1.75 mmol/L) or the ionized calcium is < 3.0 mg/dL (< 0.75 mmol/L). Signs include hypotonia, tachycardia, tachypnea, apnea, poor feeding, jitteriness, tetany, and seizures.

What are signs of hypophosphatemia?

Symptoms of hypophosphatemia

  • Confusion.
  • Appetite loss.
  • Muscle weakness.
  • Feeling tired and upset.
  • Bone pain and fractures.
  • Tooth decay or late baby teeth.
  • Slow growth and short height in children.

What is the treatment of hypophosphatemia?

In chronic hypophosphatemia, standard treatment includes oral phosphate supplementation and active vitamin D. Future treatment for specific disorders associated with chronic hypophosphatemia may include cinacalcet, calcitonin, or dypyrimadole.

Can infants get refeeding syndrome?

This study shows refeeding syndrome (RS), which has been linked to high intravenous (IV) amino acid intake in the presence of low electrolyte supply, is common in extremely low‐birth‐weight babies and especially in babies who are small‐for‐gestational‐age.

Why is sodium phosphate given?

Sodium Phosphates Injection, USP, 3 mM P/mL is indicated as a source of phosphorus, for addition to large volume intravenous fluids, to prevent or correct hypophosphatemia in patients with restricted or no oral intake.

What are the symptoms of calcium deficiency in infants?


  • Short stature.
  • Dry skin.
  • Dry hair.
  • Brittle nails.
  • Muscle cramps.
  • Tingling in the fingers and toes.
  • Cataracts.
  • Weakened tooth enamel.

How is neonatal hypocalcemia treated?

Treatment includes giving the baby a fast-acting source of glucose. This may be as simple as a glucose and water mixture or formula as an early feeding. Or your baby may need glucose given through an IV. The baby’s blood glucose levels are checked after treatment to see if the hypoglycemia occurs again.

What is the treatment for low phosphate?

Treatment of hypophosphatemia is twofold: (1) correct any precipitating causes of hypophosphatemia, and (2) replace total body phosphates. Depending on the clinical situation, replacement options include dietary phosphate, oral phosphate preparations, and IV phosphate.

What are symptoms of hypophosphatemia?

Why is hypophosphatemia the hallmark of refeeding syndrome?

The hallmark of refeeding syndrome is hypophosphatemia, which occurs within 1–3 days of an increase in food intake. Hypophosphatemia results from the intracellular movement of phosphate for the formation of ATP and other anabolic demands and places patients at risk for potentially lethal cardiac arrhythmias.

How does refeeding cause hypophosphatemia?

However, refeeding involves an abrupt shift in metabolism. This occurs with an increase in glucose, and the body responds by secreting more insulin. This can result in a lack of electrolytes, such as phosphorous. Refeeding syndrome can cause hypophosphatemia, a condition characterized by a phosphorus deficiency.