Hypocalcemia in the Newborn
Hypocalcemia is when a person
doesn't have enough calcium in the blood. In babies, it’s called neonatal
hypocalcemia. Your baby may have it at different times and from different causes.
are two types of hypocalcemia in newborns:
Early hypocalcemia. This happens in the first 2 to 3 days
of a baby's life. To some degree, it's part of a normal developmental process. It's
more likely to go away with nutrition support.
Late hypocalcemia. This starts in the first week or weeks
after birth and is less likely to go away.
Early hypocalcemia can have many
contributing factors and often goes away.
Late hypocalcemia is rare today. It
was often caused by drinking cow's milk or formula that has too much phosphate, because
calcium is linked to phosphorus levels in the body. This is no longer a common cause,
but babies without enough vitamin D may have late hypocalcemia. Babies younger than
months old need 400 IU of vitamin D each day. All breastfed babies should take a vitamin
D supplement daily. Formula-fed infants should also take a vitamin D supplement each
unless they are drinking 32 ounces of infant formula per day
Hypocalcemia can be caused by a
problem with parathyroid hormone. This hormone is made by the parathyroid glands in
neck. It helps keep the amount of calcium and phosphorus at a normal level in the
Low parathyroid hormone levels can cause too little calcium in the blood. Many
conditions, such as DiGeorge syndrome (22q11.2 deletion syndrome), may cause low
parathyroid hormone levels. Low magnesium levels may also cause low calcium levels.
is because calcium levels are linked to levels of magnesium. High phosphorus and low
calcium may be seen in people, including babies, with kidney failure. This is because
the kidneys can't get rid of phosphorus.
Hypocalcemia is more common in babies who are premature or who have a
low birth weight. This is because their parathyroid glands are less mature. Babies
growth was slower than expected before birth may be more likely to have severe
hypocalcemia. This happens because less calcium crossed the placenta. Hypocalcemia
also occur in babies who have a difficult birth or in babies whose mothers have
Symptoms of hypocalcemia may not be easy to see in newborns. Most
infants have no symptoms. If a baby does have symptoms, they may include:
- Being grouchy or fussy
- Muscle twitches
- Shaking (tremors)
- Poor feeding
The symptoms of hypocalcemia in the
newborn may seem like other health conditions. Make sure your child sees their
healthcare provider for a diagnosis.
Your baby's healthcare provider will examine your baby. They will
also do tests to check the amount of calcium in the baby’s blood.
This condition may get better without treatment, especially if there
are no symptoms. Early hypocalcemia most often goes away in a few days. Babies with
hypocalcemia may have calcium supplements in their feedings or in an IV.
Tips to help you get the most from
a visit to your child’s healthcare provider:
- Know the reason for the visit and what
you want to happen.
- Before your visit, write down
questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be
treated in other ways.
- Know why a test or procedure is
recommended and what the results could mean.
- Know what to expect if your child does
not take the medicine or have the test or procedure.
- If your child has a follow-up
appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.