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Hypocalcemia in the Newborn

What is 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 can get it at different times and from different causes.

  • Early hypocalcemia happens in the first 2 to 3 days of a baby's life. It is more likely to go away.
  • Late hypocalcemia starts in the first week or weeks after birth and is less likely to go away.

What causes hypocalcemia in the newborn?

Early hypocalcemia can have a variety of causes and usually goes away.

Late hypocalcemia is rare and has a number of known causes. Late hypocalcemia may be caused by drinking cow's milk or formula that has too much phosphate. This is no longer a common cause. Hypocalcemia can also be caused by a problem with parathyroid hormone. This hormone is made by the parathyroid glands in the neck. It helps keep the amount of calcium and phosphorus at a normal level in the blood. Low parathyroid hormone levels can cause too little calcium in the blood. A number of conditions, such as DiGeorge syndrome (22q11.2 deletion syndrome), may cause low parathyroid hormone levels. This is because calcium and phosphorus levels in the body are interrelated. Low magnesium levels may also cause low calcium levels. This is because calcium levels are related to levels of magnesium.

Which newborns are at risk for hypocalcemia?

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 whose growth has been slower than usual before birth may be more likely to have severe hypocalcemia. This happens because less calcium crossed the placenta. Hypocalcemia can also occur in babies who have a difficult birth and in babies whose mothers have diabetes.

What are the symptoms of hypocalcemia in the newborn?

Symptoms of hypocalcemia may not be obvious in newborns. Most infants have no symptoms. If a baby does have symptoms, they may include:
  • Irritability
  • Muscle twitches
  • Jitteriness
  • Tremors
  • Poor feeding
  • Lethargy
  • Seizures

The symptoms of hypocalcemia in the newborn may look like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is hypocalcemia in the newborn diagnosed?

Your baby's healthcare provider will examine your baby. He or she will also do tests to check the amount of calcium in the baby’s blood.

How is hypocalcemia in the newborn treated?

Hypocalcemia may get better without treatment, especially if there are no symptoms. Early hypocalcemia most often goes away in a few days. Babies with late hypocalcemia may have calcium supplements in their feedings or in an IV.

Key points about hypocalcemia in the newborn

  • Hypocalcemia is when a child doesn't have enough calcium in the blood.
  • There are 2 types of hypocalcemia in the newborn. Early hypocalcemia usually goes away. Late hypocalcemia does not.
  • onset happens in the first 2 days of life. Late onset happens after 3 days of life.

Next steps

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 are.
  • 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.
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Lee, Kimberly G, MD, MSc, IBCLC
Date Last Reviewed: 5/1/2018
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