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.
  • Late hypocalcemia starts in the first week or weeks after birth. It often happens after several days of formula feedings (longer than 3 days). Some formulas have high levels of a chemical called phosphate. This can lower the amount of calcium in the blood.

What causes hypocalcemia in the newborn?

Doctors do not know what causes early hypocalcemia.

Late hypocalcemia is rare and has a number of known causes. Late hypocalcemia is usually caused by drinking cow's milk or formula that has too much phosphate. It may be connected to calcium and phosphorus levels in the body. It 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.  

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. It 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 added to their infant formula. Or they may get calcium 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 onset happens in the first 2 days of life. Late onset happens after 3 days of life.
  • The cause of early onset hypocalcemia is unknown. Late onset hypocalcemia may be caused by formula that has too much phosphate.
  • Early hypocalcemia most often goes away in a few days.
  • A baby with late hypocalcemia may have calcium added to his or her infant formula.

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.