Morning Report

Nate Ostheimer
09/25/09
 Calcium Levels in Infant
 Ca transferred via placenta to infant
 Levels: Ca=10 mg/dL, iCa=1.5 mmol/L
 Level falls after birth
 Ca=8-9 mg/dL, iCa=1.1-1.35
 Reach levels of older children and adults by 2
weeks of age
 Symptoms of Hypocalcemia
 Asymptomatic
 Jittery
 Chvostek’s sign
 Trousseau’s
 Seizures
 Stridor and laryngospasm
 Arrhythmia
 Hypocalcemia in the Infant
 Early-within 3 days of birth
 Exaggeration of normal decline of calcium
 Prematurity-hypoalb, decr milk intake, impaired
response to PTH, increased calcitonin, increased
renal excretion,
 Diabetic moms-lower [PTH]?
 Birth asphyxia-incr phos due to tissue catabolism
 IUGR-decr Ca transfer across placenta
 Gentamicin-case report
 Maternal vitamin D deficiency-rare
 Hypocalcemia in Infant
Late-typically at end of first week
 Hypoparathyroidism:
 DiGeorge-failure of migration of neural crest cells to 3rd and 4th
pharyngeal pouch
 Maternal hyperparathyroidism-incr transplacental transport of Ca
suppresses neonatal PTH secretion
 Hypomagnesemia-resistance to PTH and impraired PTH
secretion
 High phosphate intake: cow’s milk/cow’s milk formula [high
phos]
 NICU babies-HCO3 admin; transfusion of citrated blood (Ca
complexes)
 Hypovitamin D