SHM Converge Scientific Abstract ePoster Gallery-If at First You Don't Refeed: A Rare Case of Hypercalcemia in a Full-Term Infant

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This case report describes a 20-day-old full-term, appropriate-for-gestational-age infant who was exclusively breastfed and presented at 27% below birth weight with signs of severe malnutrition, including pallor, jaundice, a sunken fontanelle, and poor milk transfer. The infant was diagnosed with refeeding syndrome after nutritional supplementation, with notable electrolyte abnormalities.<br /><br />The report highlights an unusual feature: hypercalcemia, which is not typically considered a hallmark of refeeding syndrome. While hypercalcemia has been reported in premature or very low birthweight infants receiving parenteral nutrition, this appears to be the first documented case in a full-term, normal birthweight infant fed breastmilk. The authors note that the hypercalcemia was driven by hypophosphatemia and resolved quickly once the phosphate abnormality was treated.<br /><br />The case emphasizes that refeeding syndrome can occur in full-term infants if there is severe postnatal weight loss and inadequate intake. Clinicians should be aware that neonates may develop hypercalcemia in addition to the more classic electrolyte disturbances seen in refeeding syndrome. Early recognition and correction of hypophosphatemia are important to prevent complications and support rapid recovery.

Asset Subtitle

Taylor M. Broome

Meta Tag

Author List Cameron Nolan, Evangelia Alexopoulos, Laura C. Page, Taylor M. Broome, Wilhemina Kennedy

Category Clinical Vignettes

Concept Refeeding Syndrome

Concept Electrolyte Abnormality

Concept Hypophosphatemia

Concept Hypercalcemia

Concept Malnutrition

Distinguished Non-Finalist

Presenter Organization Duke University Hospital

Presenting Author Taylor M. Broome

Track Pediatric

Keywords

refeeding syndrome

hypercalcemia

hypophosphatemia

full-term infant

neonatal malnutrition

exclusive breastfeeding

weight loss

electrolyte abnormalities

breastmilk feeding

case report

Refeeding Syndrome

Electrolyte Abnormality

Hypophosphatemia

Hypercalcemia

Malnutrition