Feeding Difficulties in Infancy Linked to Congenital Vitamin D Deficiency: A Case Report
Ethiopia: Vitamin D deficiency continues to be a major public health issue, especially in infants who are exclusively breastfed. The deficiency is often linked to maternal vitamin D deficiency, which can be influenced by cultural practices such as limited sun exposure.
The case report by Mesfin Wubishet, Department of Pediatrics, Arsi University College of Health Sciences, Asella, Ethiopia, and colleagues explores congenital vitamin D deficiency presenting with feeding difficulties in early infancy. The case report published in the Journal of Medical Case Reports highlights the importance of early detection and intervention in preventing severe complications of hypocalcemia due to vitamin D deficiency.
The case concerns a 50-day-old infant born to a Muslim Ethiopian mother who presented with feeding difficulties, episodes of apnea, and cyanosis since birth. Upon investigation, the underlying cause was identified as hypocalcemia-induced laryngospasm, which resulted from congenital vitamin D deficiency passed down from the mother. The mother, who had minimal sun exposure due to wearing a niqab from childhood, had very low vitamin D levels, contributing to the infant’s condition.
The baby’s symptoms included feeding struggles and frequent, brief episodes of apnea, which are rare yet serious manifestations of hypocalcemia in infants. The infant was successfully treated with intravenous calcium gluconate to address the immediate symptoms. Following this, oral calcium and vitamin D supplementation were introduced which led to the complete resolution of the symptoms and normalizing the baby’s biochemical parameters.
This case emphasizes the critical need for clinicians to consider hypocalcemia as a potential cause of unexplained feeding difficulties or recurrent apnea in newborns. Hypocalcemia-induced laryngospasm, though rare, can present with symptoms that mimic other conditions, making early diagnosis challenging. The case also underscores the importance of measuring serum calcium and vitamin D levels in both the mother and infant, particularly for high-risk groups such as mothers who follow cultural practices that limit sun exposure.
Given the findings, antenatal care needs to include routine biochemical screening for vitamin D deficiency in mothers at high risk. This proactive approach can help prevent complications like those observed in this case. Supplementing high-risk mothers with vitamin D and calcium can significantly reduce the risk of congenital vitamin D deficiency in their infants.
This report highlights the importance of vigilance in diagnosing rare but serious conditions like hypocalcemia-induced laryngospasm and the need for timely interventions to ensure better health outcomes for both mother and child.
Reference:
Wubishet, M., Meskel, T.G. & Enyew, K. Congenital vitamin D deficiency: presenting with feeding difficulty in early infancy: a case report. J Med Case Reports 19, 53 (2025). https://doi.org/10.1186/s13256-025-05076-7
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