{
    "abstract": "Vitamin D deficiency remains a significant public health concern, particularly among exclusively breastfed infants. Infants born to mothers with vitamin D deficiency, often influenced by cultural factors affecting diet, lifestyle, and clothing, are at increased risk of developing early and potentially fatal complications of hypocalcemic vitamin D deficiency. While seizures and tetany are well-recognized manifestations of hypocalcemia in infants, less common symptoms, such as feeding difficulties and recurrent apnea, are rarely documented.\u00a0.\nWe present the case of a 50-day-old Ethiopian full-term infant, born to a Muslim Ethiopian mother, who experienced feeding difficulties, frequent brief episodes of apnea, and cyanosis since birth. The underlying cause was identified as hypocalcemia-induced laryngospasm due to congenital vitamin D deficiency, which resulted from maternal vitamin D deficiency. The mother, who has worn a niqab since childhood, had minimal sun exposure, contributing to her low vitamin D levels. The infant was successfully treated with intravenous calcium gluconate, followed by oral calcium and vitamin D supplementation, leading to complete resolution of symptoms and normalization of biochemical parameters.\nHypocalcemia-induced laryngospasm presenting with feeding difficulties and recurrent apneic episodes is a rare yet serious clinical condition. This report emphasizes the need to consider hypocalcemia as a potential cause of unexplained feeding difficulties or recurrent apnea in newborns and infants. Therefore, clinicians should remain vigilant and maintain a high index of suspicion to ensure timely diagnosis and treatment. It is essential to measure serum calcium and vitamin D levels in both the mother and infant, particularly for newborns of high-risk mothers, such as those who wear conservative religious clothing like a niqab. Furthermore, routine biochemical screening for vitamin D deficiency should be incorporated into antenatal care for all high-risk mothers, with appropriate supplementation to prevent potential complications in both mothers and their infants.",
    "authors": [
        {
            "affiliation": "Department of Pediatrics, Arsi University College of Health Sciences, Asella, Ethiopia. meswubwg2009@gmail.com.",
            "firstname": "Mesfin",
            "initials": "M",
            "lastname": "Wubishet"
        },
        {
            "affiliation": "Department of Pediatrics, Arsi University College of Health Sciences, Asella, Ethiopia.",
            "firstname": "Tesfa G",
            "initials": "TG",
            "lastname": "Meskel"
        },
        {
            "affiliation": "Department of Internal Medicine, Endocrinology and Metabolism Division, Bahir Dar University, Bahir Dar, Ethiopia.",
            "firstname": "Kibret",
            "initials": "K",
            "lastname": "Enyew"
        }
    ],
    "conclusions": "Hypocalcemia-induced laryngospasm presenting with feeding difficulties and recurrent apneic episodes is a rare yet serious clinical condition. This report emphasizes the need to consider hypocalcemia as a potential cause of unexplained feeding difficulties or recurrent apnea in newborns and infants. Therefore, clinicians should remain vigilant and maintain a high index of suspicion to ensure timely diagnosis and treatment. It is essential to measure serum calcium and vitamin D levels in both the mother and infant, particularly for newborns of high-risk mothers, such as those who wear conservative religious clothing like a niqab. Furthermore, routine biochemical screening for vitamin D deficiency should be incorporated into antenatal care for all high-risk mothers, with appropriate supplementation to prevent potential complications in both mothers and their infants.",
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s13256-025-05076-7",
    "journal": "Journal of medical case reports",
    "keywords": [
        "Congenital rickets",
        "Feeding difficulty",
        "Hypocalcemia",
        "Laryngospasm",
        "Vitamin D deficiency"
    ],
    "methods": null,
    "publication_date": "2025-02-08",
    "pubmed_id": "39920774\n29026777\n34125295\n25552383\n20427879\n25822900\n27245342\n26622309\n22742603\n23961489\n25552383\n7827559\n25453856\n16871114\n22470880\n25428135\n31341474\n38415242\n18977996\n28860301\n21691184\n35215549",
    "results": null,
    "title": "Congenital vitamin D deficiency: presenting with feeding difficulty in early infancy: a case report.",
    "xml": "<Element 'PubmedArticle' at 0x7885045ce660>"
}