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Refeeding Syndrome with Hypoglycemia in a Severely Malnourished Infant

Daiji Takajo1, Natalie Sabzghabaei2

  • 1Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA. dt1449@gmail.com.

Indian Journal of Pediatrics
|January 28, 2020
PubMed

Insights

Refeeding syndrome in infants can cause dangerous hypoglycemia. This case highlights the critical need for careful monitoring during nutritional rehabilitation in severely malnourished infants, especially when initiating enteral feeding.

Area of Science:

  • Pediatrics
  • Metabolic Disorders
  • Nutritional Science

Background:

  • Severe malnutrition in infants presents significant clinical challenges.
  • Parental neglect can lead to critical infant malnutrition and associated complications.
  • Refeeding syndrome is a complex metabolic response to nutritional support.

Observation:

  • A 5-month-old infant with severe malnutrition presented with hypoglycemia, bradycardia, bradypnea, and hypothermia.
  • The infant required resuscitation with dextrose-containing intravenous fluids.
  • Refeeding was initiated on day 2 of admission.

Findings:

  • Following refeeding initiation, the infant experienced recurrent hypoglycemia.
  • Electrolyte disturbances including hypophosphatemia, hypomagnesemia, and hypokalemia were observed.
  • Hypoglycemia correlated with the commencement and escalation of enteral feeding, indicating a link to refeeding.

Implications:

  • This case represents the first reported instance of hypoglycemia associated with refeeding syndrome in an infant.
  • Highlights the potential for severe metabolic complications during nutritional rehabilitation in malnourished infants.
  • Emphasizes the importance of vigilant monitoring for hypoglycemia and electrolyte imbalances during infant refeeding protocols.

Keywords:
HypoglycemiaInfantRefeeding syndromeSevere malnutrition

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