The treatment of choice for neonatal hypomagnesemia is which of the following?

• A. Calcium
• B. Magnesium salts
• C. Vitamin D
• D. Potassium

Answer: (B)

When a neonate has low magnesium, the treatment of choice is replacement with magnesium salts. Magnesium is essential for neuromuscular stability, and deficiency increases neuronal excitability and risk of seizures. Restoring magnesium levels reverses these effects and prevents complications. Clinically, significant or symptomatic hypomagnesemia is treated with intravenous magnesium sulfate, with dosing guided by serum levels and renal function, and then continued as needed for maintenance. After stabilization, transition to maintenance therapy may be used if necessary.

Calcium, vitamin D, and potassium address other electrolyte or mineral issues and do not correct magnesium deficiency. Calcium helps with calcium-related problems, vitamin D aids calcium metabolism and bone health, and potassium addresses potassium imbalances. Monitor for signs of magnesium toxicity (e.g., loss of deep tendon reflexes, respiratory depression) because neonatal kidneys may have limited clearance.