Which condition might be a cause of hypoglycemia in a newborn?

Hypoglycemia in a newborn can occur due to several factors, and one significant cause is inborn errors of metabolism. These genetic disorders can disrupt normal metabolic processes, leading to an inability to appropriately process glucose or other substrates. For example, conditions such as galactosemia or congenital hyperinsulinism can manifest in the newborn period and may lead to low blood sugar levels.

In contrast, while excessive feeding is typically associated with hyperglycemia rather than hypoglycemia, acute respiratory distress primarily impacts oxygenation and may lead to other metabolic derangements but is not directly linked to hypoglycemia. Similarly, exogenous insulin administration can cause hypoglycemia, but this condition is less relevant in a context where a newborn does not have a known metabolic abnormality or is not receiving insulin treatment. Thus, inborn errors of metabolism stand out as a primary cause of hypoglycemia in this population, making it the correct choice.