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Alternative NamesVitamin k deficiency bleeding; VKDB
Definition Return to top
Hemorrhagic disease of the newborn is a bleeding disorder that usually develops shortly after a baby is born.
See also: Hemolytic disease of the newborn
Causes Return to top
A lack of vitamin K causes hemorrhagic disease of the newborn. Vitamin K is a fat-soluble vitamin that plays an important role in blood clotting.
Babies usually have low levels of vitamin K for a variety of reasons. Vitamin K doesn't move easily across the placenta so a newborn doesn't have much vitamin K stored up at birth. Also, there isn't much vitamin K in breast milk.
Your baby may develop this condition if:
The condition is grouped into three categories:
Early onset hemorrhagic disease of the newborn is very rare. It occurs during the first hours of birth and certainly within 24 hours. The main risk factor is the use of anti-seizure drugs or a blood thinner called coumadin during pregnancy.
Classic onset disease is also rare. It develops in breastfed infants within the first week after birth.
The late onset form is seen in infants older than 2 weeks up to 2 months old. It is particularly common in children of Asian descent.
Risk factors include:
Symptoms Return to top
The condition causes bleeding. The most common areas of bleeding include:
There may also be:
Exams and Tests Return to top
Blood clotting tests will be done.
The diagnosis is confirmed if a vitamin K shot stops the bleeding and blood clotting time (prothrombin time) is within normal limits.
Treatment Return to top
Vitamin K is given if bleeding occurs. Patients with severe bleeding may need blood transfusions.
Outlook (Prognosis) Return to top
The outlook tends to be worse for babies with late-onset hemorragic disease than other forms. There is a higher rate of bleeding inside the skull (intracranial hemorrhage) associated with the late onset condition.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your doctor if your baby has any unexplained bleeding.
Prevention Return to top
The American Academy of Pediatrics recommends giving every baby a shot of vitamin K immediately after birth. This practice has helped prevent the condition, which is now rare in the U.S.
The early onset form of the disease may be prevented by giving vitamin K shots to pregnant women who take anti-seizure medications.
References Return to top
Blood Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 103.Update Date: 4/30/2008 Updated by: Mark A Fogel, MD, FACC, FAAP, Associate Professor of Pediatrics and Radiology, Director of Cardiac MR, The Children's Hospital of Philadelphia, Division of Cardiology, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.