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</div><div><span>Vitamin K deficiency bleeding of the newborn</span></div></div>
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</noscript></div><div class="main"><div id="ency_summary"><p><a test="test" href="./002407.htm">Vitamin K</a> deficiency bleeding (VKDB) of the newborn is a bleeding disorder in babies. It most often develops in the first days and weeks of life.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>A lack of vitamin K may cause severe bleeding in newborn babies. Vitamin K plays an important role in blood clotting.</p><p>Babies often have a low level of vitamin K for a variety of reasons. Vitamin K does not move easily across the placenta from the mother to the baby. As a result, a newborn does not have much vitamin K stored up at birth. Also, the bacteria that help make vitamin K are not yet present in a newborn's gastrointestinal tract. Finally, there is not much vitamin K in mother's milk.</p><p>Your baby may develop this condition if:</p><ul><li>A preventive vitamin K shot is not given at birth (if vitamin K is given by mouth instead of as a shot, it must be given more than once, and it does not appear to be as effective as the shot).</li><li>The mother takes certain anti-seizure or blood-thinning drugs.</li></ul><p>The condition is grouped into three categories:</p><ul><li>Immediate-onset VKDB is very rare. It occurs within the first 48 hours after birth and is usually a result of anti-seizure medicines or some other medicines, including a blood thinner called warfarin (Coumadin), taken by mothers during pregnancy.</li><li>Early-onset (formerly called “classic-onset”) disease is also rare. It occurs between 1 to 14 days after birth. It is usually seen in breastfed infants who did not receive a vitamin K shot.</li><li>Late-onset VKDB is seen in infants between 2 weeks and 6 months old. It is also more likely to happen in those who did not receive a vitamin K shot.</li></ul><p>Anyone of any age with the following problems involving the gastrointestinal system is also at risk to develop this disorder:</p><ul><li><a test="test" href="./000120.htm">Alpha1-antitrypsin deficiency</a></li><li><a test="test" href="./001145.htm">Biliary atresia</a> or other cholestatic liver disease</li><li><a test="test" href="./000233.htm">Celiac disease</a></li><li><a test="test" href="./000107.htm">Cystic fibrosis</a> or other causes of pancreatic insufficiency</li><li>Diarrhea (prolonged)</li><li>Hepatitis</li><li>Inflammatory bowel disease</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Vitamin K deficiency causes bleeding. The most common areas of bleeding include:</p><ul><li>At the site of circumcision</li><li>Belly button area</li><li>Gastrointestinal tract (resulting in blood in the baby's bowel movements)</li><li>Mucous membranes (such as the lining of the nose and mouth)</li><li>Places where there has been a needle stick</li><li>The brain</li></ul><p>There may also be:</p><ul><li><a test="test" href="./003138.htm">Blood in the urine</a></li><li>Bruising</li><li><a test="test" href="./003200.htm">Seizures</a> (convulsions) or abnormal behavior due to bleeding inside the skull</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Blood clotting tests will be done.</p><p>The diagnosis can be confirmed if a vitamin K shot stops the bleeding and blood clotting time (PT or prothrombin time) quickly becomes normal (within 6 to 24 hours). (If the deficiency is not severe, the PT may not be abnormal.)</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Vitamin K is given if bleeding occurs. Babies with severe bleeding may need plasma or blood transfusions.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The outlook tends to be worse for babies with late-onset hemorrhagic disease than other forms. There is a higher rate of bleeding inside the skull (intracranial hemorrhage) associated with the late-onset condition.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Bleeding inside the skull (intracranial hemorrhage), with possible brain damage</li><li>Death</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your health care provider if your baby has:</p><ul><li>Any unexplained bleeding</li><li>Seizures</li><li>Abdominal behavior</li></ul><p>Get emergency medical care right away if the symptoms are severe.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>The early onset form of the disease may be prevented by giving vitamin K shots to pregnant women who take anti-seizure medicines. To prevent the classic and late-onset forms, the American Academy of Pediatrics recommends giving every baby a shot of vitamin K immediately after birth. Because of this practice, vitamin K deficiency is now rare in the United States except for those babies who do not receive the vitamin K shot.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Hemorrhagic disease of the newborn (HDN)</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Greenbaum LA. Vitamin K deficiency. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. <em>Nelson Textbook of Pediatrics</em>. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 66.</p><p>Hand I, Noble L, Abrams SA. Vitamin K and the newborn infant. <em>Pediatrics</em>. 2022;149(3):e2021056036. PMID: 35190810 <a href="https://pubmed.ncbi.nlm.nih.gov/35190810/" target="_blank">pubmed.ncbi.nlm.nih.gov/35190810/</a>.</p><p>Samji N, Chan A, Bhatt MD. Bleeding and clotting disorders in pediatrics. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. <em>Hematology: Basic Principles and Practice</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 148.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/31/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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