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Vitamin K deficiency bleeding of the newborn

Last updated: February 19, 2020

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Vitamin K deficiency bleeding of the newborn (VKDB) refers to spontaneous bleeding in a newborn caused by a deficiency of vitamin K dependent-coagulation factors. As vitamin K does not cross the placental barrier, is not present in breast milk, and is not synthesized in the sterile gut of a newborn, vitamin K levels are low in all neonates. VKDB is rare in industrialized countries because most children receive a vitamin K injection at birth. VKDB is categorized as early-onset (within 24 hours after birth), classic (within 4 weeks), or late-onset (between 2–8 months). Bleeding is usually intracranial, subgaleal, gastrointestinal, or nasal. Treatment is focused on managing the bleeding with, e.g., transfusions and restoring bleeding homeostasis by administering vitamin K.

  • Without prophylaxis: affects 0.25–2% of newborns

References:[1]

Epidemiological data refers to the US, unless otherwise specified.

The underlying cause is always a deficiency of vitamin K, which can be due to various factors:

References:[1][2][3]

References:[1][2]

Coagulation studies:

References:[1]

References:[1]

In the US, all newborns receive intramuscular vitamin K (0.5–1 mg) at birth.

References:[2]

  1. Nimavat DJ, Rosenkrantz T. Hemorrhagic Disease of Newborn. Hemorrhagic Disease of Newborn. New York, NY: WebMD. http://emedicine.medscape.com/article/974489-overview#a5. Updated: January 2, 2016. Accessed: July 22, 2017.
  2. Pazirandeh S, Burns DL, Lipman TO, Motil KJ, Hoppin AG. Overview of Vitamin K. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/overview-of-vitamin-k.Last updated: April 13, 2016. Accessed: December 14, 2016.
  3. American Academy of Pediatrics Committee on Fetus and Newborn. Controversies concerning vitamin K and the newborn. Pediatrics. 2003; 112 (1).