Contents

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

Possible Complications

When to Contact a Medical Professional

Prevention

Alternative Names

Hemorrhagic disease of the newborn is a bleeding disorder that usually develops shortly after a baby is born.

Causes

A lack of vitamin K causes hemorrhagic disease of the newborn. Vitamin K 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 from the mother to the baby. As a result, 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:

• 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 may not be as effective)
• You take certain anti-seizure or blood thinning drugs

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. Use of anti-seizure drugs or a blood thinner called coumadin during pregnancy is a common cause.
• Classic onset disease may be seen in breastfed infants who did not receive a vitamin K shot within the first week after birth. It is also rare.
• The late onset form is seen in infants older than 2 weeks up to 2 months old. It is more common in children who did not receive a vitamin K shot, and in those of Asian descent.

Newborns and infants with the following problems are more likely to develop this disorder:

• Alpha1-antitrypsin deficiency
• Biliary atresia
• Celiac disease
• Cystic fibrosis
• Diarrhea
• Hepatitis

Symptoms

The condition causes bleeding. The most common areas of bleeding include:

• A boy's penis if he has been circumcised
• Belly button area
• Gastrointestinal tract (may result in blood in the baby's bowel movements)
• Mucus membranes (such as the lining of the nose and mouth)
• Places where there has been a needle stick

There may also be:

• Blood in the urine
• Bruising
• Raised lump on the baby's head (suggesting bleeding underneath one of the skull bones)

Exams and Tests

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

Vitamin K is given if bleeding occurs. Patients with severe bleeding may need blood transfusions.

Outlook (Prognosis)

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.

Possible Complications

• Bleeding inside the skull (intracranial hemorrhage), with possible brain damage
• Death
• Severe bleeding

When to Contact a Medical Professional

Call your doctor if your baby has any unexplained bleeding.

Prevention

It is recommended to give every baby a shot of vitamin K immediately after birth. This practice has helped prevent the condition.

The early onset form of the disease may be prevented by giving vitamin K shots to pregnant women who take anti-seizure medications.

Alternative Names

Vitamin K deficiency bleeding; VKDB

Source: http://www.nlm.nih.gov/medlineplus/ency/article/007320.htm