Vitamin K Deficiency Bleeding (VKDB) in Newborns

What is vitamin K deficiency bleeding in a newborn?

Vitamin K deficiency bleeding (VKDB) is a problem that occurs in some newborn babies. It most often happens during the first few days and weeks of life. But it can occur up to 6 months of age. This condition used to be called hemorrhagic disease of the newborn. 

What causes vitamin K deficiency bleeding in a newborn?

Babies are born with low levels of vitamin K. Vitamin K is needed for blood to clot. Not having enough vitamin K is the main cause of vitamin deficiency bleeding. If your baby’s blood doesn’t clot, they may have severe bleeding or a hemorrhage. This can be dangerous and even cause death. The cause of vitamin K deficiency depends on the 3 types of VKDB:

• Early VKDB. This can occur right after birth or up to 24 hours of age. It's caused by certain medicines that a person may take during pregnancy.

• Classical VKDB. This occurs from 1 to 7 days after birth. It's caused by low levels of vitamin K found in newborns.

• Late VKDB. This most often occurs up to 3 months after birth. But it can occur up to 6 months after birth. It can occur in a baby who did not get a vitamin K shot at birth and who was breastfed.

Which newborns are at risk for vitamin K deficiency bleeding?

These things may make it more likely for a baby to have this condition:

• Not getting a vitamin K shot at birth. The American Academy of Pediatrics recommends that all newborns get a vitamin K shot. This can prevent severe bleeding. 

• Being breastfed only and not getting a vitamin K shot at birth. Human milk has less vitamin K than formula. Formula is made with cow’s milk and has added vitamin K. The vitamin K shot will provide what a breastfed baby needs. If you take a vitamin K supplement and breastfeed your baby, this does not raise your baby's vitamin K level.

• Being born to a parent who took certain medicines during pregnancy. These include medicines for seizures (anticonvulsants) and medicines for blood-clotting problems (anticoagulants).

What are the symptoms of vitamin K deficiency bleeding in a newborn?

Symptoms can be different in each child. They can include:

• Blood in your baby's stool that make it black and sticky (tarry).

• Blood in your baby's urine.

• Oozing of blood from around your baby’s umbilical cord or circumcision site.

• Bruising more easily than normal. This may happen around your baby's head and face.

• Being very sleepy or fussy. In severe cases, vitamin K deficiency may cause bleeding in and around the brain. Other signs of bleeding in the brain can include seizures or vomiting, not just spitting up.

The symptoms of this condition may be similar to symptoms of other health issues. Make sure your child sees a health care provider for a diagnosis.

How is vitamin K deficiency bleeding in a newborn diagnosed?

The health care provider will look at your baby's health history and check your baby for signs of bleeding. Your baby may need lab tests to measure their blood clotting times. The results of these tests can help your child’s health care provider make the diagnosis.

How is vitamin K deficiency bleeding in a newborn treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your baby will probably get a vitamin K shot.

Your baby may need a blood transfusion if they have severe bleeding. If your baby is severely ill, they may need to be treated in the intensive care unit.

What are possible problems caused by vitamin K deficiency bleeding in a newborn?

Vitamin K deficiency bleeding can lead to dangerous problems. These include dangerous bleeding that can lead to brain damage or death. Bleeding into the brain, central nervous system, stomach, intestines, or other parts of the body can cause serious problems, or even death. In the U.S., deaths and long-term problems caused by vitamin K deficiency have been greatly lowered because of vitamin K shots given at birth.

Can vitamin K deficiency bleeding in a newborn be prevented?

This condition can be prevented. The American Academy of Pediatrics recommends that all newborns get a vitamin K shot. Your child will get a shot in their upper leg (thigh) muscle. This shot should be given within 6 hours after birth. This will prevent dangerous bleeding.

Key points about vitamin K deficiency bleeding in a newborn

• Vitamin K deficiency bleeding is a problem that occurs in some newborns. It often happens during the first few days of life but may happen in the first few months

• Babies are born with low levels of vitamin K. Not having enough vitamin K is the main cause of this condition.

• Your child’s health care provider will diagnose this condition. This will be based on your child’s signs of bleeding and lab tests for blood clotting times.

• The American Academy of Pediatrics recommends that all newborns, whether breastfed or formula-fed, get a one-time vitamin K shot within 6 hours after birth. This can prevent this condition. 

Next steps

Tips to help you get the most from a visit to your child’s health care provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when you should report them to the provider.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s health care provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.