Newborns in the United States and a number of other countries usually receive an injection of vitamin K shortly after birth. Vitamin K is given to prevent vitamin K deficiency bleeding, often called VKDB. Also called classic hemorrhagic disease of the newborn, VKDB can cause serious, life-threatening hemorrhage into the brain as well as bleeding from various organs. Vitamin K is an essential element for forming clotting factors that prevent bleeding. Clotting factors form a mesh at the site of injury that stops bleeding.
Causes
While the obvious cause of VKDB is vitamin K deficiency, it's not completely clear why this is a problem for some newborns and not others. Vitamin K is undetectable in the cord blood of all newborns, Stanford School of Medicine reports. Newborns have low vitamin K levels because they have a sterile gut that doesn't yet manufacture the vitamin and because vitamin K does not pass the placenta. Since all newborns have low levels of vitamin K for several months after birth, this may be some type of protective mechanism against other diseases, "Better Birth" suggests.
Risk Factors
The incidence of VKDB in newborns is 0.25 to 1.7 percent of all infants, according to the American Academy of Pediatrics. The classic form of the disease develops within the first week of life. Breast milk does not supply as much vitamin K as formula, making breastfed babies more susceptible to the late form of VKDB than bottle-fed babies, according to the AAP. The late form of VKDB develops between the ages of 2 weeks and 6 months. Infants whose mothers take anti-seizure medications or anticoagulants, both of which interfere with formation of clotting factors, are also more likely to develop VKDB.
Symptoms
Symptoms of VKDB include bleeding into the gastrointestinal tract, oozing from the umbilicus, bruising, bleeding from the mouth, nose or ears, bleeding from the circumcision site in boys and bleeding from injection sites. Blood in the stool can occur if bleeding into the GI tract occurs. Early VKDB, which occurs within the first 24 hours of life, can also cause bleeding under the scalp, while late VKDB can cause bleeding into the brain.
Concerns
Of babies that develop VKDB, between 14 and 19 percent will die and 21 to 40 percent of survivors will have long-term brain damage, according to "Better Birth." Because of the seriousness of the disease and its preventability with a single injection of vitamin K shortly after birth, vitamin K administration is the standard of care established by the AAP in the United States. Some European studies have shown a possible connection between administration of vitamin K and the development of childhood leukemia. The AAP states that this connection is unproven.
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