Vitamin K Deficiency Bleeding

Overview

What is vitamin K?

Vitamin K is a supplement that the body needs to help blood clot. A clot is a lump that the body forms to help stop bleeding.

People mainly get Vitamin K in their diet from certain foods, especially leafy green vegetables such as spinach, and from intestinal flora (“gut bacteria”). Vitamin K also helps the body with rapid wound healing, creating strong bones, and protecting against heart disease.

What is vitamin K deficiency bleeding (VKDB)?

Vitamin K deficiency bleeding (VKDB, also known as hemorrhagic disease of the newborn), is a condition in which newborn babies bleed uncontrollably because they do not have enough vitamin K in their blood.

What are the types of vitamin K deficiency bleeding (VKDB)?

VKDB is divided into three types:

  • Early, which occurs within the first day after birth, usually in babies whose mothers used certain medications during pregnancy;
  • Classical, in which the baby is bleeding from the umbilical cord within the first week of birth;
  • Late, which can take place within the first six months of life, and usually affects babies who are breast-fed and have not had a vitamin K shot.

Symptoms and Causes

Why are babies at risk for vitamin K deficiency bleeding (VKDB)?

Babies are at risk for VKDB for several reasons:

  • Babies receive very little Vitamin K from their mothers during pregnancy, so they have very little Vitamin K in their blood when they are born.
  • Babies who are breast-fed exclusively don’t get enough Vitamin K from breast milk. Babies do not get sufficient vitamin K until they move from formula to baby food, which is usually between four and six months of age.
  • In addition, babies lack the intestinal bacteria needed to make Vitamin K.

Other factors that increase a baby’s risk for VKDB include the following:

  • Mothers using certain medications during pregnancy, including isoniazid (a drug to treat tuberculosis), or seizure medications such as phenytoin (Dilantin®) .
  • Babies who have liver disease, which can cause the vitamin K to become ineffective.
  • Babies who have diarrhea, celiac disease, or cystic fibrosis. These infants are often unable to absorb vitamins from food.

What are the symptoms of vitamin K deficiency bleeding (VKDB)?

The main symptom of VKDB is uncontrolled bleeding. The bleeding cannot be stopped naturally by the body because the baby’s blood is unable to clot (because of the lack of Vitamin K).

The baby may be bleeding internally (inside the body), so the bleeding may not be noticed right away. Babies can bleed into their intestines or into their brains, which may lead to brain damage. Signs of bleeding in the brain include sleepiness, vomiting, or seizures.

Uncontrolled bleeding is a medical emergency. Babies who bleed uncontrollably often need blood transfusions and/or surgery.

Other symptoms of VKDB include:

  • Bruises on the baby’s head.
  • External bleeding, especially from the nose or umbilical cord.
  • Unnatural skin coloring. For instance, the baby may be very pale, or the whites of the eyes may be yellow.
  • Vomiting blood.
  • Stool that is dark and sticky.

Management and Treatment

Is the Vitamin K shot safe for babies?

The vitamin K shot is safe for the baby and causes only minor side effects (pain, bruising, etc.). Babies who do not get the Vitamin K shot are 81 times more likely to have VKDB; 20 percent of babies who have VKDB will die.

Prevention

Can vitamin K deficiency bleeding (VKDB) be prevented?

The best way to prevent VKDB is to give a newborn baby a Vitamin K shot. When the baby receives a Vitamin K shot, much of the vitamin is stored in the liver to help with clotting. The rest is released slowly into the baby’s bloodstream over the next few months and will give the baby a sufficient amount of vitamin K until he or she starts eating regular food.

Last reviewed by a Cleveland Clinic medical professional on 05/07/2019.

References

  • Centers for Disease Control and Prevention. What is Vitamin K Deficiency Bleeding? (https://www.cdc.gov/ncbddd/vitamink/facts.html) Accessed 5/7/2019.
  • Centers for Disease Control and Prevention. Frequently Asked Questions (FAQ’s): Vitamin K and the Vitamin K Shot Given at Birth. (https://www.cdc.gov/ncbddd/vitamink/faqs.html) Accessed 5/7/2019.
  • American Academy of Pediatrics. Where We Stand: Administration of Vitamin K. (https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Where-We-Stand-Administration-of-Vitamin-K.aspx) Accessed 5/7/2019.
  • American Association for Clinical Chemistry/Lab Tests Online. Vitamin K Deficiency. (https://labtestsonline.org/conditions/vitamin-k-deficiency) Accessed 5/7/2019.

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