Hemorrhagic disease of the newborn (HDN) is a bleeding disorder in babies. It most often develops shortly after a baby is born.
A lack of vitamin K causes hemorrhagic disease of the newborn. Vitamin K plays an important role in blood clotting.
Babies often have low levels of vitamin K for a variety of reasons. Vitamin K does not move easily across the placenta from the mother to the baby. As a result, a newborn does not have much vitamin K stored-up at birth. Also, there is not much vitamin K in breast milk.
Your baby may develop this condition if:
The condition is grouped into three categories:
Newborns and infants with the following problems involving the gastrointestinal tract are more likely to develop this disorder:
The condition causes bleeding. The most common areas of bleeding include:
There may also be:
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.
Vitamin K is given if bleeding occurs. Patients with severe bleeding may need blood transfusions.
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.
Call your doctor if your baby has any unexplained bleeding.
The early onset form of the disease may be prevented by giving vitamin K shots to pregnant women who take anti-seizure medications.
The American Academy of Pediatrics recommends giving every baby a shot of vitamin K immediately after birth. This practice has helped prevent the classic and late-onset forms of the condition, which is now rare in the U.S.
Vitamin K deficiency bleeding; VKDB
Blood Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011.
American Academy of Pediatrics Committee on Fetus and Newborn. Policy statement: controversies concerning vitamin K and the newborn. Pediatrics. 2003;112:191-192.
Warren M et al. Notes from the field: late vitamin K deficiency bleeding in infants whose parents declined vitamin K prophylaxis--Tennessee, 2013. MMWR Morb Mortal Wkly Rep. 2013 Nov 15;62(45):901-2.
Updated by: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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