Hemorrhagic Disease of the Newborn (HDN) as a result of vitamin k deficiency

APRIL 25, 2019
healthcaretoday, vitamin K, vitamin K deficiency, VKDB, vitamin k deficiency bleeding, intracranial haemorrhage in infants
Babies without vitamin K shots are at 81% higher risk of dying.
Healthcaretoday, vitamin K, vitamin k deficiency, VKDB, vitamin k deficiency bleeding, intracranial haemorrhage in infants,
Vitamin K Deficiency Bleeding (VKDB) in infancy is a rare but potentially serious worldwide problem with a high risk of mortality or permanent disability, primarily due to the high incidence of intracranial haemorrhage (ICH) of the later onset syndrome. It is a disease of breastfeeding infants and can be prevented by administration of vitamin K (VK) to newborns shortly after birth.

Vitamin K deficiency bleeding can follow one of three patterns: early, classical and late
VKDB is usually seen in babies born to mothers who took medicines that interfere with vitamin K. Use of anti-seizure medicines or some other medicines, including a blood thinner called Coumadin, during pregnancy is a common cause. The bleeding usually happens in the skin, brain, and abdomen.
 
Classical VKDB happens in days 2 - 7 of life, usually during days 2 - 3. This is when levels of vitamin K are lowest. Common bleeding sites include the gastrointestinal system, umbilical cord site, skin, nose and circumcision site. The official cause of classical VKDB is listed as “unknown,” but breastfeeding and poor feeding (<100 mL milk/day or <3.4 ounces milk/day) are major risk factors.

Late VKDB happens after the first week of life, usually during weeks 3 - 8. The bleeding usually happens in the brain, skin and gastrointestinal tract. Bleeding in the brain is often the first sign of late VKDB.

Dr Megat Mohamad Amirul Amzar (pix), Department of Primary Care Medicine, University Malaya explained that late VKDB happens in exclusively breastfed infants who did not receive a vitamin K shot.

“Although breast milk contains vitamin K, it is insufficient for infants. Vitamin K is crucial in order to clot the blood. Without vitamin K, a small cut might trigger serious bleeding. Even when the baby is carefully taken care off, there is a high risk of bleeding in the stomach and brain if there is a lack of vitamin K. Thus, vitamin K is needed to control the bleeding until the infant reaches four to six months old."

Unfortunately, these two bleeding are detected at a later stage. Usually, a baby is already in a critical state or suffers from brain damage before the bleeding is identified.

Myths about vitamin-K
“Most parents’ – especially anti-vaxxers worry that vitamin K injection might cause the baby to suffer from yellow fever. However, study shows that 0.5 to 1mg of vitamin K injected to the muscle will not increase the risk of yellow fever. Currently, there is no research showing that vitamin K have negative implications.
 
There are also some who claim that vitamin K contain pig DNA. Amirul rubbished this with a no. However, he sternly reminded parents that vitamin K shots should not be taken lightly.
 
“It is important for parents to understand that the shots need to be taken six hours after the baby is born to lower the risk of bleeding. Vitamin K shots is no longer effective once the bleeding starts. Unstoppable bleeding will lead to death and babies without vitamin K shots are at 81% higher risk of dying,” he added.

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