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Protecting Your Baby Against Vitamin K Deficiency Bleeding


Answers to Common Questions


Question: I’m expecting a baby soon and my doctor mentioned that the baby will need a vitamin K shot at birth. Is this necessary?
Answer: The American Academy of Pediatrics recommends giving every baby a shot of vitamin K immediately after birth. This practice has helped prevent hemorrhagic disease of the newborn – also called Vitamin K Deficiency Bleeding – which is a bleeding disorder that usually develops shortly after a baby is born.

Question: Why does my baby need vitamin K?
Answer: Babies typically have low levels of vitamin K when they are born. Vitamin K does not move easily across the placenta from mother to baby, so there isn’t much vitamin K stored up in the baby’s system when they are born. There also isn't much vitamin K in breast milk so the baby won’t be getting enough of the nutrient from its mother after birth.

Question: Why is vitamin K important?
Answer: Vitamin K plays an important role in blood clotting. A lack of vitamin K causes hemorrhagic disease of the newborn.

Your baby is more likely to develop this condition if a preventive vitamin K shot is not given at birth.This rare bleeding problem is grouped into two categories:
  1. Early onset hemorrhagic disease of the newborn occurs right after birth until 1 week of life.
  2. The late onset form is seen in infants older than 2 weeks up to 3 months old.
Symptoms
The condition causes bleeding. The most common areas of bleeding include:
•    A boy's penis if he has been circumcised
•    Belly button area
•    Gastrointestinal tract (may result in blood in the baby's bowel movements)
•    Mucus membranes (such as the lining of the nose and mouth)
•    Places where there has been a needle stick
•    Blood in the urine
•    Bruising
•    Raised lump on the baby's head (suggesting bleeding underneath one of the skull bones)

Expectations (prognosis)

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. However, severe bleeding is a rare complication.

Complications
•    Bleeding inside the skull (intracranial hemorrhage), with possible brain damage
•    Death
•    Severe bleeding

Prevention
The American Academy of Pediatrics recommends giving every baby a shot of vitamin K immediately after birth. This practice has helped prevent hemorrhagic disease of the newborn.

References
Blood Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 103.
American Academy of Pediatrics Committee on Fetus and Newborn. Policy statement: controversies concerning vitamin K and the newborn. Pediatrics. 2003;112:191-192. Policy statement reaffirmed in 2009. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0011578/