Wentworth-Douglass Hospital
(603) 742-5252
Decrease (-) Restore Default Increase (+) font size
Physicians
Site Search

Definition:

Hemorrhagic disease of the newborn is a bleeding disorder that usually develops shortly after a baby is born.

See also: Hemolytic disease of the newborn



Alternative Names:

Vitamin k deficiency bleeding; VKDB



Causes, incidence, and risk factors:

A lack of vitamin K causes hemorrhagic disease of the newborn. Vitamin K is a fat-soluble vitamin that plays an important role in blood clotting.

Babies usually have low levels of vitamin K for a variety of reasons. Vitamin K doesn't move easily across the placenta so a newborn doesn't have much vitamin K stored up at birth. Also, there isn't much vitamin K in breast milk.

Your baby may develop this condition if:

  • A preventive vitamin K shot is not given at birth
  • You exclusively breastfeed your baby
  • You take certain anti-seizure drugs

The condition is grouped into three categories:

  • Early onset
  • Classic onset (this is typically the type associated with the name, hemorrhagic disease of the newborn)
  • Late onset

Early onset hemorrhagic disease of the newborn is very rare. It occurs during the first hours of birth and certainly within 24 hours. The main risk factor is the use of anti-seizure drugs or a blood thinner called coumadin during pregnancy.

Classic onset disease is also rare. It develops in breastfed infants within the first week after birth.

The late onset form is seen in infants older than 2 weeks up to 2 months old. It is particularly common in children of Asian descent.

Risk factors include:

  • Alpha1-antitrypsin deficiency
  • Biliary atresia
  • Breastfeeding
  • Celiac disease
  • Cystic fibrosis
  • Diarrhea
  • Hepatitis


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

There may also be:

  • Blood in the urine
  • Bruising
  • Raised lump on the baby's head (suggesting bleeding underneath one of the skull bones)


Signs and tests:

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.



Treatment:

Vitamin K is given if bleeding occurs. Patients with severe bleeding may need blood transfusions.



Expectations (prognosis):

The outlook tends to be worse for babies with late-onset hemorragic disease than other forms. There is a higher rate of bleeding inside the skull (intracranial hemorrhage) associated with the late onset condition.



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


Calling your health care provider:

Call your doctor if your baby has any unexplained bleeding.



Prevention:

The American Academy of Pediatrics recommends giving every baby a shot of vitamin K immediately after birth. This practice has helped prevent the condition, which is now rare in the U.S.

The early onset form of the disease may be prevented by giving vitamin K shots to pregnant women who take anti-seizure medications.



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.




Review Date: 4/30/2008
Reviewed By: Mark A Fogel, MD, FACC, FAAP, Associate Professor of Pediatrics and Radiology, Director of Cardiac MR, The Children's Hospital of Philadelphia, Division of Cardiology, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Find What You Need

Events
Careers
Foundation
About Us
Contact
Directions
News
Social Media Agreement
Joint Notice
Web Privacy Policy
WDH Staff Portal

Centers & Services

Cancer Center
Cardiovascular Care
Joint Replacement
Women & Children's
Physician Offices
Other Services

Conditions & Treatments

Health Library

Support Services

Support Groups
Care-Van
Dental Center
Social Work
Food & Nutrition
Integrative Wellness
Spiritual Care
Concerns & Grievances
Homecare and Hospice

For Patients

Pay Your Bill Online
Pricing Estimates
Financial Assistance
Interpreter Services
Surgery Preparation
Medical Record Request
Advance Directives
Clinical Research & Trials

For Healthcare Professionals

Work and Life
Financial Well-Being
Career and Growth

The Wentworth-Douglass Health System includes:

 

Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100