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Hemorrhagic Disease Of Newborn (VKDB)– Causes, Symptoms & Treatment

5 min read

Some babies are born with some disorders making their early days difficult and unsafe. Hemorrhagic disease is one of those alarming disorder that affects the newborn.

What Is Hemorrhagic Disease?

Hemorrhagic disease is a rare bleeding disorder that often develops due to the coagulation disturbance during first few days of the life of the baby. It is also known as vitamin K deficiency bleeding (VKDB). It is potentially a life threatening condition.
According to the onset of first symptoms the hemorrhagic disease is grouped into:

  • Early onset: Here, the first symptom of VKBD is uncovered during the first few hours of birth (within 24 hours) of the baby which is very rare. Use of anti-convulsants drugs for seizures or anti-coagulants for clotting disorders by the mother during pregnancy is a common cause of this condition
  • Classic onset: When the first symptom of VKBD emerges after two to seven days post birth, which is also relatively rare, is the classic onset. It is found among the breast-fed infants who did not receive a vitamin K shot within the first week after birth
  • Late onset: Here, an appearance of the first symptom occurs when the baby is two weeks to six months old. This fairly common VKBD condition is found among the children who do not receive a vitamin k shot. Intracranial bleeding (bleeding inside the skull) which is life-threatening is associated with the late-onset cases

What Causes Hemorrhagic Disease (VKDB) In Babies?

As the name indicates, deficiency of vitamin K (which is an important factor in blood clotting) is the main cause of hemorrhagic disease.

Why Are Newborns Liable To Vitamin K Deficiency?

Newborn babies are subjected to vitamin K deficiency due to several reasons.

  • Impermeable placenta: Vitamin K does not transfer easily across the placenta from the mother to the baby during pregnancy. Therefore, a newborn does not have enough vitamin K stored-up at birth
  • Exclusive breast feeding: The level of vitamin K in breast milk is very low. As the newborns depend exclusively on the breast milk for nutrition, their blood will become deprived of enough vitamin K to form the clot
  • Undeveloped gut flora: The vitamin K is normally synthesized by lactobacillus, the good intestinal bacteria, which are not yet present in the newborn’s intestine
  • Babies with other diseases: Some babies having other diseases like diarrhea (lose motion), celiac disease (small intestine being hyper sensitive to gluten and faces difficulty in digesting the food), or cystic fibrosis (genetic disorder affects respiration and digestion) or hepatitis often exhibit trouble in absorbing the vitamin K from the food they intake
  • Babies with liver disease: Babies born with liver diseases are often found to be unable to use the vitamin K their body stored

Is Vitamin K Deficiency Bleeding Dangerous For My Baby?

Yes. Vitamin K deficiency bleeding is often life threatening for the newborns. As newborns blood does not have enough vitamin K to form a clot, a bleeding can occur anywhere (external or internal) in their body. Internal bleeding (into their intestine or brain) are often unnoticed and cause damages to internal organs like the brain and prove to be fatal. Studies show that one out of five babies with VKDB unfortunately die.

What Are The Symptoms Of Hemorrhagic Disease In A Newborn?

There are some signs which seem insignificant which can occur prior to the significant signs that can develop into life threatening event of the new born. Those subtle signs include:

  • Low body weight
  • Slow increase in the weight gain

The classic symptom is obviously, bleeding. The bleeding can occur from anywhere (from single or multiple areas) in the body of the baby. The most common areas of bleeding include:

  • Umbilical stump (belly button area from where the umbilical cord is removed)
  • Points where the vaccination has been done with the needle or needle stick area
  • Boys’s penises if he has been circumcised(the surgical removal of the foreskin from the penis)
  • Mucus membranes of the lining of nose and mouth
  • The gastrointestinal track, resulting in the presence of blood in the stool

What Is This Raised Lump On My Baby’s Head?

If the lump appears earlier, it is often due to cephalohematoma (pooling of the blood from ruptured blood vessels between the skull and inner layers of the skin during delivery). Cephalohematoma usually resolves its own.
But if the lump appears later it could be due to an intracranial hemorrhage (bleeding inside the skull), which is a life-threatening condition.

How Is Hemorrhagic Disease (VKDB) Diagnosed In Babies?

When the doctor doubts of VKDB in your child after a physical examination and studying the symptoms shown by the baby and complete medical history, he will make the baby to undergo some blood clotting tests. The baby will fail the test if he has VKDB. Now he will be administered a shot of vitamin K1. If the blood clots VKBD is confirmed.

What Signs Should I Look In My Baby When He Is Diagnosed With VKDB?

More often you will not be fortunate enough to read the warning signs before the potentially fatal incidents start. However, be alert if any of the following sign shows up once your child is diagnosed with VKBD:

  • When after three weeks the white part of your baby’s eye turns yellow which often indicates jaundice. Jaundice is a classic sigh of hepatitis. Infants with hepatitis can develop hemorrhagic disease
  • Bleeding from the baby’s umbilical cord
  • Presence of blood in the stool
  • Presence of blood in the urine
  • Bleeding from the nose
  • Irritability, excessive sleepiness, seizures, or a lot of throwing up. All these symptoms can indicate intracranial hemorrhage (bleeding in the brain)

How Is Hemorrhagic Disease In Babies Treated?

Specific treatment for VKDB will be determined by your baby’s physician depending on the baby’s condition. It may vary from a shot of vitamin K given whenever bleeding occurs, to the blood transfusion if bleeding is severe.

What Can I Do To Prevent Hemorrhagic Disease In My Baby?

If you are taking anti-seizure medications, the early onset of hemorrhagic disease in your baby can be prevented by taking vitamin K shots during pregnancy. Health organizations recommend giving every baby a shot of vitamin K immediately after birth (into the muscle in his thigh) as a preventive measure. This practice is proved to prevent the classic and late-onset of hemorrhagic disease.

Why Is A Vitamin Shot Recommended For All Newborns?

The vitamin k shots are very much safe for the newborn. In fact, Newborns who do not get a vitamin K shot, are at an increased probability to develop severe bleeding 81 times more than those newborns who get the shot. The dose of the shot is generally very high when compared to the daily requirement. No need to get confused here. All the children are born without sufficient vitamin K as the vitamin k in the mother’s blood can’t be able to cross the placenta. Not only they are born without sufficient vitamin K, but they also won’t have a good supply of vitamin k till they turn six months old and starts to have food other than breast milk. Hence, giving your baby vitamin K shot before 6 hours past his birth is very important.

How Do Vitamin K Shots Help The Baby?

Vitamin K shot acts in two ways. To understand better, imagine that the dose is divided into two parts when the shot is given to the newborn.
The first part goes into the newborn’s circulatory system instantly and increase the level of vitamin K in the blood so that the baby’s vitamin levels don’t drop perilously low during the first days of life. Some of this vitamin K is stored in the liver and it is utilized by the blood clotting mechanism. Second, whatever is left of the vitamin K is discharged gradually throughout the following 2-3 months, providing a steady supply of vitamin K until a newborn child find another source around six months when a new diet is introduced other than breast milk.

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