Late Vitamin K Deficiency Causes Serious Bleeding in Infants

The American Academy of Pediatrics recommends a single intramuscular (IM) dose of vitamin K for all newborns following birth to prevent vitamin K deficiency bleeding (VKDB). Late VKDB occurs primarily in exclusively breastfed infants who do not receive adequate vitamin K after birth. The condition presents after 2 weeks, with severe gastrointestinal (GI) or intracranial hemorrhage. Oral administration of vitamin K at birth has been shown to prevent early VKDB but does not eliminate the risk for late-onset VKDB.

Between February and September 2013, four confirmed cases of late VKDB were diagnosed in Tennessee. Three infants (ages 6 to 15 weeks) had diffuse intracranial hemorrhage, and the fourth had GI bleeding. Parents of each of the infants…