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Intracranial hemorrhage due to late hemorrhagic disease in two siblings

Hüseyin Per1, Sefer Kumandaş, Mehmet Akif Ozdemir

  • 1Department of Pediatric Neurology, Erciyes University Medical Faculty, Kayseri, Turkey.

The Journal of Emergency Medicine
|June 27, 2006
PubMed

Insights

Severe vitamin K deficiency can cause late hemorrhagic disease of the newborn (HDN), leading to dangerous intracranial bleeding in exclusively breastfed infants. All newborns should receive a 1 mg intramuscular vitamin K dose to prevent this serious condition.

Area of Science:

  • Neonatal Medicine
  • Pediatric Hematology
  • Nutritional Science

Background:

  • Vitamin K deficiency is a known cause of hemorrhagic disease of the newborn (HDN), presenting in early, classic, or late forms.
  • Late HDN, occurring between 1 week and 6 months, is particularly linked to intracranial hemorrhage in exclusively breastfed infants.
  • This condition remains a significant cause of mortality and morbidity in regions without routine vitamin K prophylaxis.

Observation:

  • This study details two siblings who experienced intracranial bleeding.
  • Both infants were exclusively breastfed and did not receive routine vitamin K supplementation.
  • This observation highlights a potential risk in fully breastfed infants.

Findings:

  • Exclusively breastfed infants without vitamin K supplementation are at high risk for severe vitamin K deficiency.
  • Severe deficiency can lead to life-threatening intracranial hemorrhages, a key feature of late HDN.
  • The reported cases underscore the vulnerability of this demographic to severe bleeding events.

Implications:

  • Routine vitamin K prophylaxis for all newborns is crucial for preventing late HDN and intracranial hemorrhages.
  • A single intramuscular dose of 1 mg vitamin K is recommended for all newborns.
  • Implementing universal vitamin K prophylaxis can significantly reduce infant mortality and morbidity associated with HDN, especially in developing countries.

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