Vitamin K deficiency: a case report and review of current guidelines

Area of Science:

• Pediatrics
• Hematology
• Nutritional Science

Background:

• Vitamin K is essential for synthesizing crucial blood clotting factors.
• Vitamin K Deficiency Bleeding (VKDB) can occur in newborns due to insufficient vitamin K levels.
• VKDB poses a significant bleeding risk, particularly in infants.

Observation:

• A 2-month-old infant exclusively breastfed and receiving daily oral vitamin K supplementation developed bleeding from vaccine injection sites.
• Despite initial oral vitamin K prophylaxis at birth and ongoing supplementation, the infant presented with symptoms suggestive of late-onset VKDB.
• Treatment with intravenous Vitamin K led to a complete recovery, confirming the diagnosis.

Findings:

• This case highlights a potential failure of standard oral vitamin K prophylaxis in preventing late-onset VKDB.
• The infant's exclusively breastfed status and specific supplementation regimen may have contributed to the deficiency.
• Late-onset VKDB can manifest even with seemingly adequate preventive measures.

Implications:

• Current vitamin K prophylaxis guidelines, particularly regarding oral dosage and timing, may need re-evaluation for exclusively breastfed infants.
• Standardizing VKDB prevention strategies across different clinical scenarios and infant feeding practices is crucial.
• Further research is warranted to optimize vitamin K supplementation protocols to prevent VKDB effectively.