Abstract
Newborns are susceptible to postnatal Vitamin K deficiencies from limited placental
transfer, gastrointestinal absorption, and bioavailability in breast milk and formula
preparations. For over 50 years, the American Academy of Pediatrics has recommended
prophylactic vitamin K to prevent hemorrhagic disease in newborns. Yet, public skepticism
contributes to increasing refusal rates. We present three cases of vitamin K-dependent
bleeding following parental refusal of postnatal prophylaxis. Two patients experienced
intracranial hemorrhage with resultant neurological devastation and mortality, respectively.
The third child presented with symptomatic hematuria. Perinatal providers must partner
with families and advocate vitamin K prophylaxis to limit unnecessary morbidity and
mortality.
KEY WORDS
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References
- Vitamin K deficiency bleeding in an apparently healthy newborn infant: The compelling need for evidence-based recommendation.Italian Journal of Pediatrics. 2019; 45: 30
- Pivka-II plasma levels as markers of subclinical vitamin K deficiency in term infants.Journal of Maternal-Fetal and Neonatal Medicine. 2012; 25: 1660-1663
- Birth plan alterations among American women in response to COVID-19.Health Expectations: An International Journal of Public Participation in Health Care and Health Policy. 2020; 23: 969-971
- Reasons for refusal of newborn vitamin K prophylaxis: Implications for management and education.Hospital Pediatrics. 2016; 6: 15-21
- Vitamin K and the newborn Infant.Pediatrics. 2022; 149e2021056036
- Vitamin K and the newborn.New England Journal of Medicine. 1993; 329: 957-958
- Investigation of public perception of brain death using the internet.Chest. 2018; 154: 286-292
- Refusal of vitamin K injection: Survey of the current literature and practical tips for pediatricians.Pediatric Annals. 2018; 47: e334-e338
- Refusal of intramuscular vitamin K by parents of newborns: A review.Hospital Pediatrics. 2020; 10: 286-294
- Refusal of vitamin K by parents of newborns: A survey of the better outcomes through research for newborns network.Academic Pediatrics. 2017; 17: 368-373
- Newborn vitamin K prophylaxis: A historical perspective to understand modern barriers to uptake.Hospital Pediatrics. 2019; 9: 55-60
- Parental refusal of vitamin K and neonatal preventive services: A need for surveillance.Maternal and Child Health Journal. 2017; 21: 1079-1084
- Prothrombin complex concentrate for intracerebral hemorrhage secondary to vitamin K deficiency bleeding in a 6-week-old child.Journal of Pediatrics. 2015; 167: 1443-1444
- Neonatal vitamin K refusal and nonimmunization.Pediatrics. 2014; 134: 497-503
- Vitamin K prophylaxis for prevention of vitamin K deficiency bleeding: A systematic review.Journal of Perinatology. 2016; 36: S29-S35
- Rise in late onset vitamin K deficiency bleeding in young infants because of omission or refusal of prophylaxis at birth.Pediatric Neurology. 2014; 50: 564-568
- Applying lessons from vaccination hesitancy to address birth dose vitamin K refusal: Where has the trust gone?.Seminars in Perinatology. 2020; 44151242
- Trust the internet or trust your physician: Public perception of brain death isn't a no brainer.Chest. 2018; 154: 238-239
- Vitamin K is necessary for newborns.Pediatrics in Review. 2020; 41: 305-306
- The vitamin K cycle.Journal of Thrombosis and Haemostasis: JTH. 2005; 3: 1873-1878
- Observations on the prophylactic use of vitamin K in the newborn infant.Journal of Pediatrics. 1960; 56: 343-346
- Are pediatricians complicit in vitamin K deficiency bleeding?.Pediatrics. 2015; 136: 753-757
- The presentation of a fussy infant with bruising: Late-onset vitamin K deficiency bleeding.Pediatric Emergency Care. 2019; 35: e70-e71
- Pocket Book of Hospital Care for Children, 2nd edition: Guidelines for the Management of Common Childhood Illnesses.2013 (Retrieved from:)
Article info
Publication history
Published online: September 15, 2022
Identification
Copyright
Copyright © 2022 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
