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Classic presentation: breastfeeding failure with umbilical stump and gastrointestinal bleeding by postnatal day 7. Oozing from circumcision, venipuncture, and heel sticks is also common. Beware bleeding into the scalp or intracranial space.
Due to essential vitamin K deficiency which exists at birth as the fetus receives little vitamin K from the uteroplacental circulation. It is responsible for impaired neonatal clotting function (deficiency of factors II, VII, IX, and X).
Prevented by a single intramuscular dose of 1mg vitamin K in the first few hours following delivery.
References
American Academy of Pediatrics Committee on Fetus and Newborn. Controversies concerning vitamin K and the newborn. Pediatrics. 2003;112:191-192.
American Academy of pediatrics, the American College of Obstetricians and Gynecologists. Care of the neonate. In: Gilstrap LC, Oh W, eds. Guidelines for Perinatal Care. 5th ed. Elk Grove Village, Ill, Wash DC: American Academy of Pediatrics, teh American College of Obstetricians and Gynecologists; 2002:187-236.