Vitamin K deficiency bleeding (VKDB): a preventable disorder

Posted: 19/04/2023

Vitamin K deficiency bleeding (VKDB) is a rare but serious disorder in newborns. This article will cover what the disorder is, how it is prevented, risk factors, and how claims for negligence may arise, and follows on from our previous article in this series, which examined jaundice in newborn babies.

What is VKDB?

Vitamin K is a vitamin which is naturally present in the body. It plays an important role in helping blood to clot and preventing abnormal bleeding. Babies are born with much lower levels of vitamin K than adults; at birth, the amount of vitamin K stored in a baby’s liver is 30%-60% lower than the amount typically stored in an adult liver. If a newborn does not receive additional vitamin K, their stores will quickly become depleted.

Vitamin K deficiency can lead to a rare but serious disorder called vitamin K deficiency bleeding (VKDB) - also known as haemorrhagic disease of the newborn. This disorder can cause bleeding from the nose, mouth, belly button, and bowels, and into the brain. Bleeding into the brain can cause brain damage, leading to cerebral palsy, neurodevelopmental disability, and even death.

To prevent this, it is therefore standard practice to provide babies with vitamin K within 24 hours of birth, as recommended by the NICE guidelines for postnatal care, and the Department of Health. This is generally given as a single injection or orally.

Are some babies at higher risk of VKDB?

Some babies are at a higher risk of developing VKDB, including:

• babies born prematurely;
• babies born following complicated births;
• babies whose mothers are on certain medications, for example, antiepileptic drugs;
• babies who are not well in the neonatal period;
• babies who have liver disease; and
• babies who are struggling to take or absorb feeds.

For babies at a higher risk of VKBD, an injection is recommended over oral vitamin K.

How might a claim for negligence arise?

The risk of VKDB is virtually eliminated with the provision of a vitamin K injection immediately after birth. Parents considering refusing consent for their baby to be given vitamin K should be properly informed of the benefits of providing it, and the risk of VKDB if it is withheld. Claims for clinical negligence relating to VKDB can arise in the following situations:

• failure to administer vitamin K to a newborn;
• delay in administering vitamin K to a newborn;
• failure to diagnose and treat VKDB appropriately; or
• failure to adequately advise parents of the risks of not providing vitamin K.

If you have been affected by any of these issues and would like some professional advice, our specialist birth injury team is here to offer an informal discussion to let you know what your options are. Please call 0800 328 9545, email clinnegspecialist@penningtonslaw.com or complete our online assessment form.

Previous articles in this series:

• Facial paralysis: why it occurs in newborn children, and how it should be treated
• Genetic disorders: Down's, Edwards' and Patau's syndrome
• Understanding hypoxic-ischemic encephalopathy (HIE)
• Intrauterine infection (chorioamnionitis): diagnosis, treatment and complications
• Jaundice in newborn babies – what is it and why might it lead to a claim?

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