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Hemorrhagic disease of the newborn despite vitamin K prophylaxis at birth

Late hemorrhagic disease of the newborn (HDN) presents 0.5–6 months after birth with mucocutaneous and intracranial bleeding. We describe here two cases of late HDN in infants who received vitamin K. The first case is a previously healthy breastfed male who received one dose of oral vitamin K at birth and developed an intracranial hemorrhage 5 weeks later. He was treated with intravenous vitamin K and recombinant factor VIIa prior to emergent craniectomy. An unrelated infant presented at 5 months of age with diarrhea and easy bruising despite IM vitamin K at birth. These cases illustrate the morbidity associated with late HDN. Pediatr Blood Cancer 2008;50:1075–1077. © 2007 Wiley‐Liss, Inc.