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Haemorrhagic disease of the newborn
A syndrome characterised by spontaneous internal or external bleeding accompanied by hypoprothrombinaemia, slightly decreased platelets and markedly elevated bleeding and clotting times, usually occurring between the third and sixth day of life and effectively treated with vitamin K.
Cancerweb 2000


Haemorrhagic disease of the newborn (HDN) was a term first coined in 1984 by Charles Townsend to describe an acquired bleeding disorder in the newborn, due to vitamin K (VK) deficiency and not being related to a traumatic birth or haemophilia (Ijland, 2008). Today the term HDN has being replaced by vitamin K deficiency bleeding (VKDB), as not all neonatal bleeding is due to VK deficiency (Tulchinsky, 2007 & Ijland, 2008). VKDB is considered a significant neonatal threat which is entirely preventable by the prophylactic administration of VK (Tulchinski, 2007 & AAP, 2003).
In infants up to and including 6 months of age, VK deficiency although rare, represents a significant public health problem throughout the world (Tulchinski, 2007). The time of onset of VKDB is unpredictable, compared to what was previously thought and this led to many countries in the 80’s and 90’s, carrying out much needed research. This has led researchers to recognising that three VKDB syndromes exist, these being, early, classic and late syndromes (Ijland, 2008, NHMRC, 2006 & Shearer, 1995).
Early VKDB syndrome is diagnosed if onset is between 0 – 24 hours. Common bleeding sites are the Cephalohaematoma, intracranial, intrathorasic and intra-abdominal. This is usually associated with maternal drug taking, eg anticonvulsants – phenytoin, barbiturates or carbomazepam, the antitubercaular drugs rifampicin or isoniazid and the VK antagonist wafarin and phenprocoumarin. The reported incidence in infants without VK prophylaxis and whose mothers have taken these drugs is between 6 – 12% (FAO, 2008,...