CDC finds cluster of newborns in Tennessee with bleeding disorder

Report highlights importance of vitamin K shot at birth

The Centers for Disease Control and Prevention and the Tennessee Department of Health have identified a cluster of newborns in Tennessee with late vitamin K deficiency bleeding (VKDB). VKDB is a serious, but preventable bleeding disorder that can cause bleeding in the brain. In each case, the newborn’s parents declined vitamin K injection at birth, mainly because they were unaware of the health benefits of vitamin K at birth.  Preliminary findings of CDC’s investigation, in collaboration with the Tennessee Department of Health, were published today in the Morbidity and Mortality Weekly Report (MMWR).

“Not giving vitamin K at birth is an emerging trend that can have devastating outcomes for infants and their families,” said CDC Director Tom Frieden, M.D., M.P.H. “Ensuring that every newborn receives a Vitamin K injection at birth is critical to protect infants.”

Between February and September, 2013, four cases of late VKDB were diagnosed at a hospital in Nashville, Tennessee. Three of the infants had bleeding within the brain and the fourth had gastrointestinal bleeding. None of the infants received a vitamin K injection at birth.

“Fortunately all of the infants survived,” said Lauren Marcewicz, MD, EIS officer with CDC’s National Center on Birth Defects and Developmental Disabilities.  “It is important for health professionals to educate parents about the health benefits of vitamin K at birth.”

In the United States, a vitamin K injection at birth has been a standard practice since it was first recommended by the American Academy of Pediatrics in 1961. A dose of vitamin K at birth prevents VKDB. The late form of VKDB can develop in infants two weeks to 6 months of age who did not receive the vitamin K injection at birth and do not have enough vitamin K dependent proteins in their bodies to allow normal blood clotting.  Untreated, this can cause bleeding in the brain, which may lead to neurological problems and can even be fatal. The risk for developing late VKDB has been estimated at 81 times greater among infants who do not receive a vitamin K injection at birth than in infants who do receive it.

CDC continues to work with Tennessee Department of Health to determine if other cases of late VKDB occurred in the state in recent years.  Also, a case-control study is under way to assess whether any additional risk factors might contribute to the development of late VKDB in children who do not receive vitamin K at birth.

For more information on the investigation, please visit: www.cdc.gov/mmwr/

For more information on vitamin K recommendations, please visit: http://pediatrics.aappublications.org/content/28/3/501.abstract?ijkey=5057ff1f52ecf82c5b38a252b912b8d462b673f7&keytype2=tf_ipsecsha

Through the Affordable Care Act, more Americans will qualify to get health care coverage that fits their needs and budget, including important preventive services children’s immunization.. Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more. Open enrollment in the Marketplace began October 1 and ends March 31, 2014. For those enrolled by December 15, 2013, coverage starts as early as January 1, 2014.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES