Vitamin K Deficiency Bleeding

Overview and Considerations

Caroline W. Burke, MSN, RN, CPNP


J Pediatr Health Care. 2013;27(3):215-221. 

In This Article


A 4-week-old White male infant was brought to the emergency department (ED) by his parents because of lethargy, irritability, decreased interest in breastfeeding, and one episode of emesis 3 hours before arriving at the ED. Earlier in the day, the infant presented to his primary care provider (PCP) with parental concern for fussiness, increased sleepiness, and difficulty breastfeeding of a 2-day duration. Because he was afebrile at that time and had no focal concerns, he was sent home with planned follow-up for persistent or worsening symptoms.

The infant's mother reported that he had been breastfeeding well until 2 days prior to presentation when he seemed "less interested" in latching. He had been feeding at the breast every 4 hours, with only 5 to 10 minutes of latch. The parents denied arching or emesis with feedings. The patient was less interactive than in the past and sleeping more than usual (not waking to eat every 3 to 4 hours as he had been) and was difficult to console while awake. The parents reported no cough, congestion, rhinorrhea, diarrhea, or constipation. The patient had no change in his voiding pattern, and his last diaper change was 30 minutes before arrival at the ED. The family denied any contacts with sick people, day care attendance, traumatic events, or known injuries.