Pathophysiology

Classical haemorrhagic disease of the newborn is almost exclusively a disease of breast fed babies; incidence may be as high as 1/2500 deliveries in the UK. This is a true deficiency; human milk has less vitamin K than formula milk and there is less bacterial synthesis of vitamin K due to the sterile gut of the newborn. Immaturity of the liver and impaired production of the vitamin K factors may be a contributing factor. The late form ~40-100/million live births also is seen in breast fed babies but is mainly due to malabsorption of vitamin K, secondary to cholestasis, or GIT pathology.

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