(HealthDay News) – Four cases of vitamin K deficiency bleeding (VKDB) have been reported in Tennessee, according to a report published in the Nov. 15 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Michael Warren, MD, from the Tennessee Department of Health in Nashville, and colleagues investigated a cluster of four cases of infants with late VKDB, diagnosed at a children’s hospital from February to September 2013. The parents of these infants had declined intramuscular vitamin K administration at birth.

The researchers note that all four infants survived. The infant with gastrointestinal bleeding recovered fully, while the three with intracranial hemorrhage were undergoing neurologist follow-up and one had evidence of a gross motor defect. In a random sample of infants born in 2013, 3.4% of 3,080 infants discharged from the newborn nursery at one Nashville hospital and 28% of 218 neonates born at birthing centers did not receive vitamin K administration. The parents of the infants with VKDB cited concern about increased risk for leukemia, an impression that the injection was unnecessary, and not wanting to expose the newborns to toxins, as reasons for declining vitamin K. At the time of declining prophylaxis, parents had limited or no knowledge about the risk for development of late VKDB.

“A survey of all parents identified through these record reviews who declined vitamin K administration for their children is planned to better understand why some parents decline this safe and effective prophylaxis,” the authors write.

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