Risk factors for late hemorrhagic disease of the newborn (LHDN): When the infants with idiopathic LHDN are assessed they often are diagnosed with liver disorders that reduce the production of bile salts. These liver disorders are mild and asymptomatic and usually resolve without incident, except in cases where the infants have not received IM vitamin K (VK) prophylaxis. Secondary LHDN is most commonly associated with diseases that affect the concentration of bile salts in the small intestine such as cystic fibrosis, alpha-I antitrypsin deficiency, and bile duct atresia. Studies of VK absorption after oral VK prophylaxis have highlighted the large variation in absorption between infants, pointing to individual differences in VK absorption via the intestines.
-Freda Seddon, excerpted from letter to the editor, Midwifery Today Issue 42
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LDHN mainly affects breastfed babies who received no vitamin K prophylaxis or who have a gastrointestinal disorder associated with fat malabsorption or liver disease. Risk factors include prematurity, low birth weight, birth trauma (e.g. shoulder dystocia, face presentation, vacuum extraction), perinatal asphyxia, and disorders that interfere with the baby's absorption of fat.
-Jennifer Enoch, Midwifery Today Issue 40 o=o=o=o=o=o
Reprinted from Midwifery Today E-News (Vol 1 Issue 41, Oct 8, 1999)
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