Delayed Complementary Feeding as a Risk Factor for Vitamin K Deficiency Bleeding in a 9-Month-old Infant

Vitamin K deficiency bleeding (VKDB) is a well-known entity in the newborn period, classically presenting during the first week of life. VKDB causing massive bleeding beyond 3 months of age, in an otherwise healthy child, is extremely rare. We present a rare case of massive intracranial bleed in an infant who had received routine vitamin K prophylaxis at birth. His blood investigations revealed severe anemia with a grossly deranged coagulation profile and high proteins induced by vitamin K absence (PIVKAII). His coagulation parameters normalised within 12 hours of Vitamin K and a single dose of FFP. He was a well-nourished child with no evidence of malabsorption. He had no risk factors for VKDB except for extended exclusive breastfeeding. His coagulation profile remained normal at the 6-month review, also. VKDB should be considered outside the typical age group in a child with delayed introduction of complementary feeds.