Because the child is vitamin K deficient, there is an impaired production of the various coagulation factors that are required for proper blood coagulation. The liver produces these factors.Newborns are relatively vitamin K deficient at birth for various reasons. Prior to birth, the placenta does not pass vitamin K to the baby sufficiently. This means at that the child typically has low stores of the vitamin K at birth. To compound the issue, breast milk has low levels of the vitamin and the gut flora has not yet reached the stage where it can produce vitamin K for the child naturally.The disease causes an increased risk of bleeding at various sites on the body. The most common sties of bleeding are the umbilicus, digestive tract, mucous membranes, at circumcision and the venipunctures from blood being drawn from the child.However, this condition is rare and many parents are able to determine whether they want to have their child injected or not. If this condition does occur, bleeding into the brain may occur within 3 to 7 weeks after birth in approximately 5 out of 100,000 births if the child does not receive the injection. Approximately 90% of these cases are in children who are being breastfed, as breast milk has very small amounts of vitamin K present. Forty percent of the children who develop this condition will either suffer from permanent brain damage or they will die.The cause of the bleeding is typically due to the liver’s inability to make the blood clotting factors required out of vitamin K. Supplementation of vitamin K assists in this situation. This rare condition is highly preventable by simply injecting the child with vitamin K at birth.The downside to these injections is that several studies have shown large amounts of vitamin K to cause an increased risk in the development of childhood leukemia. Approximately six studies show that the children who receive these injections have a 10-20% increased risk of developing this cancer. Because vitamin K plays a role in cell division and cell division occurs rapidly after birth, the introduction of large amounts of vitamin K may cause these cells to divide in an uncontrolled manner, when they would typically divide at a rate requiring precise amounts of vitamin K.Many studies have shown that HDN can be avoided by simply providing the breastfed infant low oral doses of liquid vitamin K over a period of time. Additionally, the supplementation of the breastfeeding mother can assist in the child-receiving vitamin K. Although, supplementation prior to childbirth does not have an effect on the unborn child’s vitamin K stores.Ultimately, it is up to the parents to determine whether or not they want to have their child supplemented via injection or if they would prefer to use another form of gradual supplementation that can be just as effective at preventing HDN without increasing the child’s likelihood of developing childhood leukemia.