Doctors found a 9-month-old baby who had a serious brain bleed caused by low vitamin K levels, even though the baby received vitamin K at birth. This is very unusual because vitamin K deficiency bleeding normally happens in newborns during their first week of life. The baby’s only risk factor was being breastfed exclusively without any solid foods for much longer than typical. This case teaches doctors an important lesson: when babies don’t start eating solid foods on schedule, they might develop vitamin K problems later, which can be dangerous. The good news is that vitamin K treatment fixed the problem quickly.

The Quick Take

  • What they studied: Why did a healthy 9-month-old baby develop a serious brain bleed from vitamin K deficiency, even though he received vitamin K at birth?
  • Who participated: One healthy 9-month-old infant who was exclusively breastfed without any solid foods introduced
  • Key finding: Delayed introduction of solid foods (complementary feeding) was the main risk factor for vitamin K deficiency bleeding in this older infant, which is extremely rare outside the newborn period
  • What it means for you: Starting babies on solid foods around 6 months of age may help prevent vitamin K deficiency problems. If your baby is exclusively breastfed beyond 6 months without solid foods, talk to your pediatrician about introducing appropriate foods. This case is very rare, but it highlights the importance of following feeding guidelines.

The Research Details

This is a case report, which means doctors are describing what happened with one specific patient to teach other doctors about an unusual situation. The doctors carefully reviewed the 9-month-old baby’s medical history, blood tests, and treatment to understand why he developed vitamin K deficiency bleeding so late in life. They looked at his diet, his health history, and his response to treatment. Case reports are like medical detective stories—they help doctors recognize patterns they might not expect and learn from unusual situations.

Case reports are important because they alert doctors to rare problems that might be missed. Normally, vitamin K deficiency bleeding happens in newborns during the first week of life, so doctors might not think to check for it in a 9-month-old. By sharing this case, the doctors are helping other pediatricians recognize that delayed solid food introduction could be a hidden risk factor in older babies.

This is a single case report, so it describes one patient’s experience rather than testing many patients. While case reports have limitations, they are valuable for identifying rare problems and unusual patterns. The doctors provided detailed information about the baby’s blood tests, imaging, and treatment response, which makes the case well-documented. However, one case cannot prove that delayed solid foods definitely causes vitamin K problems—it only suggests this might be a risk factor worth investigating further.

What the Results Show

The 9-month-old baby came to the hospital with a serious brain bleed. Blood tests showed he had very low red blood cells (severe anemia) and severely abnormal blood clotting. Tests specifically measuring vitamin K status (PIVKA-II levels) were extremely high, indicating severe vitamin K deficiency. This was surprising because the baby had received vitamin K at birth as a preventive measure. The baby had no other obvious reasons for vitamin K problems—he wasn’t sick, didn’t have digestive problems, and was well-nourished. The only unusual thing about his care was that he had been exclusively breastfed without any solid foods being introduced, which is longer than the typical 6-month exclusive breastfeeding period. When doctors gave him vitamin K and blood products (FFP), his blood clotting problems fixed themselves within 12 hours, which is remarkably fast.

When the doctors checked the baby’s blood clotting six months later, everything was still normal. This showed that the vitamin K treatment worked and the problem didn’t come back. The baby recovered well from the brain bleed with appropriate treatment.

Vitamin K deficiency bleeding is well-known in newborns, typically appearing in the first week of life. Cases after 3 months of age are extremely rare, making this case unusual. The case suggests that delayed introduction of solid foods might be an overlooked risk factor for vitamin K problems in older infants. Previous research has shown that breast milk alone contains less vitamin K than formula or solid foods, which may explain why extended exclusive breastfeeding without solid foods could cause problems.

This is a single case report, so it describes one baby’s experience and cannot prove that delayed solid foods definitely causes vitamin K deficiency in all babies. Many babies are exclusively breastfed beyond 6 months without developing this problem. The case doesn’t tell us how common this problem might be or exactly how many months of exclusive breastfeeding increases the risk. More research with larger groups of babies would be needed to understand the true connection between feeding practices and vitamin K deficiency risk.

The Bottom Line

Follow standard feeding guidelines: exclusively breastfeed until around 6 months of age, then gradually introduce appropriate solid foods. If you’re exclusively breastfeeding beyond 6 months, discuss this with your pediatrician. There is no need to panic—this case is extremely rare—but it’s a good reminder that feeding guidelines exist for important reasons. (Confidence level: Moderate, based on one case report and existing nutritional science)

Parents and caregivers of exclusively breastfed babies, especially those planning to delay solid foods beyond 6 months. Pediatricians should be aware of this rare possibility when evaluating older infants with unexplained bleeding problems. This case is not relevant to formula-fed babies or babies already eating solid foods.

Vitamin K deficiency problems can develop gradually over months of exclusive breastfeeding without solid foods. Treatment with vitamin K works very quickly (within hours to days). Prevention through timely introduction of solid foods is much better than waiting for problems to develop.

Want to Apply This Research?

  • Track the introduction of complementary foods (solid foods) starting around 6 months of age, noting the date each new food is introduced and the baby’s tolerance. Log any unusual bleeding, bruising, or health concerns.
  • Set a reminder at 6 months of age to discuss introducing solid foods with your pediatrician if exclusively breastfeeding. Plan and track the gradual introduction of iron-rich foods (like fortified cereals, meat, or beans) which also contain vitamin K.
  • Monitor feeding milestones monthly and track any signs of unusual bleeding or bruising. Keep records of solid food introduction dates and types. Schedule regular pediatric check-ups to ensure feeding progress is on track.

This case report describes one infant’s rare experience and should not cause unnecessary alarm. Vitamin K deficiency bleeding in older infants is extremely uncommon. This information is educational and not a substitute for professional medical advice. Always consult with your pediatrician about your baby’s feeding plan, especially if exclusively breastfeeding beyond 6 months or if you notice any signs of unusual bleeding or bruising. Do not delay introducing solid foods or change feeding practices without discussing with your healthcare provider first.