Hemorrhagic disease of the newborn: an unusual etiology of neonatal bleeding.

Emergency physicians may encounter presentations of bleeding in the neonate that have multifactorial etiologies. A case of a 15-day-old male infant with umbilical bleeding that exhibited many of the characteristic features of hemorrhagic disease of the newborn (nonmedically attended birth, breastfeeding, no definite history of Vitamin K administration, bleeding from iatrogenic puncture sites, and isolated prolongation of the prothrombin time and partial thromboplastin time) is presented. A differential diagnosis and laboratory evaluation of bleeding in the newborn are summarized, and treatment recommendations for hemorrhagic disease of the newborn are discussed.