The patchy, painful skin lesions described two hours after birth are most consistent with deficiency of which vitamin?

The patchy, painful skin lesions described two hours after birth are most consistent with deficiency of which vitamin?

• A. Vitamin C
• B. Vitamin K
• C. Iron supplement
• D. Vitamin D

Answer: (B)

Bleeding into the skin soon after birth points to a deficiency in a coagulation vitamin, specifically vitamin K. Vitamin K is essential for activating the coagulation factors II, VII, IX, and X. Newborns have very low vitamin K stores, limited gut bacteria to synthesize it initially, and placental transfer plus breast milk provide little vitamin K. Without adequate vitamin K, the coagulation cascade cannot function properly, leading to hemorrhagic manifestations like patchy, painful skin lesions within the first hours of life. This is the classic presentation of hemorrhagic disease of the newborn, which is preventable with intramuscular vitamin K given at birth. The other options don’t fit this rapid, mucocutaneous bleeding pattern driven by impaired clotting factor activation.

Bleeding into the skin soon after birth points to a deficiency in a coagulation vitamin, specifically vitamin K. Vitamin K is essential for activating the coagulation factors II, VII, IX, and X. Newborns have very low vitamin K stores, limited gut bacteria to synthesize it initially, and placental transfer plus breast milk provide little vitamin K. Without adequate vitamin K, the coagulation cascade cannot function properly, leading to hemorrhagic manifestations like patchy, painful skin lesions within the first hours of life. This is the classic presentation of hemorrhagic disease of the newborn, which is preventable with intramuscular vitamin K given at birth. The other options don’t fit this rapid, mucocutaneous bleeding pattern driven by impaired clotting factor activation.