Two hours after birth, a neonate develops patchy, painful, dark red lesions that progress to purple and black. This neonate needs

• A. Platelet transfusion
• B. Vitamin K
• C. Antibiotics
• D. Steroids

Answer: (B)

Neonatal hemorrhagic disease from vitamin K deficiency leads to spontaneous bleeding manifests as purpura or ecchymoses that can progress to dark, painful lesions. Newborns have very low stores of vitamin K and their gut flora isn’t yet producing enough vitamin K, so they’re at risk in the first hours to days after birth. Providing vitamin K restores the liver’s ability to produce active clotting factors II, VII, IX, and X, helping to stop the bleeding. This is why giving vitamin K is the appropriate treatment in this scenario.

The other options don’t address the underlying coagulation defect: platelets would be for a platelet problem, antibiotics for infection, and steroids for inflammatory or immune processes.