Over 10 years ago, William Hathaway described the 50-year chequered history of the association between a neonatal bleeding disorder and vitamin K deficiency and its prevention as a splendid example of the cyclical nature of discovery-rediscovery in medical science 1. The lessons that should have been learnt from the extensive body of early work were reiterated in a recent lively review in this Journal 2. In the UK these forgotten lessons first resurfaced in a 1983 Lancet article entitled ‘haemorrhagic disease of the newborn returns’ 3. Of course this rare deficiency syndrome, now more accurately termed vitamin K deficiency bleeding (VKDB), had never gone away but had merely been rediscovered at a time of a progressive trend towards exclusive breast feeding. The latter had long since been established as an important risk factor for neonatal hypoprothrombinaemia 4.
- undercarboxylated prothrombin