Which of the following is not true about late onset Hemorrhagic disease of newborn (HDN)?

Ans. a (Begins between 2-7 days of life) (Ref Care of Newborn by Maherbansingh 6,th/336; Oski's Pediatrics - Pg. 468)As classified by Hathaway, hemorrhagic disease of the newborn (HDN) can occur in early, classic, and late forms.Early HDN presents in first 24 hrs of life generally with catstrophic bleeding. Classic vitamin K deficiency bleeding of the newborn is the most common type of hemorrhagic disease in newborns and classic HDN occurs between 2 and 7 days of life and usually presents as Gl bleeding. Vitamin K (0.5 to 1 mg) given IMIy at birth prevents classic hemorrhagic disease of the newborn, which occurs at 2-7 days of age. Late onset HDN occurs l-3months after birth and is asso with a high incidence CNS hemorrhage and motality.HDN (Hemorrhagic disease of newborn)FeaturesEarly HDNClassical HDNLate HDNOnset< 24 hoursUp to 1-7 days2-16 weeksPresentationConcealed bleedingBleeding from umbilical cord stump, nose, GIT and during surgery (e.g., circumcision)Bleeding more common from sites like intracranial; vessels, skin, mucous membrane, GIT, etcEtiologyIn utero vitamin K deficiency# Most common due to physiologic deficiency of vitamin K in newborns fed with breast milk.# Vitamin K content of human milk (15 mcg/L) is half that of the cow milk.# Predisposing factors are:- Chronic diarrhea,- Malabsorption,- Hepatic cholestasis (e.g. bililary atresia)- Long-term broad-spectrum antibiotics and- Mucovisidosis.- Warfarin therapy- Rare in formula-fed babies and those who have received inj. vitamin K at birth.- Mortality is 20% in late HDN.