I recently wrote about babies dying from a rare but deadly condition called vitamin K deficiency hemorrhage. To report this story, I analyzed hundreds of rows of data, contacted more than 50 hospitals and birth centers, and filed nearly 90 public records requests. But the autopsy reports documenting how these babies died painted the clearest picture of these tragedies.
I share some of the most important lessons learned from autopsy reports in hopes of raising awareness about this disease and highlighting what decades of research and interviews with dozens of doctors have revealed. In most cases, a simple injection of vitamin K at birth could have prevented death.
To protect the family’s privacy, ProPublica is not releasing the baby’s name, date or year of death, or location within the state.
Babies need vitamin K to help blood clot, but babies aren’t born with enough vitamin K in their bodies. Two researchers won the Nobel Prize in 1943 for their discovery of vitamin K and its ability to form blood clots and stop bleeding in infants. Vitamin K injections have been a standard intervention for newborns in the United States since being recommended by the American Academy of Pediatrics more than 60 years ago.
However, in recent years, parents have begun to refuse vaccinations. Vitamin K injections are not vaccines, but they have become embroiled in the anti-vaccination movement. False and misleading information online has led some parents to believe that the shots are harmful. Additionally, some parents are expressing a desire for a more natural birth experience without drug intervention. Others don’t want their baby to experience the pain of an injection they believe is unnecessary.
Hospital data and research studies document this shift. In December, a national survey of more than 5 million births found that the proportion of infants not receiving vitamin K jumped 77% from 2017 to 2024. The Centers for Disease Control and Prevention reports that newborns who do not receive the vaccine are 81 times more likely to develop delayed vitamin K deficiency bleeding than those who do. Often there are no warning signs. The baby was healthy and happy days, even hours, before the fatal hemorrhage.
1. The role of vitamin K deficiency in infant death
Minnesota infant autopsy report obtained by ProPublica and edited to protect privacy.
Although not all deaths are investigated by coroners or medical examiners, I have filed open records requests in several states and counties and obtained applicable deaths. One of the first things that stood out was how clear the role of vitamin K is in many cases. Vitamin K deficiency was listed in the autopsy as a direct cause or contributing factor to death. Details about parents who refused vitamin K injections were also usually included.
In this autopsy, conducted in Minnesota, the coroner determined that the baby died from vitamin K deficiency hemorrhage. The second line included the fact that vitamin K was not administered as part of preventive care after the baby’s birth.
The naming of vitamin K deficiency as the cause of death was important because it removed any doubt that the bleeding could have been caused by another factor, such as an injury. Similar words were used in other autopsy cases I looked at.
One of the challenges with vitamin K deficiency bleeding is data. State and federal agencies do not track which babies are not vaccinated and which babies bleed or die. Many medical experts told me that the number of deaths directly attributed to vitamin K (fewer than a dozen per year) is only part of the story. Every year, hundreds of infants die from spontaneous bleeding in the brain. These experts say some of these deaths are likely related to vitamin K deficiency bleeding. This has led doctors to call for improved reporting and tracking.
2. Things you had with your baby
Autopsy reports reviewed by ProPublica often included descriptions of what items the infants arrived with. Retrieved and edited by ProPublica to protect your privacy
Most autopsies involved more than listing medical findings. It included an overview and description of the baby’s weight, height, hair, eye color, etc. One detail that shocked me was when the babies came to the morgue. A hospital band around my ankle, a clean diaper, and a blue blanket.
It reminded me of Tim O’Brien’s classic collection of short stories, The Things They Carried, about what soldiers carry with them, both physically and mentally. These items were a heartbreaking reminder that these babies are just that: babies who have yet to take their first steps or kick a soccer ball for the first time.
3. What the babies endured
Some reports have described intracranial hemorrhage, such as this report from Alabama. Retrieved and highlighted by ProPublica
Autopsies often described in painstaking detail the conditions the babies endured. In this one-month-old case from Alabama, an autopsy revealed that the baby had suffered from a subdural hemorrhage and a subarachnoid hemorrhage. These hemorrhages are a type of hemorrhage that occurs in different areas just above the brain. The first is subdural, which occurs when blood collects under one of the layers of tissue in the skull that protect the brain. Subarachnoid hemorrhage occurs in the space beneath another layer. Cerebral edema is a type of swelling of the brain, and brain necrosis is the death of living brain tissue. An autopsy also determined that the cause was “neonatal bleeding disorder.” This is the former name for vitamin K deficiency bleeding, and some clinicians still use this name.
Autopsies are official records and are often written as such. I reached out to pathologists and other doctors to help me understand and translate the medical terminology. Although it was painful, it was important to document it. Our job as reporters is to testify to the truth, no matter how dire.
4. How hard the doctors tried to save them
Many of the reports refer to doctors’ attempts to save the infant’s life. Retrieved from ProPublica
Part of the autopsy had a section titled “Evidence of Medical Intervention.” In it, pathologists explained what steps doctors and nurses took to save the baby. Doctors inserted a tube into the baby’s airway, connected him to an IV and ordered a blood transfusion. This section is excruciating to read because if things had gone differently, the baby might have survived.
In this Kentucky case, the medical team tried several life-saving measures. Still, the baby coded twice. Doctors were able to revive him the first time, but the second time they tried to bring him back for about 30 minutes before his parents finally told him they could stop.
5. The baby was very small when he died.
Arizona infant autopsy report obtained by ProPublica and edited to protect privacy.
The autopsy results highlight how these deaths were avoidable. I am reminded of this when I see the tiny footprints of one of my babies in the autopsy records.
Parents often frame their baby’s footprints and display them on the wall or tuck them into keepsake boxes. Footprints often evoke fond memories.
But when those footprints appear in the autopsy records, they become a tragic reminder of how small the baby was when she died.
