A bleeding disorder is a health condition that makes it hard for the body to stop bleeding. This can happen when the blood doesn’t clot the way it should. Clots are the body’s way of sealing cuts or injuries to stop bleeding.

When a blood vessel breaks, small shards of cells in the blood called platelets make clots. They rush to the site of the break and stick to the broken edges of the vessel. They clump together to seal off openings. This stops the blood from leaking out.

Then, proteins called clotting factors come along and strengthen the plug. These proteins work to form strands of fibrin that weave through the platelets and hold the clot in place. This makes the platelet plug strong and stable — like adding mortar between bricks.

Without effective clotting, kids with bleeding disorders may:

• Bruise easily
• Bleed more than expected
• Have frequent nosebleeds

Some bleeding disorders are genetic and get passed down in families. Others develop on their own. If your child has a bleeding disorder, our team can help find the cause. We’ll offer the right care to keep them safe and healthy.

Our team cares for a large number of bleeding disorders, including some of the most common kinds.

Platelet Disorders

Platelet disorders affect how platelets work or how many your child has. If they don’t have enough platelets, their blood doesn’t clot effectively. Thrombocytopenia is the general name for a low number of platelets in the blood.

• Platelet function defects: The platelets are present but don’t work the way they should.
• Idiopathic thrombocytopenia (ITP): The immune system attacks platelets, causing easy bruising and bleeding.
• Alpha granule defects: The platelets are missing parts they need to work properly.
• Storage pool disorders: The platelets don’t release the chemicals needed for clotting.
• Glanzmann thrombasthenia: A rare disorder where platelets can’t stick together.
• Bernard-Soulier syndrome: A rare condition where platelets are too large and don’t work right.
• MYH9 defects: A genetic condition that causes low platelet counts and other problems.

Clotting Factor Disorders

Clotting factor disorders are when the body doesn’t make enough of the clotting proteins needed to solidify the platelet plug.

There are 13 main clotting factors. When one or more are missing or don’t work well, blood doesn’t clot well. These are factor disorders or deficiencies. There are several common types with specific names.

These include:

• Hemophilia (A, B, C): The name used for some of the most common factor deficiencies (Factor VIII, Factor IX, Factor XI). Due to genetic changes in the code for the clotting factors cause bleeding.
• Factor I deficiency: The body doesn’t make enough fibrinogen, a protein needed for blood clots. Afibrinogenemia is the most severe when fibrinogen is completely absent. Hypofibrinogenemia is when fibrinogen is present in low amounts. Dysfibrinogenemia is when the body makes fibrinogen that doesn’t work.

Most other clotting factor deficiencies are very rare. They are usually named by the specific factor that’s missing or not working right.

These include:

• Factor V deficiency: Sometimes called parahemophilia
• Factor VII, X, XII, XIII deficiencies: Usually just named after the missing factor.

Von Willebrand Disease

Von Willebrand disease is a common bleeding disorder that affects both platelets and clotting factors. It is due to low levels or abnormal function of von Willebrand factor, which plays a key role in clotting at both platelet plug formation and clotting factors levels. It is not a factor deficiency but can lower Factor VIII levels.

It has three distinct types

• Type 1: The most common and mildest type. The body makes less von Willebrand factor than normal, but it still works.
• Type 2: The body makes von Willebrand factor, but it doesn’t work the right way. Bleeding symptoms can range from mild to moderate.
• Type 3: The rarest and most severe type. The body makes little or no von Willebrand factor, which can cause serious bleeding.

Bleeding Regulation Disorders

These are rare conditions that affect how the body controls bleeding and how fast clots break down.

• Antiplasmin deficiency: This makes it hard for the body to stop clots from breaking down too quickly. It can lead to longer or sudden bleeding.
• Plasminogen activator inhibitor 1 (PAI-1) deficiency: A rare condition where the body can’t form strong clots.

Bleeding in Newborns

Vitamin K deficiency bleeding can happen in babies who don’t get a vitamin K shot at birth. It often shows up in the first few weeks of life. It can cause serious bleeding and can be life-threatening if not treated quickly.

Inherited Syndromes That Cause Bleeding

Some rare genetic conditions cause bleeding along with other health issues. Wiskott-Aldrich Syndrome affects the immune system and causes very low platelet counts. Kids with this condition often have frequent infections, bruising and bleeding.

Every child is different, so we tailor each care plan to their needs. Your child’s care plan will depend on:

• Their age
• Their health
• Their diagnosis
• How their body responds to treatment

Ways we treat bleeding disorders include:

• Medicines: These may help the blood clot more easily or replace missing clotting factors.
• Hormone therapy: Your body’s hormones can help release clotting factors stored in the body. Man-made versions can too.
• Transfusions: We can give your child clotting factors or platelets through an IV to stop or prevent bleeding.
• Special glues and ointments: Can help close wounds and stop bleeding on the skin.
• Therapy: Physical therapy can help if bleeding affects joints or muscles.

We’ll work closely with you to find the safest, most effective care plan for your child.

We know this can feel overwhelming — but you’re not alone. Our team is here to answer your questions, ease your worries and give your child the best possible care.

When you come to Children’s Wisconsin for bleeding disorder care, here’s what you can expect:

• A full evaluation: We’ll review your child’s symptoms, medical history and family background. Most children will also need blood tests to check clotting and platelet function.
• A team approach: You’ll meet doctors, nurses and experts who all focus on kids with bleeding disorders.
• A personalized care plan: Based on your child’s diagnosis, we’ll create a care plan that fits their needs. That may mean medicines, lifestyle changes or monitoring.
• Education and support: We’ll teach you about your child’s condition and how to handle bleeding at home. We’ll connect you with helpful resources.
• Follow-up care: We’ll track how your child is doing over time. We can adjust your child’s care as needed. We’re here to offer you long-term support, including connecting you with our partners at Versiti.