Selkirk Medical Group
Information for Parents-to-be ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Vitamin K for babies
Vitamin K Prophylaxis A single supplementation of vitamin K is recommended for newborns to prevent Vitamin K Deficiency Bleeding( VKDB) also down as Hemorrhagic Disease of the Newborn.
Why is vitamin K important? Vitamin K is a clotting factor in blood. In adults Vitamin K is primarily made from bacteria in the gut. However that process does not begin infants until after birth and normal levels of Vitamin K do not occur in babies until between 6 weeks and 6 months. Regardless of the level of Vitamin K in the maternal blood, the placenta transfers only small amounts to the baby. Neither human breastmilk nor colostrums are considered good sources of Vitamin K.
Vitamin K Deficiency Bleeding may occur in apparently healthy newborns. Bleeding may be internal or external and the disease may involve severe bleeding such as intracranial hemorrhage into the brain.
How common is Vitamin K deficiency bleeding? It is difficult to determine the exact incidence of VKDB since vitamin K has been used as a preventative measure for fifty years. The BC Perinatal Health Program estimates the range of incidences from 0.1 / 1000 to 15 / 1000 depending on risk factors and feeding. Some pediatricians place the risk as high has 1 / 250 for exclusively breastfed infants.
How can Vitamin K deficiency bleeding be prevented? A single injection of 1 mg of vitamin K intramuscularly( into the thigh muscle) of the newborn within the first few hours after birth will prevent most cases of VKDB. Good quality case control studies have shown no association between vitamin K and childhood leukaemia( as was suggested by a study in the 1990’ s).
A formulation of Vitamin K suitable for oral administration is not approved for use in Canada. If the oral route is chosen the infant should be given 1-2mg shortly after birth, and repeated at 1-2 weeks and at 4 weeks.
Key Points
� Vitamin K supplementation is normally administered to the newborn within the first hours postpartum
� If parents choose to give Vitamin K orally, they should be aware that the effectiveness of this route is not well known and likely is less effective than the injected vitamin K
� If parents decline to have the Vitamin K administered to the newborn after considering the risks and benefits, an Informed Refusal should be signed.
� It is important to watch the baby for poor growth / feeding, failure to thrive, and‘ warning bleeds’ 19