prevention

Last reviewed 01/2018

Vitamin K1 should be given prophylactically in all newborn infants shortly after birth, either orally or by intramuscular injection - available regimes (intramuscular or oral) can be effective in the prevention of haemorrhagic disease of the newborn (HDN) - but only if fully completed (1).

There is evidence associating intramuscular as opposed to oral vitamin K with childhood cancer. However, this conjecture has been questioned by a large, retrospective study which found no difference between oral and intramuscular routes and associated risk.

Oral vitamin K is not as effective in preventing late onset haemorrhagic disease. Nevertheless, there is a continuing trend in Europe to move towards oral agents.

Many cases of catastrophic HDN are preceded by warning bleeds or jaundice, and the incidence of HDN might be reduced if these signs were always recognised.

Rrelative risk for developing late has vitamin K deficiency bleeding been estimated at 81 times greater among infants who do not receive intramuscular vitamin K than in infants who do receive it (2)

Reference:

• CMO's Update 29 (February 2001), 3.
• McNinch AW, Tripp JH. Haemorrhagic disease of the newborn in the British Isles: two year prospective study. BMJ 1991;303:1105-9.