Newborn Infant and role of Vitamin K

American Academy of Pediatrics recommended the Intramuscular administration of vitamin K for the prevention of vitamin K deficiency bleeding (VKDB) as a standard of care in 1961. 

It recommends-

  1. Vitamin K administration to all newborn infants weighing >1500 g as a single, intramuscular dose of 1 mg within 6 hours of birth.
  2. Administering vitamin K dose of 0.3 mg/kg to 0.5 mg/kg as a single, intramuscular dose to preterm infants weighing ≤1500 g. However, a single intravenous dose of vitamin K for preterm infants should not be used as prophylaxis.
  3. Pediatricians and other health care providers must be aware of the benefits of vitamin K administration and the risks of refusal. Furthermore, they should convey this information to the infant’s caregivers.
  4. VKDB should be considered when assessing bleeding in the first 6 months of life, including infants who received prophylaxis, and particularly in exclusively breastfed infants.

Although VKDB can be successfully prevented with vitamin K administration, its incidence is continuously rising, which may be attributable to parental refusal as well as lowered efficacy of alternate methods of administration. 

Source: Hand I, Noble L, Abrams SA. Vitamin K and the Newborn Infant. Pediatrics,2022;149 (3): e2021056036.

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