Updated Prenatal Directory Joomag Prenatal Directory Update July 2017 | Page 21

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