Vitamin K

​When first venturing into parenthood, we are inundated with options.  One of those is whether or not to give your newborn baby Vitamin K (either as 3 oral doses, or more commonly as an injection at birth).

​ This is the pamphlet you are likely to receive as your information about vitamin K.  It is worded in a way that that implies you might be making a bad decision if you choose not to have it.  It does contain useful information to help you prepare for any backlash or pressure if you do choose not to, by hinting at high risk babies and highlighting actual symptoms to watch for.  You can use this to start your own research.  What this pamphlet does not show is the risk factor for what vitamin K will prevent compared to the risk factor for not giving it.  It brushes off any possible side effects.  This brochure also does not address why 30 years ago (around 1980), newborns started receiving vitamin k.  In order to make an informed decision, one you are truly comfortable with, we need to add to this brochure using up to date research.

Sara Wickham's book Vitamin K and the newborn details the options surrounding vitamin k.  It is an informative and respectful guide, which is also helpful for understanding the informed decision making process generally.  

Here is a list of several research papers:

Puckett RM, Offringa M. Prophylactic vitamin K for vitamin K deficiency bleeding in neonates. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD002776. DOI: 10.1002/14651858.CD002776.

Hey, E. Vitamin K--what, why, and when.  Arch Dis Child Fetal Neonatal Ed. 2003 Mar;88(2):F80-3.

Vitamin K prophylaxis to prevent neonatal vitamin K deficient intracranial haemorrhage in Shizuoka prefecture. Nishiguchi T, Saga K, Sumimoto K, Okada K, Terao T Br J Obstet Gynaecol 1996 Nov;103(11):1078-1084.

Plasma concentrations after oral or intramuscular vitamin K1 in neonates. McNinch AW, Upton C, Samuels M, Shearer MJ, McCarthy P, Tripp JH, L'E Orme R. Arch Dis Child. 1985 Sep;60(9):814-8.

[Effect of oral and intramuscular vitamin K on the factors II, VII, IX, X, and PIVKA II in the infant newborn under 60 days of age] [Article in Spanish] Arteaga-Vizcaino M, Espinoza Holguin M, Torres Guerra E, Diez-Ewald M, Quintero J, Vizcaino G, Estevez J, Fernandez N.  Rev Med Chil. 2001 Oct;129(10):1121-9.

Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W. Pediatrics. 2006 Apr;117(4):1235-42.

[Vitamin K 1 concentration and vitamin K-dependent clotting factors in newborn infants after intramuscular and oral administration of vitamin K 1] [Article in Hungarian] Goldschmidt B, Kisrakoi C, Teglas E, Verbenyi M, Kovacs I.  Orv Hetil. 1990 Jun 17;131(24):1297-300.

Vitamin K - An Alternative Perspective. Midwife Sara Wickham provides a much-needed update on vitamin K prophylaxis.  AIMS Journal, Summer 2001, Vol 13 No 2

Brousson MA Controversies surrounding the administration of vitamin K to newborns: A review, CMAJ 1996, 154:3, pp 307-315.

Canadian Paediatric Society, Fetus and Newborn Committee. The use of vitamin K in the perinatal period, CMAJ 1988, 139, pp 127-130.

Cornelissen M, Von Kries R, Schubiger G and Loughnan PM. Prevention of vitamin K deficiency bleeding: efficacy of different multiple oral dose schedules of vitamin K, European Journal of Pediatrics, 1997, 156 pp 126-130.

Greer FR Vitamin K status of lactating mothers and their infants, 1998, Acta Paediatric Scan Suppl, 88: 430, pp 95-103.

Golding J, Greenwood R, Birmingham K and Mott M. Childhood cancer, intramuscular vitamin K and pethidine given during labour, 1992, British Medical Journal, 305, pp. 341-346.

Loughnan PM and McDougall PN. Epidemiology of late onset haemorrhagic disease: a pooled data analysis, 1993 Journal of Paediatric Child Health, 29, pp 177-181.

NHMRC 2000 Vitamin K for Newborn Babies, Canberra Australia.

NHMRC, Paediatric Division of the RACP, RANCOG, RACGP, ACMI, Joint statement and recommendations on Vitamin K administration to newborn Infants to prevent vitamin K deficiency bleeding in infancy. October 2000, Canberra.

Puckett RM, Offringa M. Prophylactic vitamin K for vitamin K deficiency bleeding in neonates (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.

Schubiger G, Stocker C, Banziger O and Zimmerman H. Oral vitamin K prophylaxis for newborns with a new mixed-micellar preparation of phylloquinone: 3 years experience in Switzerland, 1999, European Journal of Paediatrics, 158, pp 599-602.

Shearer MJ Vitamin K metabolism and nutriture, 1992, Blood Reviews, 6 pp 92-104.

Sutor AH, Von Kries R, Cornelisson EAM, McNinch AW, and Andrew M. Vitamin K deficiency bleeding (VKDB) in infancy, 1999, Thromb Haemost 81, 456-461.

Von Kries R. Neonatal vitamin K prophylaxis: the Gordian knot still awaits untying, 1998, British Medical Journal, 316: 161-162.

Von Kries R. Oral versus intramuscular phytomendione: Safety and efficacy compared, 1999, Drug Safety, 21:1, pp 1-6.
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Wariyar U, Hilton S, Pagan J, Tin W and Hey E. Six years' experience of prophylactic oral vitamin K, 2000, Arch Dis Child Fetal Neonatal, 82:1, F64-F68.