Six years' experience of prophylactic oral vitamin K
Unni Wariyara, Stephen Hiltona, Julie Paganb, Win Tinb, Edmund Heya
a Northumberland
Health Authority, Morpeth, b Department
of Paediatrics, South Cleveland Hospital,
Middlesbrough
Correspondence to: Dr U K Wariyar, Department of Paediatrics, Royal Victoria Infirmary, Newcastle upon Tyne NE4 1LP. Email:u.k.wariyar{at}ncl.ac.uk
Accepted 24 June 1999
AIMS
The ability of
oral vitamin K to eliminate all risk of vitamin K deficiency bleeding
during the first three months of life was studied.
METHODSBabies (n=182
000) in the north of England judged well enough to be offered milk
within 12 hours of birth were given 1 mg of phytomenadione (vitamin
K1) suspended in a medium chain triglyceride oil by mouth
at delivery between 1993 and 1998. The parents of those who were
breastfed were given a further three doses to give to the baby once
every two weeks after discharge.
RESULTSFour
breastfed babies developed late vitamin K deficiency bleeding. In two,
staff failed to follow policy guidelines, and in two there was
undiagnosed 
1 antitrypsin deficiency. Audit suggested
that 93% of breastfed babies had all four doses, as advised.
CONCLUSIONSAn oral
product that parents can administer themselves would be popular if
licensed, but the total dose offered may need to be more than in this
study if babies with undiagnosed liver disease are to be protected.
Keywords: vitamin K prophylaxis; bleeding; breast feeding
© 2000 by Archives of Disease in Childhood
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