The routine use of vitamin K in the newborn

The coagulation system of the newborn infant shows some functional impairment during the first few days of life. While these abnormalities are transient and can probably be regarded as ‘physiological’ in some babies, others, especially those who are breast fed, are at risk of suffering life-threatening haemorrhage. There is good evidence that, in at least some newborn babies, the coagulation abnormalities may be corrected by giving vitamin K. Although occasional serious accidents have resulted from the practice of administering intramuscular vitamin K in the delivery room, no fatalities have been reported in the recent literature. The preparation of vitamin K in current use appears to have no side effects when given intraumscularly or orally to newborn infants. Since the majority of newborn babies in most hospitals in this country are breast fed for at least the first few days of life it would seem appropriate for prophylactic vitamin K to be given either to all newborn infants soon after birth or to those at increased risk of developing HDN. Administration by mouth is probably safer than by intramuscular injection but more detailed research is needed to establish the efficacy and optimal dosage for the oral route. The requirement for vitamin K beyond the first few days of life has not been defined and objective recommendations concerning the prevention of late-onset haemorrhagic disease must await the results of further studies.