Vitamin K to Newborn Babies

Neonatologists (doctors specialising in care of babies), midwives, health visitors and public health doctors are responding to the recommendations from the Department of Health which recommend that all babies should receive vitamin K within 24 hours following birth.

Why does my baby need vitamin K?

Compared with adults, all babies have very low levels of vitamin K in their bodies. Without vitamin K, blood cannot clot normally and the baby can develop a tendency to bleed easily. In some cases, this leads to serious bleeding from the stomach, umbilicus (navel) or intestine (gut) and in a few cases to bleeding in the brain. This condition is called Vitamin K Deficiency Bleeding (VKDB).

Studies show that in babies who do not receive vitamin K, the risk to the baby of developing VKDB is one in 10,000. However, it is not possible to predict which babies are at risk of bleeding. We do know that this potentially dangerous condition can be reduced by giving the baby vitamin K after birth. 

How can I protect my baby from Vitamin K Deficiency Bleeding (VKDB)?

We recommend that all babies are given an injection into the thigh muscle in the first day of life as this effectively prevents VKDB in virtually all babies. Should you decide that you do not wish your baby to have any form of vitamin K supplement, it is important to discuss this with your GP or community midwife who can advise you of the actions to take if symptoms of VKDB appear.

The current preparation used for both Intramuscular injection and oral administration of vitamin K is prepared from an animal derived (bovine) source. There is currently no other vitamin K product licensed and available for use as an alternative. If you have reasons why you would not wish your baby to receive an animal derived product we are currently unable to offer a substitute preparation as there is no licensed product available.

Can Vitamin K be given orally?

Vitamin K can be given to babies as a liquid by mouth. However, it is less effective as the absorption of the whole drug cannot be guaranteed. Oral vitamin K has to be given in a three-dose course over the first four – six weeks and there is a risk that babies will miss out on the second or third doses and therefore not complete the course.

The formulation of oral vitamin K to be used is Konakion MM Paediatric 2mg (0.2ml) and should be given at birth and at 7 days of age.

Those babies who received oral Konakion MM Paediatric at birth and seven days, and are still breast feeding, should receive a third oral dose (2mg in 0.2 ml) at four weeks of age.

It is really important that your baby receives follow up doses of oral vitamin K as there is a risk of late onset haemorrhagic disease of your baby.

How to administer oral vitamin K?

Should you choose to give your baby oral vitamin K your baby will be given the initial dose at birth. Your midwife will show you how this is administered.

A second dose of oral vitamin K will need to be given by yourselves at one week old.

The oral syringe and Vitamin K ampoule will be supplied to you by the midwife.  

If you are breastfeeding, it is recommended that you give a further dose at four weeks of age. This is because breastmilk does not contain sufficient amounts of vitamin K to meet the recommendations.

When given please document this in the baby’s red health record book ( section 3b) and yellow book  if you still have it.

Can Vitamin K harm my baby?

In 1992, one study suggested that vitamin K given by injection was associated with a higher risk of childhood cancer than giving vitamin K by mouth or no vitamin K at all. This study caused concern and for some time hospitals have given vitamin K by mouth to newborn babies. Further research in several countries since 1992 has not confirmed the link between the vitamin K injection and childhood cancer.

If you have any questions please ask your midwife or ask to speak to a member of the neonatology team.

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