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January 1988

Vitamin K Prophylaxis: Oral or Parenteral?

Am J Dis Child. 1988;142(1):14-16. doi:10.1001/archpedi.1988.02150010020011

Sir.—Vitamin K prophylaxis for all newborns has been recommended since 1961,1 and the need for parenteral vitamin K prophylaxis has recently been reaffirmed.2 Several authors, however, have argued for oral instead of parenteral vitamin K administration3,4 to avoid the troublesome injection.

The safety of parenteral vitamin K prophylaxis (intramuscular or subcutaneous) in preventing classical hemorrhage disease of the newborn has been established beyond doubt, whereas the relationship between vitamin K prophylaxis and late-onset hemorrhagic disease (LHD) due to vitamin K deficiency has not been clearly determined. From patient reports providing information as to whether the affected infants had been given parenteral vitamin K prophylaxis at birth (Table), however, we have found some evidence of a protective effect; bleeding despite parenteral vitamin K prophylaxis at birth was observed in only four of 63 patients with late-onset vitamin K deficiency hemorrhage.

A recent study on the prevalence of