What is the recommended dose of Vitamin K (Vit K) for a newborn?

From the Guidelines

Newborns should receive a single intramuscular dose of vitamin K1 (phytonadione) at 1 mg within the first hours after birth. This recommendation is based on the most recent and highest quality study available, which suggests that intramuscular application is the preferred route for vitamin K administration in newborns 1. The vitamin K injection prevents vitamin K deficiency bleeding (VKDB), a rare but serious condition that can cause dangerous internal bleeding, particularly in the brain.

Key Points

• The American Academy of Pediatrics recommends routine administration of intramuscular vitamin K1 to all infants on the first day of life to reduce the risk of VKDB 1.
• The dose of 1 mg is supported by recent guidelines and position papers in pediatric nutrition, which emphasize the importance of vitamin K prophylaxis in healthy newborn infants 1.
• Oral vitamin K regimens may be offered as an alternative for parents who decline the injection, but they are less effective and require multiple doses.
• The vitamin K injection has been standard practice for decades and has an excellent safety record.

Administration

• The injection should be administered within the first hours after birth, regardless of birth method or feeding choice.
• The intramuscular route is preferred due to its immediate protection and excellent safety record.
• For parents who decline the injection, an oral vitamin K regimen may be offered, but it is essential to educate them on the importance of completing the full course of treatment to ensure adequate protection against VKDB.

From the FDA Drug Label

A single intramuscular dose of phytonadione 0. 5 to 1 mg within one hour of birth is recommended. The recommended dose of Vitamin K for a newborn is 0.5 to 1 mg administered intramuscularly within one hour of birth, as recommended by the American Academy of Pediatrics 2.

From the Research

Vitamin K Dose for Newborns

• The recommended dose of vitamin K for newborns is 0.5 mg to 1.0 mg, administered intramuscularly (IM) at birth 3.
• This dose is effective in preventing vitamin K deficiency bleeding (VKDB) in newborns 4, 5, 3.
• Oral vitamin K administration is also an option, but it requires multiple doses and is considered an inferior alternative to IM administration 4, 5, 3.
• The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine IM administration of a single dose of vitamin K at 0.5 mg to 1.0 mg to all newborns 3.
• For premature infants, a dose of 0.5 mg of vitamin K may be sufficient to prevent hemorrhagic disease of the newborn 6.

Administration Routes and Schedules

• Intramuscular (IM) administration is the most effective route for preventing VKDB in newborns 4, 5, 3.
• Oral administration requires multiple doses, typically 2.0 mg at birth, repeated at 2 to 4 and 6 to 8 weeks of age 3.
• The success of oral prophylaxis depends on the protocol regimen and parent compliance 5.

Special Considerations

• Exclusive breastfeeding and cholestasis are closely associated with vitamin K deficiency and result in late-onset VKDB 5.
• Preterm infants may require a lower dose of vitamin K, such as 0.3 mg/kg for babies with birth weights below 1000 g 6.