From the Guidelines
All babies receive vitamin K injections at birth to prevent a potentially dangerous bleeding condition called Vitamin K Deficiency Bleeding (VKDB). Newborns are naturally deficient in vitamin K because very little crosses the placenta during pregnancy, and breast milk contains low amounts. The standard dose is 0.5-1 mg of vitamin K given as a single intramuscular injection in the thigh shortly after birth, as recommended by the European Society of Gastroenterology, Hepatology and Nutrition 1. This injection provides immediate protection that lasts for several months until the baby's body can produce adequate vitamin K on its own. Without this supplementation, babies are at risk for serious bleeding, which can occur in the brain, intestines, or other organs. This bleeding risk is highest in the first week of life but can occur up to 6 months of age. Vitamin K is essential for blood clotting, and the injection is a safe, effective way to prevent this rare but potentially fatal condition, with minimal side effects, typically limited to minor pain at the injection site 1.
Some key points to consider:
- The intramuscular application is the preferred route for vitamin K administration in newborns 1.
- The recommended dose of vitamin K for newborns is 1 mg of vitamin K1 by intramuscular injection at birth, or 3 × 2 mg vitamin K1 orally at birth, at 4 to 6 days and at 4 to 6 weeks 1.
- Vitamin K deficiency can lead to bleeding complications, and the injection is a crucial preventive measure 1.
- The protection provided by the vitamin K injection is particularly important because symptoms of bleeding may not appear until significant damage has occurred.
It's worth noting that while there are different recommendations for vitamin K administration, the most recent and highest quality study recommends intramuscular injection as the preferred route 1. Additionally, the study highlights the importance of vitamin K supplementation in preventing VKDB in newborns.
From the FDA Drug Label
Vitamin K1 Injection is indicated in: ... prophylaxis and therapy of hemorrhagic disease of the newborn;
The reason all babies receive Vitamin K injections at birth is for the prophylaxis of hemorrhagic disease of the newborn. This is because babies are at risk of bleeding due to vitamin K deficiency, which can lead to serious health problems. The injection helps to prevent this condition by ensuring the baby has adequate levels of vitamin K to support blood clotting. 2
From the Research
Vitamin K Injections in Newborns
- All babies receive vitamin K injections at birth to prevent vitamin K deficiency bleeding (VKDB) 3, 4, 5, 6, 7.
- VKDB can occur in the first week of life ("classic" VKDB) and also between 2 weeks and 3 months of age ("late" VKDB) 4.
- Newborns are at risk for VKDB due to inadequate prenatal storage and deficiency of vitamin K in breast milk 5.
- A single intramuscular injection of vitamin K at birth effectively prevents VKDB 3, 4, 5.
Reasons for Vitamin K Prophylaxis
- Vitamin K is essential for the synthesis of coagulation factors, and infants can easily develop vitamin K deficiency due to poor placental transfer, low vitamin K content in breast milk, and poor intestinal absorption 3.
- Exclusive breastfeeding and cholestasis are closely associated with vitamin K deficiency and result in late-onset VKDB 3.
- Vitamin K deficiency bleeding can present as bleeding in the skin or gastrointestinal tract, with as many as half of affected neonates experiencing intracranial bleeding 4.
Administration Routes
- Intramuscular prophylactic injections reduce the incidence of early-onset, classic, and late-onset VKDB 3.
- Oral administration of vitamin K is an alternative strategy, but it requires multiple doses and is less effective than intramuscular injection 3, 5.
- The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine intramuscular administration of a single dose vitamin K at 0.5 mg to 1.0 mg to all newborns 5.