Belgian Consensus Recommendations to Prevent Vitamin K Deficiency Bleeding in the Term and Preterm Infant

• Published in: Nutrients Vol. 13; no. 11; p. 4109
• Main Authors: Fiesack, Simon, Smits, Anne, Rayyan, Maissa, Allegaert, Karel, Alliet, Philippe, Arts, Wim, Bael, An, Cornette, Luc, De Guchtenaere, Ann, De Mulder, Nele, George, Isabel, Henrion, Elisabeth, Keiren, Kirsten, Kreins, Nathalie, Raes, Marc, Philippet, Pierre, Van Overmeire, Bart, Van Winckel, Myriam, Vlieghe, Vinciane, Vandenplas, Yvan
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 16-11-2021; MDPI
• Subjects: Anticoagulants; Babies; Birth; Birth weight; Bleeding; Breastfeeding & lactation; Disease prevention; Dosage; Intravenous administration; Lipids; Literature reviews; Microbiota; Neonates; Newborn babies; Nutrient deficiency; Oral administration; Pediatrics; Phylloquinone; Premature babies; preterm; Prophylaxis; Questionnaires; Review; term; Vitamin K; vitamin K deficiency bleeding; Belgium
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13114109

Neonatal vitamin K prophylaxis is essential to prevent vitamin K deficiency bleeding (VKDB) with a clear benefit compared to placebo. Various routes (intramuscular (IM), oral, intravenous (IV)) and dosing regimens were explored. A literature review was conducted to compare vitamin K regimens on VKDB incidence. Simultaneously, information on practices was collected from Belgian pediatric and neonatal departments. Based on the review and these practices, a consensus was developed and voted on by all co-authors and heads of pediatric departments. Today, practices vary. In line with literature, the advised prophylactic regimen is 1 or 2 mg IM vitamin K once at birth. In the case of parental refusal, healthcare providers should inform parents of the slightly inferior alternative (2 mg oral vitamin K at birth, followed by 1 or 2 mg oral weekly for 3 months when breastfed). We recommend 1 mg IM in preterm <32 weeks, and the same alternative in the case of parental refusal. When IM is perceived impossible in preterm <32 weeks, 0.5 mg IV once is recommended, with a single additional IM 1 mg dose when IV lipids are discontinued. This recommendation is a step towards harmonizing vitamin K prophylaxis in all newborns.