The use of vitamin K in the perinatal period. Fetus and Newborn Committee, Canadian Paediatric Society.

The incidence of hemorrhagic disease of the newborn (HDNB) can be expected to increase in Canada as breast-feeding becomes more popular. There are three clinical patterns of hemorrhagic disease: early HDNB (usually related to maternal drug ingestion), classic HDNB (related to breast-feeding) and late hemorrhagic disease of infancy (related to the combination of breast-feeding and diseases that cause fat malabsorption). Despite the knowledge that the disease can virtually be prevented by the administration of vitamin K, not all newborns are being routinely considered for such treatment. The Canadian Paediatric Society has made several recommendations: (a) women who take drugs that interfere with vitamin K1 metabolism should receive oral doses of vitamin K1 daily for a minimum of 2 weeks before expected delivery; (b) all healthy term infants should receive a single dose of vitamin K1, orally or intramuscularly, within 6 hours after birth; (c) all other newborns, including preterm, low-birthweight and sick infants, should receive a single intramuscular dose of vitamin K1 within 6 hours after birth; and (d) infants at high risk for secondary late-onset hemorrhagic disease due to fat malabsorption should receive vitamin K1 orally every day or intramuscularly once a month.