Six years' experience of prophylactic oral vitamin K

Aims-The ability of oral vitamin K to eliminate all risk of vitamin K defic iency bleeding during the first three months of life was studied. Methods-Babies (n=182 000) in the north of England judged well enough to be offered milk within 12 hours of birth were given 1 mg of phytomenadione (v itamin K,) suspended in a medium chain triglyceride oil by mouth at deliver y between 1993 and 1998. The parents of those who were breastfed were given a further three doses to give to the baby once every two weeks after disch arge. Results-Four breastfed babies developed late vitamin K deficiency bleeding. In two, staff failed to follow policy guidelines, and in two there was und iagnosed alpha(1) antitrypsin deficiency. Audit suggested that 93% of breas tfed babies had all four doses, as advised. Conclusions-An oral product that parents can administer themselves would be popular if licensed, but the total dose offered may need to be more than i n this study if babies with undiagnosed liver disease are to be protected.