


This has not been a problem when vitamin K1 is given in normal therapeutic doses (0.5 - 1mg). The effect was particularly seen in premies, though it was also present - albeit to a lesser degree - in term infants. Vitamin K1 has been associated with hyperbilirubinemia only in extremely high doses (25 – 30mg). We now give infants vitamin K1 (phytonadione). As a result, use of this form of vitamin K was abandoned. There were reports of hemolytic anemia and hyperbilirubinemia severe enough to cause kernicterus in the mid 1950s with high doses (50mg) of vitamin K2 (menadione).There is good consensus among experts that IM vitamin K prophylaxis is safe and is not associated with childhood cancer.Only one other study (aside from 1992 paper from the same author) suggested a possible association between vitamin K and the risk of ALL. Many studies since then in Europe and in US have refuted this claim and found no association between the two.One study published in the British Medical Journal in 1990 raised this concern, suggesting that the risk of cancer was doubled in babies who received vitamin K at birth.maternal vitamin K supplements of 5mg/day (800% RDA) has been shown in one study to raise infant serum levels to near formula-fed levels, but there is no FDA approved multi-vitamin that contains this amount of vitamin K.maternal dietary changes have little effect on overall vitamin K status of newborn.since multiple doses are required, compliance is an issue with all oral regimens.Failures have not been reported with IM prophylaxis. in countries that have gone to PO prophylaxis, failures (even with good compliance) have been reported.Some have given infants the injectible liquid by mouth, but this is an unstudied intervention - there is no safety or effectiveness data available.

there is no licensed PO form in the US.2mg PO vitamin K after first feeding then 2mg within first week followed by 25mcg daily for 13 weeks.2 – 4mg PO vitamin K after first feeding then 2mg within first week and weekly while breastfeeding.2 – 4mg PO vitamin K after first feeding then 2mg at 2 – 4 weeks and again at 6 – 8 weeks.
