Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant

Simon Fiesack; Anne Smits; Maissa Rayyan; on behalf of the Groups; Karel Allegaert; Philippe Alliet; Wim Arts; An Bael; Luc Cornette; Ann De Guchtenaere; Nele De Mulder; Isabel George; Elisabeth Henrion; Kirsten Keiren; Nathalie Kreins; Marc Raes; Pierre Philippet; Bart Van Overmeire; Myriam Van Winckel; Vinciane Vlieghe; Yvan Vandenplas

doi:10.3390/nu13114109

Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant

Simon Fiesack, Anne Smits, Maissa Rayyan, on behalf of the Groups, Karel Allegaert, Philippe Alliet, Wim Arts, An Bael, Luc Cornette, Ann De Guchtenaere, Nele De Mulder, Isabel George, Elisabeth Henrion, Kirsten Keiren, Nathalie Kreins, Marc Raes, Pierre Philippet, Bart Van Overmeire, Myriam Van Winckel, Vinciane VliegheYvan Vandenplas^*

^*Corresponding author for this work

Pharmacy

Research output: Contribution to journal › Review article › Academic › peer-review

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Abstract

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.

Original language	English
Article number	4109
Journal	Nutrients
Volume	13
Issue number	11
DOIs	https://doi.org/10.3390/nu13114109
Publication status	Published - 16 Nov 2021

Bibliographical note

Funding Information:
Groups: Vlaamse Vereniging voor Kindergeneeskunde, Groupement Belge des P?diatres de Langue Fran?aise, Bel-gische Vereniging voor Kindergeneeskunde/Soci?t? Belge de P?diatrie, the Belgian Academy of Paediatrics, Kind en Gezin, Belgische Vereniging Neonatolo-gie/Groupement Belge de N?onatologie.

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© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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Belgian Consensus Recommendations to Prevent Vitamin K Deficiency Bleeding in the Term and Preterm InfantFinal published version, 629 KBLicence: CC BY

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Fiesack, S., Smits, A., Rayyan, M., on behalf of the Groups, Allegaert, K., Alliet, P., Arts, W., Bael, A., Cornette, L., De Guchtenaere, A., De Mulder, N., George, I., Henrion, E., Keiren, K., Kreins, N., Raes, M., Philippet, P., Van Overmeire, B., Van Winckel, M., ... Vandenplas, Y. (2021). Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant. Nutrients, 13(11), [4109]. https://doi.org/10.3390/nu13114109

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title = "Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant",

abstract = "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.",

author = "Simon Fiesack and Anne Smits and Maissa Rayyan and {on behalf of the Groups} and Karel Allegaert and Philippe Alliet and Wim Arts and An Bael and Luc Cornette and {De Guchtenaere}, Ann and {De Mulder}, Nele and Isabel George and Elisabeth Henrion and Kirsten Keiren and Nathalie Kreins and Marc Raes and Pierre Philippet and {Van Overmeire}, Bart and {Van Winckel}, Myriam and Vinciane Vlieghe and Yvan Vandenplas",

note = "Funding Information: Groups: Vlaamse Vereniging voor Kindergeneeskunde, Groupement Belge des P?diatres de Langue Fran?aise, Bel-gische Vereniging voor Kindergeneeskunde/Soci?t? Belge de P?diatrie, the Belgian Academy of Paediatrics, Kind en Gezin, Belgische Vereniging Neonatolo-gie/Groupement Belge de N?onatologie. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

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doi = "10.3390/nu13114109",

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Fiesack, S, Smits, A, Rayyan, M, on behalf of the Groups, Allegaert, K, Alliet, P, Arts, W, Bael, A, Cornette, L, De Guchtenaere, A, De Mulder, N, George, I, Henrion, E, Keiren, K, Kreins, N, Raes, M, Philippet, P, Van Overmeire, B, Van Winckel, M, Vlieghe, V & Vandenplas, Y 2021, 'Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant', Nutrients, vol. 13, no. 11, 4109. https://doi.org/10.3390/nu13114109

TY - JOUR

T1 - Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant

AU - Fiesack, Simon

AU - Smits, Anne

AU - Rayyan, Maissa

AU - on behalf of the Groups

AU - Allegaert, Karel

AU - Alliet, Philippe

AU - Arts, Wim

AU - Bael, An

AU - Cornette, Luc

AU - De Guchtenaere, Ann

AU - De Mulder, Nele

AU - George, Isabel

AU - Henrion, Elisabeth

AU - Keiren, Kirsten

AU - Kreins, Nathalie

AU - Raes, Marc

AU - Philippet, Pierre

AU - Van Overmeire, Bart

AU - Van Winckel, Myriam

AU - Vlieghe, Vinciane

AU - Vandenplas, Yvan

N1 - Funding Information: Groups: Vlaamse Vereniging voor Kindergeneeskunde, Groupement Belge des P?diatres de Langue Fran?aise, Bel-gische Vereniging voor Kindergeneeskunde/Soci?t? Belge de P?diatrie, the Belgian Academy of Paediatrics, Kind en Gezin, Belgische Vereniging Neonatolo-gie/Groupement Belge de N?onatologie. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021/11/16

Y1 - 2021/11/16

N2 - 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.

AB - 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.

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U2 - 10.3390/nu13114109

DO - 10.3390/nu13114109

M3 - Review article

AN - SCOPUS:85119017838

SN - 2072-6643

VL - 13

JO - Nutrients

JF - Nutrients

IS - 11

M1 - 4109

ER -

Belgian consensus recommendations to prevent vitamin k deficiency bleeding in the term and preterm infant

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