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

Research output: Contribution to journalReview articleAcademicpeer-review

4 Citations (Scopus)
203 Downloads (Pure)

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 languageEnglish
Article number4109
JournalNutrients
Volume13
Issue number11
DOIs
Publication statusPublished - 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.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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