Altering recommendations on infants taking vitamin K after birth, including injecting vitamin K, can prevent up to five cases of bleeding a year, according to recommendations from the Committee on Nutrition of the Health Council of the Netherlands.
Current recommendations in the Netherlands are for all infants to receive vitamin K orally immediately after birth. Breast-fed infants receive higher dosages of vitamin K than formula-fed infants, as they are less able to absorb vitamin K and at a greater risk of deficiency and bleeding.
However, some data has shown the increasing the dose of vitamin K does not result in a reduction in the number of bleedings in the breast-fed infants.
New guidance
In light of this data, the Committee on Nutrition of the Health Council of the Netherlands scrutinised the latest evidence and came up with new recommendations for infants.
The committee said it relied on studies from countries abroad, as there wasn’t relevant domestic data.
Studies showed that a single intramuscular administration of vitamin K provides better protection than current Dutch policy, including infants in the ' at risk' group.
A disadvantage noted with oral intake was compliance and that diarrhoea may reduce the absorption of the vitamin, they added.
It also advises adopting the German and Swiss model of oral intake of vitamin K for those not in the at-risk group.
Vitamin K injection
The committee recommends that all breast-fed infants in the Netherlands should switch to a single intramuscular administration of one milligram of vitamin K shortly after birth.
Additionally, the committee recommends offering an oral alternative to parents who do not want to have their child injected.
The recommendation is to take three times two milligrams of vitamin K (at birth, after four to six days and four to six weeks) for breast-feeding infants.
The recommendation for those bottle-fed infants remains the same: one milligram shortly after birth.
The committee said it believes the new recommendations could prevent two to five cases of late vitamin K bleedings a year. The committee also recommended discussing the importance and potential of taking vitamin K during pregnancy.