This is the current release of the guideline.

American Academy of Pediatrics (AAP) Policies are reviewed every 3 years by the authoring body, at which time a recommendation is made that the policy be retired, revised, or reaffirmed without change. Until the Board of Directors approves a revision or reaffirmation, or retires a statement, the current policy remains in effect.

• Early vitamin K deficiency bleeding (formerly known as classic hemorrhagic disease of the newborn)
• Late vitamin K deficiency bleeding

Prevention

Family Practice
Pediatrics
Preventive Medicine

Physicians

To present updated recommendations for the use of vitamin K in the prevention of early and late vitamin K deficiency bleeding

All newborns, particularly newborns who are breastfed exclusively

Intramuscular vitamin K₁ administration

• Rate of late vitamin K deficiency bleeding
• Relationship between newborn parenteral administration of vitamin K and incidence of childhood cancer

Searches of Electronic Databases

Not stated

Not stated

Not stated

Not applicable

Review

Not stated

Not stated

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

Peer Review

Not stated

Because parenteral vitamin K has been shown to prevent vitamin K deficiency bleeding (VKDB) of the newborn and young infant and the risks of cancer have been unproven, the American Academy of Pediatrics recommends the following:

1. Vitamin K₁ should be given to all newborns as a single, intramuscular dose of 0.5 to 1 mg (American Academy of Pediatrics, American College of Obstetricians and Gynecologists, 1992).
2. Additional research should be conducted on the efficacy, safety, and bioavailability of oral formulations and optimal dosing regimens of vitamin K to prevent late vitamin K deficiency bleeding.
3. Health care professionals should promote awareness among families of the risks of late vitamin K deficiency bleeding associated with inadequate vitamin K prophylaxis from current oral dosage regimens, particularly for newborns who are breastfed exclusively.

None provided

The type of evidence supporting each recommendation is not specifically stated.

Appropriate use of vitamin K in the prevention of early and late vitamin K deficiency bleeding

Some earlier studies attempted to show an association between intramuscular vitamin K administration and increased incidence of childhood cancer, but more recent studies failed to substantiate this concern.

The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

An implementation strategy was not provided.

Staying Healthy

Effectiveness

Not applicable: The guideline was not adapted from another source.

2003 Jul

American Academy of Pediatrics - Medical Specialty Society

American Academy of Pediatrics

Committee on Fetus and Newborn

Committee on Fetus and Newborn, 2002-2003: Lillian Blackmon, MD, Chairperson; Daniel G. Batton, MD; Edward F. Bell, MD; William A. Engle, MD; William P. Kanto, Jr, MD; Gilbert I. Martin, MD; Warren Rosenfeld, MD; Ann R. Stark, MD

*Carol A. Miller, MD Past Committee Member

Liaisons: Keith J. Barrington, MD, Canadian Paediatric Society; Tonse Raju, MD, DCH, National Institutes of Health; Laura E. Riley, MD, American College of Obstetricians and Gynecologists; Kay M. Tomashek, MD, Centers for Disease Control and Prevention; Carol Wallman, MSN, RNC, NNP, National Association of Neonatal Nurses

Staff: Jim Couto, MA

*Lead author

Not stated

This is the current release of the guideline.

American Academy of Pediatrics (AAP) Policies are reviewed every 3 years by the authoring body, at which time a recommendation is made that the policy be retired, revised, or reaffirmed without change. Until the Board of Directors approves a revision or reaffirmation, or retires a statement, the current policy remains in effect.

None available

None available

This NGC summary was completed by ECRI on February 19, 2004. The information was verified by the guideline developer on March 29, 2004.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Permissions Editor, American Academy of Pediatrics (AAP), 141 Northwest Point Blvd, Elk Grove Village, IL 60007.