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Re: Vitamin K for Preterm Infants

Dear Editor,

I enjoyed Dr Leaf’s succinct review on vitamins for infants and young children [1].

I offer one minor correction: contrary to what is stated in the article, the Department of Health has never made any specific recommendation for vitamin K dosage in preterm infants, either in the 1998 letter of the Chief Medical and Nursing Officers [2] or, to my knowledge, at any other time.

The quoted dose of 0.4mg/kg would appear to be an empirical one recommended by the manufacturers of Konakion MM (Roche UK Ltd) and is not evidence based. Fortuitously, however, it appears not to be far off the mark as a suitable prophylactic vitamin K dose for preterm infants. Our recent work suggests that an intramuscular dose of 0.3mg/kg (as recommended by the American Academy of Pediatrics for infants of <1000g [3]) is an adequate prophylactic dose to protect preterm infants of <32 weeks’ gestation against vitamin K deficiency bleeding in the neonatal period [4].

Yours sincerely,

Dr Paul Clarke

References:

[1] Leaf AA; RCPCH Standing Committee on Nutrition. Vitamins for babies and young children. Arch Dis Child. 2007; 92: 160-4.

[2] Department of Health. Vitamin K for newborn babies. London: HMSO, 1998. (PL/CMO(98)3, PL/CNO/98/4). Available at: http://www.dh.gov.uk/ assetRoot/04/01/33/98/04013398.pdf [Accessed 2nd February 2007]

[3] American Academy of Pediatrics. Nutritional needs of preterm infants. In: American Academy of Pediatrics Committee on Nutrition. Pediatric Nutrition Handbook. 5th ed., Elk Grove Village, IL: American Academy of Pediatrics; 2004: 350-1.