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The vitamin K debacle: cut the Gordian knot
  1. JOHN H TRIPP, Senior Lecturer in Child Health,
  1. Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
    1. ANDREW W MCNINCH, Consultant Paediatrician, Department of Child Health
    1. Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK

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      Editor,—In his letter1 about our annotation on vitamin K,2 Dr Williams questions the incidence quoted for vitamin K deficiency bleeding among babies given no prophylaxis. We thank him for drawing our attention to what was a typographical error [on our part]. The incidence of vitamin K deficiency bleeding should have read 10/100 000 live births. There was an additional error: the manufacturer of Orakay is BMS Laboratories, Beverley, Yorkshire, UK. We apologise for relying on an older Department of Health recommendation for vitamin supplementation.3

      We remain of the opinion that recommending breast feeding mothers to provide vitamin supplements to their infants is unlikely to reduce breast feeding rates; it has not in the Netherlands (Visser H, personal communication). Most mothers are aware that formula feeds contain supplements and accept vitamin K prophylaxis. We do not state that 25 μg vitamin K is “safe”, meaning that it is proved beyond reasonable doubt to be fully effective with no adverse effects—that cannot be claimed for any regimen. We argue that this regimen is logical and practical. There are theoretical reasons to believe (and some reports confirm) that it is more effective than current UK regimens and, in relation to vitamin K, it should be no less safe than formula feeding. We are faced with a dilemma—no proposed solution is perfect, but we need a better policy than we have at present.

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