Which vitamin K preparation for the newborn?

Newborn babies are at risk of bleeding as a result of vitamin K deficiency. Vitamin K supplements given at birth reduce this risk but it is not clear which preparation should be used. Until the early 1990s, it was standard practice to give vitamin K as a single intramuscular injection at birth (Konakion Ampoules 1 mg/0.5 ml-Roche). Studies published in 1990 and 1992 suggested a possible link between intramuscular vitamin K injection and childhood cancers, particularly leukaemias. Our response was to recommend that vitamin K injection be given orally (not then a licensed route) until a licensed oral preparation became available. Such a preparation is now marketed as Konakion MM Paediatric (Roche). In addition, the suggested association between intramuscular vitamin K and cancer has been further investigated. In this article, we update our advice.