Belgian Consensus Recommendations to Prevent Vitamin K Deficiency Bleeding in the Term and Preterm Infant

Simon Fiesack, Anne Smits, Maissa Rayyan, Karel Allegaert, Philippe Alliet, Wim Arts, An Bael, Luc Cornette, Ann De Guchtenaere, Nele De Mulder, Isabel George, Elisabeth Henrion, Kirsten Keiren, Nathalie Kreins, Marc Raes, Pierre Philippet, Bart Van Overmeire, Myriam Van Winckel, Vinciane Vlieghe, Yvan VandenplasOn Behalf Of The Groups

Research output: Contribution to journalScientific reviewpeer-review

2 Citations (Scopus)
129 Downloads (Pure)


Neonatal vitamin K prophylaxis is essential to prevent vitamin K deficiency bleeding (VKDB) with a clear benefit compared to placebo. Various routes (intramuscular (IM), oral, intravenous (IV)) and dosing regimens were explored. A literature review was conducted to compare vitamin K regimens on VKDB incidence. Simultaneously, information on practices was collected from Belgian pediatric and neonatal departments. Based on the review and these practices, a consensus was developed and voted on by all co-authors and heads of pediatric departments. Today, practices vary. In line with literature, the advised prophylactic regimen is 1 or 2 mg IM vitamin K once at birth. In the case of parental refusal, healthcare providers should inform parents of the slightly inferior alternative (2 mg oral vitamin K at birth, followed by 1 or 2 mg oral weekly for 3 months when breastfed). We recommend 1 mg IM in preterm <32 weeks, and the same alternative in the case of parental refusal. When IM is perceived impossible in preterm <32 weeks, 0.5 mg IV once is recommended, with a single additional IM 1 mg dose when IV lipids are discontinued. This recommendation is a step towards harmonizing vitamin K prophylaxis in all newborns.

Original languageEnglish
Article number4109
Number of pages16
Issue number11
Publication statusPublished - 16 Nov 2021

Bibliographical note

Funding Information:
Groups: Vlaamse Vereniging voor Kindergeneeskunde, Groupement Belge des Pédiatres de Langue Française, Bel-gische Vereniging voor Kindergeneeskunde/Société Belge de Pédiatrie, the Belgian Academy of Paediatrics, Kind en Gezin, Belgische Vereniging Neonatolo-gie/Groupement Belge de Néonatologie.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Copyright 2021 Elsevier B.V., All rights reserved.


  • vitamin K
  • vitamin K deficiency bleeding
  • Term
  • preterm
  • prophylaxis


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