Oral Vitamin K Prophylaxis in Newborns: A Survey of Clinician Opinions and Practices

Abstract

OBJECTIVES: The majority of newborns in the United States receive intramuscular (IM) vitamin K for prophylaxis against vitamin K deficiency bleeding (VKDB). Oral vitamin K is less effective than IM vitamin K in preventing VKDB but is widely used in Europe and by some in the United States when parents refuse IM vitamin K for their newborn. Our aim was to assess the practices, opinions, and knowledge of newborn clinicians regarding oral vitamin K prophylaxis when parents refuse IM vitamin K. METHODS: We conducted an electronic survey of newborn clinicians from 3 academic medical centers in California, Iowa, and Connecticut. Descriptive statistics and χ2 tests were performed. RESULTS: Of 160 newborn clinicians at 3 sites, 110 (69%) completed the survey. Of respondents, 58 (53%) believed the incidence of IM vitamin K refusal is increasing and had prescribed or recommended oral vitamin K at least once. Regarding knowledge, 32 (28%) and 23 (20%) respondents did not know whether oral vitamin K decreases the risk of early- and late-onset VKDB, respectively. There were no significant differences in opinions, knowledge, or practices across institutions or practice settings (NICU, well-newborn nursery, or both) (P > .05). CONCLUSIONS: Our study findings suggest that newborn clinicians may lack knowledge about the effectiveness of oral vitamin K in preventing VKDB. More information is needed about oral vitamin K regimens and outcomes of newborns who receive oral vitamin K.