One dose of vitamin K reduced clinical bleeding at 1 - 7 days , including bleeding after circumcision , and improved biochemical indices of coagulation status .
There was no evidence of a difference between the oral and intramuscular route in effects on biochemical indices of coagulation status .
REVIEW ER 'S CONCLUSIONS A single dose ( 1.0 mg ) of intramuscular vitamin K after birth is effective in the prevention of classic HDN .
Either intramuscular or oral ( 1.0 mg ) vitamin K prophylaxis improves biochemical indices of coagulation status at 1 - 7 days .
Neither intramuscular nor oral vitamin K has been tested in r and omized trials with respect to effect on late HDN .
Oral vitamin K , either single or multiple dose , has not been tested in r and omized trials for its effect on either classic or late HDN
BACKGROUND  Vitamin K deficiency can cause bleeding in an infant in the first weeks of life .
This is known as Hemorrhagic Disease of the Newborn ( HDN ) .
HDN is divided into three categories : early , classic and late HDN .
Early HDN occurs within 24 hours post partum and falls outside the scope of this review .
Classic HDN occurs on days one to seven ; common bleeding sites are gastrointestinal , cutaneous , nasal and from a circumcision .
Late HDN occurs from week 2 - 12 ; the most common bleeding sites are intracranial , cutaneous , and gastrointestinal .
Vitamin K is commonly given prophylactically after birth for the prevention of HDN , but the preferred route is uncertain .
OBJECTIVES To review the evidence from r and omized trials in order to determine the effectiveness of vitamin K prophylaxis in the prevention of classic and late HDN .
Main questions are : Is one dose of vitamin K , given after birth , able to significantly reduce the incidence of classic and late HDN ?
Is there a significant difference between the oral route and the intramuscular route in preventing classic and late HDN ?
Are multiple oral doses of vitamin K , given after birth , able to significantly reduce the incidence of classic and late HDN ?
Prevention of vitamin K deficiency bleeding: efficacy of different multiple oral dose schedules of vitamin K
Abstract There is consensus that  late vitamin K deficiency bleeding ( VKDB )  should be prevented by vitamin K prophylaxis . One single dose of 1 mg vitamin K1 is effective if given i.m . or s.c . , but not if given orally . Repeated oral doses might be as effective as the parenteral dose but the optimal dose regimen remains to be established . Different oral dose schedules are presently used in different countries . In Australia , Germany , The Netherl and s and Switzerl and active surveillance data on late VKDB were collected in a similar manner and failure rates compared . Identical case definitions were used . There were three basic strategies for oral and one for parenteral vitamin K prophylaxis for healthy newborns in the four countries : ( 1 ) daily supplementation of low dose vitamin K ( 25 μg ) for breast-fed infants ( The Netherl and s ) ; ( 2 ) 3 × 1 mg orally [ Australia ( January 1993 – March 1994 ) and Germany ( December 1992 – December 1994 ) ] ; ( 3 ) 1 mg vitamin K i.m . ( Australia since March 1994 ) ; and ( 4 ) 2 × 2 mg vitamin K ( new mixed micellar preparation ) ( Switzerl and ) . The respective failure rates per 100,000 live births ( including cases given all recommended doses and those given incomplete prophylaxis ) were for strategy : ( 1 ) 0.2 ( 0–1.3 ) in The Netherl and s ; ( 2 ) 2.3 ( 95 % CI 1.6–3.4 ) in Germany and 2.5 ( 1.1–4.8 ) in Australia ( oral prophylaxis ) ; ( 3 ) Australia ( i.m . prophylaxis ) 0 ( 0–0.9 ) ; and ( 4 ) 3.6 ( 0.7–10.6 ) in Switzerl and . The failure rates for complete prophylaxis only were : strategy ( 1 ) 0 ( 0–0.7 ) in The Netherl and s ; ( 2 ) 1.8 ( 1.1–2.8 ) in Germany and 1.5 ( 0.5–3.6 ) in Australia ; ( 3 ) Australia ( i.m . ) 0 ( 0–0.9 ) ; and ( 4 ) 1.2 ( 0–6.5 ) in Switzerl and . Conclusions The Australian data confirm that three oral doses of 1 mg vitamin K are less effective than i.m . vitamin K prophylaxis . A daily low oral dose of 25 μg vitamin K1 following an initial oral dose of 1 mg after birth for exclusively breast-fed infants may be as effective as parenteral vitamin K prophylaxis . The effectiveness of the “ mixed-micellar ” preparation of vitamin K1 needs further study
One dose of vitamin K reduced clinical bleeding at 1 - 7 days , including bleeding after circumcision , and improved biochemical indices of coagulation status .
There was no evidence of a difference between the oral and intramuscular route in effects on biochemical indices of coagulation status .
REVIEW ER 'S CONCLUSIONS A single dose ( 1.0 mg ) of intramuscular vitamin K after birth is effective in the prevention of classic HDN .
Either intramuscular or oral ( 1.0 mg ) vitamin K prophylaxis improves biochemical indices of coagulation status at 1 - 7 days .
Neither intramuscular nor oral vitamin K has been tested in r and omized trials with respect to effect on late HDN .
Oral vitamin K , either single or multiple dose , has not been tested in r and omized trials for its effect on either classic or late HDN
BACKGROUND  Vitamin K deficiency can cause bleeding in an infant in the first weeks of life .
This is known as Hemorrhagic Disease of the Newborn ( HDN ) .
HDN is divided into three categories : early , classic and late HDN .
Early HDN occurs within 24 hours post partum and falls outside the scope of this review .
Classic HDN occurs on days one to seven ; common bleeding sites are gastrointestinal , cutaneous , nasal and from a circumcision .
Late HDN occurs from week 2 - 12 ; the most common bleeding sites are intracranial , cutaneous , and gastrointestinal .
Vitamin K is commonly given prophylactically after birth for the prevention of HDN , but the preferred route is uncertain .
OBJECTIVES To review the evidence from r and omized trials in order to determine the effectiveness of vitamin K prophylaxis in the prevention of classic and late HDN .
Main questions are : Is one dose of vitamin K , given after birth , able to significantly reduce the incidence of classic and late HDN ?
Is there a significant difference between the oral route and the intramuscular route in preventing classic and late HDN ?
Are multiple oral doses of vitamin K , given after birth , able to significantly reduce the incidence of classic and late HDN ?