Editorials

Vitamin K at birth

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7051.179 (Published 27 July 1996) Cite this as: BMJ 1996;313:179
  1. Alvin Zipursky
  1. Emeritus professor Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada M5G 1X8

    Haemorrhagic disease of the newborn can be eradicated without risk of leukaemia or cancer

    That all newborn infants are deficient in vitamin K is apparent from their low plasma concentrations of vitamin K and a deficiency of the vitamin K dependent coagulation factors II, VII, IX, and X. This deficiency results in (early) haemorrhagic disease of the newborn in 0.4%-1.7% of babies in the first week of life.1 Late haemorrhagic disease occurs almost exclusively in breast fed infants, from 2 to 12 weeks of age, who did not receive intramuscular vitamin K at birth. The incidence has been reported to vary from 4.4 to 10.5 per 100 000 births.2

    Vitamin K given intramuscularly at a dose of 1.0 mg corrects deficiency, prevents haemorrhagic disease of the newborn, and was standard practice until 1990. But in that year Golding et al reported an increased incidence of leukaemia and cancer in children who had received vitamin K intramuscularly at birth.3 This study, based on observations from the Oxford Survey of Childhood Cancers, was followed by a case-control study at two hospitals in Bristol, showing that the incidence of cancer in children who had received vitamin K at birth was twice that of children who had received either no vitamin K or an oral dose only.4

    Golding et al's conclusions were supported by observations of the potential carcinogenicity of vitamin K. Israels et al reported that the addition of vitamin K to lymphocyte suspensions increased the rate of sister chromatic exchange,5 which correlates with a …

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