PEDIATRIC PHARMACOTHERAPY A Monthly Newsletter for Health Care Professionals from the Children’s Medical Center at the University of Virginia

he prevention of vitamin K-deficiency bleeding (VKDB) in infancy remains a worldwide concern. The condition was initially termed "hemorrhagic disease of the newborn" by Townsend in 1894 to describe 50 infants he observed with bleeding within the first two weeks of life. The relationship between bleeding in early infancy and vitamin K deficiency, however, was not established until much later. In their 1952 landmark study of over 33,000 infants, Dam and colleagues showed that vitamin K administered in the perinatal period could prevent hypoprothrombinemia. Determination of the optimal method for administering vitamin K took several additional years. In 1961, the American Academy of Pediatrics began recommending routine prophylaxis with 0.5 to 1 mg dose of vitamin K given intramuscularly (IM) as a single dose within an hour of delivery to prevent VKDB. That initial recommendation remains unchanged forty years later.