A survey was distributed among new breastfeeding mothers in northern England to gain insight into their experiences with different forms of neonatal vitamin K prophylaxis. Two-thirds of mothers were knowledgeable about the reasons for giving vitamin K and a quarter felt that they had not received adequate information on the subject. The importance of neonatal vitamin K prophylaxis must be fully explained by healthcare workers to all expectant parents

Haining, Shona

Howlett, Helen

Limerick, Siobhan

Matthias Strehle, Eugen

Norman, Justine

English

Northumbria University Research Portal

Northumbria Research LinkCitation: Matthias Strehle, Eugen, Limerick, Siobhan, Howlett, Helen, Haining, Shona and Norman, Justine (2014) A vitamin K prophylaxis survey among breastfeeding mothers. Infant, 10 (6). pp. 182-183. ISSN 1745-1205 Published by: Stansted News LimitedURL: http://www.infantjournal.co.uk/journal.html <http://www.infantjournal.co.uk/journal.html>This version was downloaded from Northumbria Research Link: http://nrl.northumbria.ac.uk/42553/Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University’s research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners.  Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any  format or medium without formal permission of the copyright holder.  The full policy is available online: http://nrl.northumbria.ac.uk/pol  i cies.html  This  document  may differ  from the  final,  published version of  the research  and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher’s website (a subscription may be required.)                        182                                                                                                                                                                                          V O L U M E  1 0  I S S U E  6   2 0 1 4 infantS U R V E Y © 2014 SNL All rights reserved During the last century, great progresshas been made regarding theprevention and treatment of infantilevitamin K deficiency bleeding (VKDB).1While there is consensus that everynewborn would benefit from prophylacticvitamin K, this goal has not been achievedglobally due to lack of resources in someregions. One milligram of vitamin K givenintramuscularly at birth is considered thesafest and most effective way to preventVKDB,2 however, other forms of vitamin Kprophylaxis have been explored.3,4The authors previously reported a surveyamong midwives on the tolerability andacceptability of an oral vitamin K regimen.It consisted of oral phytomenadione(Konakion MM Paediatric 1mg or Neokaycapsule 1mg) for all healthy infants,followed by Neokay drops 50μg daily forthree months for breastfed infants only.Preterm and sick infants received 0.5mgKonakion MM Paediatric intramuscularly.5This vitamin K policy has been successfullyimplemented in this hospital trust andneighbouring NHS Trusts forapproximately five years. For the currentstudy, which covered a larger population inthe north east of England, a cohort ofbreastfeeding mothers was asked directlyabout their general knowledge and viewson vitamin K prophylaxis and about thespecific regimen of vitamin K used in theirnewborn infant.MethodsThis project, conducted as part of a localchild health service improvementprogramme, consisted of an anonymous,voluntary, cross-sectional parent survey.Formal ethics approval was not required;A vitamin K prophylaxis survey amongbreastfeeding mothers A survey was distributed among new breastfeeding mothers in northern England to gain insightinto their experiences with different forms of neonatal vitamin K prophylaxis. Two-thirds ofmothers were knowledgeable about the reasons for giving vitamin K and a quarter felt that theyhad not received adequate information on the subject. The importance of neonatal vitamin Kprophylaxis must be fully explained by healthcare workers to all expectant parents.Eugen-Matthias Strehle1,2Consultant Paediatricianstrehle@doctors.org.ukSiobhan Limerick1,3Research MidwifeHelen Howlett1Research MidwifeShona Haining4Senior Research and Development ManagerJustine Norman3General Practitioner1Northumbria Healthcare NHS FoundationTrust2The Medical School, Newcastle University3 49 Marine Avenue Surgery, Whitley Bay 4NHS North of England CommissioningSupport, NewcastleKeywordsbreastfeeding; vitamin K deficiencybleeding; vitamin K prophylaxisKey pointsStrehle E.M., Limerick S., Howlett H.,Haining S., Norman J. A vitamin Kprophylaxis survey among breastfeedingmothers. Infant 2014; 10(6): 182-83.1. Appropriate vitamin K prophylaxisprevents most cases of vitamin Kdeficiency bleeding, which is morecommon in breastfed infants.2. Healthcare staff and new parentsshould be given more detailedinformation about the reasons forgiving vitamin K to every neonate.however, the survey was registered with theResearch Departments of NHS North ofTyne and Northumbria Healthcare NHSFoundation Trust. A four-page question-naire was drafted, consisting of anintroductory paragraph and 25 fixed-alternative and open-ended questions.6During a nine-month period, 150questionnaires were distributed to newparents via 11 GP surgeries and fivebreastfeeding support groups, which werespread across the region. In addition,hospital databases were searched fornumbers of deliveries and breastfeedingrates. The total population of the studyarea was approximately 800,000.ResultsDuring the study period, 6,892 infantswere born in the region and 2,826 of them(41%) were breastfed at 6-8 weeks of age.In all, 63 breastfeeding mothers returnedthe completed questionnaire, giving aresponse rate of 42%. ■ 61 mothers (97%) were educated in theUK and of European origin. ■ 16 mothers (25%) received standardschool education (GCSE or A Level) and47 (75%) graduated from higher educa-tion, for instance with a university degree. ■ The women were divided into age ranges:- 20-29 years (16; 25%)- 30-39 years (45; 72%) - >40 years (2; 3%) ■ The male to female ratio of the newborninfants was 0.8 (28 boys, 35 girls). ■ 41 mothers (65%) were primiparas; 16(25%) had two children; five (8%) hadthree children and one (2%) had four. ■ 59 infants (94%) received vitamin K pro-phylaxis at birth. S U R V E YV O L U M E  1 0  I S S U E  6   2 0 1 4                                                                                                                                                                                                                           183infantThe reasons for the four infants who didnot receive vitamin K prophylaxis at birthwere given as parental choice (2; 3%) andnot having been offered by healthcare staff(2; 3%). Vitamin K was administered at birthorally to 48 neonates (81%) and intra-muscularly to 11 (19%). The importanceof supplementing the vitamin K stores ofnewborn infants was explained to 50mothers (79%) during or after their preg-nancy, whereas 13 mothers (21%) were notgiven this information or did not recall it. Forty women (63%) had some under-standing of why vitamin K prophylaxis wasgiven, eg ‘helps with blood clotting’ or‘prevents bleed in brain’. The other 23(37%) gave an incorrect or no answer.Only 37 parents (59%) reported receiving aleaflet containing details about vitamin K. Forty-five infants out of 48 (94%) wereissued with one bottle of vitamin K dropsto be taken daily for three months afterdischarge from hospital. All 45 mothersforgot to give vitamin K occasionally:■ 20 (44%) on less than five days■ 5 (12%) on 5-10 days ■ 20 (44%) on >10 days. Thirty-seven mothers (82%) found theoral preparation easy to administer. Eightwomen (18%) stated that remembering togive it was a problem or that their infantspat it out. The 18 infants (28%) that were not givendrops to take home included those injectedwith vitamin K intramuscularly and thosewhose parents declined prophylaxis. Almost three-quarters (46) of surveyedmothers (73%) intended to exclusivelybreastfeed for a period of 6-12 months.The majority of children were less thanone year of age and none of them hadsuffered a serious illness since birth (birthdates were not provided in this anonymoussurvey). A significant proportion of women (16;25%) felt that they had not been givensufficient information regarding vitamin Kprophylaxis. Ten out of 11 mothers (91%)whose infants had received intramuscularvitamin K were overall satisfied with thisform of preventative treatment.Acceptability and tolerability of the oralvitamin K supplement among the studiedwomen and children was similarly high (45out of 48; 94%). However, some motherswould have preferred a better tasting oralsolution that could be given less frequently(weekly or monthly) or an injection forconvenience and to increase compliance.communication processes of parents andstaff on a NICU emphasised theimportance of good communicationbetween health professionals and families.13A number of parents preferred to receivemedical information from doctors directly,implying that family physicians andobstetricians as well as midwives, have arole to play in educating parents accordingto national recommendations.The majority of breastfeeding mothersin this survey were white primiparas intheir thirties who had higher qualifications.To obtain a bigger picture, studies similarto this one should be performed indifferent regions, including mothers ofbreastfed and formula-fed infants.References1. Strehle E.M. Vitamin K deficiency and its preventionand treatment in infants. In: Watson R.R. et al. (eds).Nutrition in Infancy, Volume 1. New York: SpringerScience and Business Media;2013:429-39.2. CDC. Notes from the field: late vitamin K deficiencybleeding in infants whose parents declined vitaminK prophylaxis – Tennessee, 2013. Morb Mortal WklyRep 2013;62:901-02.3. Ipema H.J. Use of oral vitamin K for prevention oflate vitamin K deficiency bleeding in neonates wheninjectable vitamin K is not available. AnnPharmacother 2012;46:879-83.4. Busfield A., Samuel R., McNinch A., Tripp J.H.Vitamin K deficiency bleeding after NICE guidanceand withdrawal of Konakion Neonatal. Arch DisChild 2013,98:41-47.5. Strehle E.M., Howey C., Jones R. Evaluation of theacceptability of a new oral vitamin K prophylaxis forbreastfed infants. Acta Paediatr 2010;99:379-83.6. Abramson J.H., Abramson Z.H. Research Methods inCommunity Medicine. 6th ed. Chichester, UK: JohnWiley 2008. 7. Office for National Statistics. Ethnicity and NationalIdentity in England and Wales 2011. Newport: ONS;2012.8. Bansal N., Chalmers J.W., Fischbacher C.M. et al.Ethnicity and first birth: age, smoking, delivery,gestation, weight and feeding. Eur J Public Health2014 doi: 10.1093/eurpub/cku059. 9. Mathews M.E., Leerkes E.M., Lovelady C.A., LabbanJ.D. Psychosocial predictors of primiparousbreastfeeding initiation and duration. J Hum Lact2014;30:480-87. 10. British National Formulary for Children. Vitamin K[Online] Available from: www.medicinescomplete.com/mc/bnf/current/ PHP6277-vitamin-k.htm[Accessed 27 October 2014].11. Busfield A., McNinch A., Tripp J. Neonatal vitamin Kprophylaxis in Great Britain and Ireland: the impactof perceived risk and product licensing oneffectiveness. Arch Dis Child 2007;92:754-58.12. Gosai S., Broadbent R.S., Barker D.P. et al. Medicaland midwifery attitudes towards vitamin Kprophylaxis in New Zealand neonates. J PaediatrChild Health 2014;50:536-39.13. Wigert H., Dellenmark M.B., Bry K. Strength andweaknesses of parent-staff communication in theNICU: a survey assessment. BMC Pediatr2013;13:71.DiscussionFor this survey, 63 new breastfeedingmothers were asked about their opinionson vitamin K prophylaxis. Their whiteBritish background was fairly typical forthis region of England where ethnicminorities account for approximately 5%of the population.7 The observation seenhere, that breastfeeding mothers tend to beolder and better educated than the averagenew mother, is confirmed by two recentlarge studies from Scotland and the USA.8,9The Chief Medical and Nursing Officersof the UK have advised that vitamin K isgiven intramuscularly or orally to allneonates.10 Injections are more effective butalso more distressing, whereas the mainissue with repeated oral supplementation isa lack of compliance. In the studypresented here, four in every five childrenreceived vitamin K orally and one in five,by injection. This result differs from thenational figures, reported in a survey of230 maternity units in Great Britain andIreland: 60% administered vitamin Kintramuscularly, 24% orally and 16% gavethe parents a choice.11According to this relatively small survey,prophylactic vitamin K was not given tofour out of 63 infants (6%), which isconcerning. The daily vitamin Krequirement for infants below six monthsof age is 10μg. Formula-fed infantstypically receive 50μg vitamin K daily butbreastfed infants only 1μg daily.5 Thisexplains why VKDB is more common inbreastfed infants who are notsupplemented.4Although overall satisfaction of theparticipating mothers with the respectivevitamin K prophylaxis was >90%, thissurvey revealed several areas forimprovement: ■ One third of women did not have ade-quate knowledge about vitamin K and itsimportance for blood clotting ■ At least 20% stated that they were notprovided with such information duringpregnancy ■ 40% did not receive written information. Recently, doctors and midwives in NewZealand were interviewed regarding theirattitudes towards prophylactic vitamin K.12It was found that a significant proportionof midwives did not feel the need to givevitamin K to all newborn infants. Thisdemonstrates a knowledge gap that mustbe closed as it has consequences for parenteducation. A large survey investigating the

A vitamin K prophylaxis survey among breastfeeding mothers

Northumbria Research Link

Northumbria Research Link
Citation: Matthias Strehle, Eugen, Limerick, Siobhan, Howlett, Helen, Haining, Shona and Norman, 
Justine (2014) A vitamin K prophylaxis survey among breastfeeding mothers. Infant, 10 (6). pp. 182-
183. ISSN 1745-1205 
Published by: Stansted News Limited
URL: http://www.infantjournal.co.uk/journal.html <http://www.infantjournal.co.uk/journal.html>
This version was downloaded from Northumbria Research Link: http://nrl.northumbria.ac.uk/42553/
Northumbria University has developed Northumbria Research Link (NRL) to enable users to access 
the University’s research output. Copyright © and moral rights for items on NRL are retained by the 
individual author(s) and/or other copyright owners.  Single copies of full items can be reproduced, 
displayed or performed, and given to third parties in any format or medium for personal research or 
study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, 
title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata 
page. The content must not be changed in any way. Full items must not be sold commercially in any  
format or medium without formal permission of the copyright holder.  The full policy is available online: 
http://nrl.northumbria.ac.uk/pol  i cies.html  
This  document  may differ  from the  final,  published version of  the research  and has been made 
available online in accordance with publisher policies. To read and/or cite from the published version 
of the research, please visit the publisher’s website (a subscription may be required.)
                        
182                                                                                                                                                                                          V O L U M E  1 0  I S S U E  6   2 0 1 4 infant
S U R V E Y © 2014 SNL All rights reserved 
During the last century, great progresshas been made regarding the
prevention and treatment of infantile
vitamin K deficiency bleeding (VKDB).1
While there is consensus that every
newborn would benefit from prophylactic
vitamin K, this goal has not been achieved
globally due to lack of resources in some
regions. One milligram of vitamin K given
intramuscularly at birth is considered the
safest and most effective way to prevent
VKDB,2 however, other forms of vitamin K
prophylaxis have been explored.3,4
The authors previously reported a survey
among midwives on the tolerability and
acceptability of an oral vitamin K regimen.
It consisted of oral phytomenadione
(Konakion MM Paediatric 1mg or Neokay
capsule 1mg) for all healthy infants,
followed by Neokay drops 50μg daily for
three months for breastfed infants only.
Preterm and sick infants received 0.5mg
Konakion MM Paediatric intramuscularly.5
This vitamin K policy has been successfully
implemented in this hospital trust and
neighbouring NHS Trusts for
approximately five years. For the current
study, which covered a larger population in
the north east of England, a cohort of
breastfeeding mothers was asked directly
about their general knowledge and views
on vitamin K prophylaxis and about the
specific regimen of vitamin K used in their
newborn infant.
Methods
This project, conducted as part of a local
child health service improvement
programme, consisted of an anonymous,
voluntary, cross-sectional parent survey.
Formal ethics approval was not required;
A vitamin K prophylaxis survey among
breastfeeding mothers 
A survey was distributed among new breastfeeding mothers in northern England to gain insight
into their experiences with different forms of neonatal vitamin K prophylaxis. Two-thirds of
mothers were knowledgeable about the reasons for giving vitamin K and a quarter felt that they
had not received adequate information on the subject. The importance of neonatal vitamin K
prophylaxis must be fully explained by healthcare workers to all expectant parents.
Eugen-Matthias Strehle1,2
Consultant Paediatrician
strehle@doctors.org.uk
Siobhan Limerick1,3
Research Midwife
Helen Howlett1
Research Midwife
Shona Haining4
Senior Research and Development Manager
Justine Norman3
General Practitioner
1Northumbria Healthcare NHS Foundation
Trust
2The Medical School, Newcastle University
3 49 Marine Avenue Surgery, Whitley Bay 
4NHS North of England Commissioning
Support, Newcastle
Keywords
breastfeeding; vitamin K deficiency
bleeding; vitamin K prophylaxis
Key points
Strehle E.M., Limerick S., Howlett H.,
Haining S., Norman J. A vitamin K
prophylaxis survey among breastfeeding
mothers. Infant 2014; 10(6): 182-83.
1. Appropriate vitamin K prophylaxis
prevents most cases of vitamin K
deficiency bleeding, which is more
common in breastfed infants.
2. Healthcare staff and new parents
should be given more detailed
information about the reasons for
giving vitamin K to every neonate.
however, the survey was registered with the
Research Departments of NHS North of
Tyne and Northumbria Healthcare NHS
Foundation Trust. A four-page question-
naire was drafted, consisting of an
introductory paragraph and 25 fixed-
alternative and open-ended questions.6
During a nine-month period, 150
questionnaires were distributed to new
parents via 11 GP surgeries and five
breastfeeding support groups, which were
spread across the region. In addition,
hospital databases were searched for
numbers of deliveries and breastfeeding
rates. The total population of the study
area was approximately 800,000.
Results
During the study period, 6,892 infants
were born in the region and 2,826 of them
(41%) were breastfed at 6-8 weeks of age.
In all, 63 breastfeeding mothers returned
the completed questionnaire, giving a
response rate of 42%. 
■ 61 mothers (97%) were educated in the
UK and of European origin. 
■ 16 mothers (25%) received standard
school education (GCSE or A Level) and
47 (75%) graduated from higher educa-
tion, for instance with a university degree. 
■ The women were divided into age ranges:
- 20-29 years (16; 25%)
- 30-39 years (45; 72%) 
- >40 years (2; 3%) 
■ The male to female ratio of the newborn
infants was 0.8 (28 boys, 35 girls). 
■ 41 mothers (65%) were primiparas; 16
(25%) had two children; five (8%) had
three children and one (2%) had four. 
■ 59 infants (94%) received vitamin K pro-
phylaxis at birth. 
S U R V E Y
V O L U M E  1 0  I S S U E  6   2 0 1 4                                                                                                                                                                                                                           183infant
The reasons for the four infants who did
not receive vitamin K prophylaxis at birth
were given as parental choice (2; 3%) and
not having been offered by healthcare staff
(2; 3%). 
Vitamin K was administered at birth
orally to 48 neonates (81%) and intra-
muscularly to 11 (19%). The importance
of supplementing the vitamin K stores of
newborn infants was explained to 50
mothers (79%) during or after their preg-
nancy, whereas 13 mothers (21%) were not
given this information or did not recall it. 
Forty women (63%) had some under-
standing of why vitamin K prophylaxis was
given, eg ‘helps with blood clotting’ or
‘prevents bleed in brain’. The other 23
(37%) gave an incorrect or no answer.
Only 37 parents (59%) reported receiving a
leaflet containing details about vitamin K. 
Forty-five infants out of 48 (94%) were
issued with one bottle of vitamin K drops
to be taken daily for three months after
discharge from hospital. All 45 mothers
forgot to give vitamin K occasionally:
■ 20 (44%) on less than five days
■ 5 (12%) on 5-10 days 
■ 20 (44%) on >10 days. 
Thirty-seven mothers (82%) found the
oral preparation easy to administer. Eight
women (18%) stated that remembering to
give it was a problem or that their infant
spat it out. 
The 18 infants (28%) that were not given
drops to take home included those injected
with vitamin K intramuscularly and those
whose parents declined prophylaxis. 
Almost three-quarters (46) of surveyed
mothers (73%) intended to exclusively
breastfeed for a period of 6-12 months.
The majority of children were less than
one year of age and none of them had
suffered a serious illness since birth (birth
dates were not provided in this anonymous
survey). 
A significant proportion of women (16;
25%) felt that they had not been given
sufficient information regarding vitamin K
prophylaxis. Ten out of 11 mothers (91%)
whose infants had received intramuscular
vitamin K were overall satisfied with this
form of preventative treatment.
Acceptability and tolerability of the oral
vitamin K supplement among the studied
women and children was similarly high (45
out of 48; 94%). However, some mothers
would have preferred a better tasting oral
solution that could be given less frequently
(weekly or monthly) or an injection for
convenience and to increase compliance.
communication processes of parents and
staff on a NICU emphasised the
importance of good communication
between health professionals and families.13
A number of parents preferred to receive
medical information from doctors directly,
implying that family physicians and
obstetricians as well as midwives, have a
role to play in educating parents according
to national recommendations.
The majority of breastfeeding mothers
in this survey were white primiparas in
their thirties who had higher qualifications.
To obtain a bigger picture, studies similar
to this one should be performed in
different regions, including mothers of
breastfed and formula-fed infants.
References
1. Strehle E.M. Vitamin K deficiency and its prevention
and treatment in infants. In: Watson R.R. et al. (eds).
Nutrition in Infancy, Volume 1. New York: Springer
Science and Business Media;2013:429-39.
2. CDC. Notes from the field: late vitamin K deficiency
bleeding in infants whose parents declined vitamin
K prophylaxis – Tennessee, 2013. Morb Mortal Wkly
Rep 2013;62:901-02.
3. Ipema H.J. Use of oral vitamin K for prevention of
late vitamin K deficiency bleeding in neonates when
injectable vitamin K is not available. Ann
Pharmacother 2012;46:879-83.
4. Busfield A., Samuel R., McNinch A., Tripp J.H.
Vitamin K deficiency bleeding after NICE guidance
and withdrawal of Konakion Neonatal. Arch Dis
Child 2013,98:41-47.
5. Strehle E.M., Howey C., Jones R. Evaluation of the
acceptability of a new oral vitamin K prophylaxis for
breastfed infants. Acta Paediatr 2010;99:379-83.
6. Abramson J.H., Abramson Z.H. Research Methods in
Community Medicine. 6th ed. Chichester, UK: John
Wiley 2008. 
7. Office for National Statistics. Ethnicity and National
Identity in England and Wales 2011. Newport: ONS;
2012.
8. Bansal N., Chalmers J.W., Fischbacher C.M. et al.
Ethnicity and first birth: age, smoking, delivery,
gestation, weight and feeding. Eur J Public Health
2014 doi: 10.1093/eurpub/cku059. 
9. Mathews M.E., Leerkes E.M., Lovelady C.A., Labban
J.D. Psychosocial predictors of primiparous
breastfeeding initiation and duration. J Hum Lact
2014;30:480-87. 
10. British National Formulary for Children. Vitamin K
[Online] Available from: www.medicinescomplete.
com/mc/bnf/current/ PHP6277-vitamin-k.htm
[Accessed 27 October 2014].
11. Busfield A., McNinch A., Tripp J. Neonatal vitamin K
prophylaxis in Great Britain and Ireland: the impact
of perceived risk and product licensing on
effectiveness. Arch Dis Child 2007;92:754-58.
12. Gosai S., Broadbent R.S., Barker D.P. et al. Medical
and midwifery attitudes towards vitamin K
prophylaxis in New Zealand neonates. J Paediatr
Child Health 2014;50:536-39.
13. Wigert H., Dellenmark M.B., Bry K. Strength and
weaknesses of parent-staff communication in the
NICU: a survey assessment. BMC Pediatr
2013;13:71.
Discussion
For this survey, 63 new breastfeeding
mothers were asked about their opinions
on vitamin K prophylaxis. Their white
British background was fairly typical for
this region of England where ethnic
minorities account for approximately 5%
of the population.7 The observation seen
here, that breastfeeding mothers tend to be
older and better educated than the average
new mother, is confirmed by two recent
large studies from Scotland and the USA.8,9
The Chief Medical and Nursing Officers
of the UK have advised that vitamin K is
given intramuscularly or orally to all
neonates.10 Injections are more effective but
also more distressing, whereas the main
issue with repeated oral supplementation is
a lack of compliance. In the study
presented here, four in every five children
received vitamin K orally and one in five,
by injection. This result differs from the
national figures, reported in a survey of
230 maternity units in Great Britain and
Ireland: 60% administered vitamin K
intramuscularly, 24% orally and 16% gave
the parents a choice.11
According to this relatively small survey,
prophylactic vitamin K was not given to
four out of 63 infants (6%), which is
concerning. The daily vitamin K
requirement for infants below six months
of age is 10μg. Formula-fed infants
typically receive 50μg vitamin K daily but
breastfed infants only 1μg daily.5 This
explains why VKDB is more common in
breastfed infants who are not
supplemented.4
Although overall satisfaction of the
participating mothers with the respective
vitamin K prophylaxis was >90%, this
survey revealed several areas for
improvement: 
■ One third of women did not have ade-
quate knowledge about vitamin K and its
importance for blood clotting 
■ At least 20% stated that they were not
provided with such information during
pregnancy 
■ 40% did not receive written information. 
Recently, doctors and midwives in New
Zealand were interviewed regarding their
attitudes towards prophylactic vitamin K.12
It was found that a significant proportion
of midwives did not feel the need to give
vitamin K to all newborn infants. This
demonstrates a knowledge gap that must
be closed as it has consequences for parent
education. A large survey investigating the


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A vitamin K prophylaxis survey among breastfeeding mothers

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