Vitamin K Deficiency -Hemorrhagic Disease- Government of India Guidelines

Vitamin K Deficiency Bleeding (VKDB) previously known as Hemorrhagic Disease of the Newborn (HDN), is a well-known clinical entity for over 100 years. Vitamin K is required for the synthesis of coagulation factors that prevent and control bleeding. All neonates have low levels of Vitamin K owing to poor transport of Vitamin K across placenta, low Vitamin K content in breast milk, and because gut colonization that is critical for its synthesis takes a few days to establish.

National Health Mission, Government of India has issued the Standard Treatment Guidelines for Vitamin K Deficiency Bleeding. Following are the major recommendations :

1. All newborns delivered in health facilities at all levels including a sub-centre should receive Vitamin K prophylaxis.


2. Vitamin K prophylaxis is given as a single dose IM injection soon after birth. (Once the newborn is in skin-to-skin contact with the mother and breast feeding is initiated).


3. All newborns with birth weight of 1000 gm or more should be administered 1 mg of Vitamin K IM while those weighing less than 1000 gm should receive 0.5 mg dose.


4. Injection Vitamin K should be given IM on the antero-lateral aspect of the thigh using a 26 gauze needle and 1 ml syringe strictly following safe injection practices.


5. In cases that need urgent referral, Vitamin K prophylaxis may be given at the health facility where referral is made and should be documented accordingly.


6. It should be a routine practice to record the date and dose in the Labour Room/OT registers, neonatal case sheets, and referral/discharge slip.


7. Facility in-charge should ensure that medical and nursing staff will administer and document the use of prophylactic Vitamin K to all newborns.


8. All facilities will ensure regular supplies of Vitamin K preparation, syringes, etc.


9. Records of Injection Vitamin K administration should be validated from delivery room registers, case sheets, discharge tickets, and referral registers during routine monitoring visits. This information will be finally transferred into MCTS