Did "Controversies Concerning Vitamin K and the Newborn" Cover All the Controversies?

To the Editor .— We are concerned about the July 2003 American Academy of Pediatrics policy statement about vitamin K, “Controversies Concerning Vitamin K and the Newborn,” which recommends a 0.5- to 1-mg dose for vitamin K in the newborn.1 We have reason to believe this dose is too high for some infants. The 4th and 5th editions of Pediatric Nutrition Handbook, 2,3 by the American Academy of Pediatrics, recommends 0.3 mg/kg vitamin K for infants with birth weights <1000 g.2,3 Kumar et al4 documented that premature infants (28 weeks’ gestation, 90% formula fed) had excessively high plasma vitamin K levels of 130.7 ± 125.6 ng/mL on day 14 of life after receiving 1 mg of vitamin K intramuscularly shortly after birth and 71.2 ± 39.6 μg/kg per day from total parenteral nutrition (TPN). In our study, “Vitamin K Prophylaxis for Preterm Infants: 1 mg versus 0.5 mg,”5 we reported …