Vitamin K prophylaxis in less developed countries: policy issues and relevance to breastfeeding promotion

Am J Public Health. 1998 Feb;88(2):203-9. doi: 10.2105/ajph.88.2.203.


Vitamin K prophylaxis prevents hemorrhagic disease of the newborn. The present review estimates the potential magnitude of this problem in less developed countries, assessing the need for prophylaxis, along with its cost-effectiveness and feasibility. Late hemorrhagic disease, occurring between 2 and 12 weeks, often leads to death or permanent disability. Its median incidence in developed countries is 7 per 100,000 births. Incidences in less developed countries may be much higher. Three incidence scenarios are proposed and the corresponding losses of disability-adjusted life-years (DALYs) calculated. Under the intermediate scenario, late hemorrhagic disease accounts for 0.1% to 0.2% of DALYs lost to children less than 5 years of age. Assuming a cost of +1.00 per injection, each DALY saved would cost +133. Decisions on prophylaxis must be made on a national basis, considering mortality levels and causes, health budgets, and feasibility. Comparison with the impact of diseases prevented by breast-feeding shows that concern with hemorrhagic disease should not affect breast-feeding promotion efforts, although strategies for supplementing breast-fed infants must be explored.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding*
  • Cost of Illness
  • Cost-Benefit Analysis
  • Developing Countries* / economics
  • Disabled Persons
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Vitamin K / economics
  • Vitamin K / therapeutic use*
  • Vitamin K Deficiency Bleeding / economics
  • Vitamin K Deficiency Bleeding / prevention & control*


  • Vitamin K