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

Cesar G. Victora, Philip Van Haecke

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


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 0.20% of DALYs lost to children less than 5 years of age. Assuming a cost of $1.00 per injection, each DALY saved would cost $1.33. 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.

Original languageEnglish (US)
Pages (from-to)203-209
Number of pages7
JournalAmerican Journal of Public Health
Issue number2
StatePublished - Feb 1998
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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