A student midwife asks about vitamins to prevent haemorrhagic disease of the newborn. Which is the most appropriate to recommend?

• A. Folic acid
• B. Vitamin D
• C. Phytomenadione (Vitamin K)
• D. Vitamin C

Answer: (C)

Preventing haemorrhagic disease of the newborn relies on supplying vitamin K because newborns have very low vitamin K stores and their sterile gut cannot immediately provide it. Vitamin K is essential for activating clotting factors II, VII, IX, and X, so giving phytomenadione (vitamin K1) at birth ensures these factors function properly and prevents VKDB, which can cause serious bleeding including intracranial hemorrhage. The usual practice is a single dose given soon after birth, most commonly by intramuscular injection, with oral regimens used in some settings. Folic acid prevents neural tube defects, vitamin D supports bone health, and vitamin C prevents scurvy, so they do not prevent haemorrhagic disease of the newborn.