Aims-The ability of oral vitamin K to eliminate all risk of vitamin K deficiency bleeding during the first three months of life was studied. Methods-Babies (n=182 000) in the north of England judged well enough to be oVered milk within 12 hours of birth were given 1 mg of phytomenadione (vitamin K 1 ) suspended in a medium chain triglyceride oil by mouth at delivery between 1993 and 1998. The parents of those who were breastfed were given a further three doses to give to the baby once every two weeks after discharge. Results-Four breastfed babies developed late vitamin K deficiency bleeding. In two, staV failed to follow policy guidelines, and in two there was undiagnosed 1 antitrypsin deficiency. Audit suggested that 93% of breastfed babies had all four doses, as advised. Conclusions-An oral product that parents can administer themselves would be popular if licensed, but the total dose oVered may need to be more than in this study if babies with undiagnosed liver disease are to be protected.