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Scottish National Midwifery Formulary
Midwifery Formulary for Neonates

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

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GGC Maternity and Gynaecology Handbook

Midwifery Formulary for Neonates

Scottish National Midwifery Formulary

Central Nervous System

Medicine as per BNF category	Arrangement for supply or administration	Legal status	Version of page	Scottish National Midwifery Formulary local arrangements
Opioid antagonists
Naloxone -Neonate	ME	POM	V3	In Patient. 200microgram (0.5ml) by IM injection into the anterior thigh once only.

Vitamin K Group of Medicines

Medicine as per BNF category	Arrangement for supply or administration	Legal status	Version of page	Scottish National Midwifery Formulary local arrangements
Introduction			V3
Phytomenadione (Vit K) IM 2mg in 0.2ml injection Neonate	ME	POM	V3	Scotland National Midwifery Formulary Monograph. See local guideline and PGD. Healthy infants ≥ 36+0 weeks and ≥ 2.5kg 1mg (0.1ml) IM single dose at birth. NB ampoule contains 2mg in 0.2ml.
Phytomenadione (Vit K) IM 2mg in 0.2ml injection NeonateGGC	ME	POM	V4 GGC	GGC Guideline – note variation from National Midwifery Formulary Monograph. See local guideline and PGD. Premature infants <36 + 0 weeks 0.5mg (0.05ml) IM single dose at birth. infants ≥ 36+0 weeks 1mg (0.1ml) IM single dose at birth. NB ampoule contains 2mg in 0.2ml.
Phytomenadione (Vit K) oral Neokay® Neonate	ME	POM	V3	Scotland National Midwifery Formulary Monograph. See local guideline and PGD. Oral prophylaxis in all healthy neonates including preterm babies who are not at particular risk of bleeding disorders and whose parents do not want IM vitamin K (Phytomenadione ). Give 1mg Neokay by mouth once. Continue once weekly for 12 weeks for exclusively breast-fed babies. Another dose should be given if the first dose is spat out or the baby is sick within 3 hours of the dose being given.
Phytomenadione (Vit K) oral Neokay® NeonateGGC	ME	POM	V4GGC	GGC Guideline – note variation from National Midwifery Formulary Monograph. See local guideline and PGD. Oral prophylaxis in all healthy neonates including preterm babies who are not at particular risk of bleeding disorders and whose parents do not want IM vitamin K (Phytomenadione). Give 1mg Neokay by mouth once weekly for 12 weeks. Another dose should be given if the first dose is spat out or the baby is sick within 3 hours of the dose being given.

Phytomenadione (Vit K) *oral Paediatric 2mg in* *0.2ml Konakion MM®* Neonate**	ME	POM	V3	Scotland National Midwifery Formulary Monograph. See local guideline and PGD. When Neokay capsules not available then Konakion Paediatric MM can be used as an oral solution if required. Oral prophylaxis in healthy neonates of 36 weeks gestation and older and whose parents do not want IM vitamin K (Phytomenadione). Give 2mg (0.2ml) Paediatric Konakion MM by mouth at birth and repeated between 4 and 7 days. Exclusively breast fed babies will require a further dose at 1 month. Maximum of 3 doses in accordance with local guideline. Doses must be administered by healthcare professionals.
Phytomenadione (Vit K) *oral Paediatric 2mg in* *0.2ml Konakion MM®* NeonateGGC**	ME	POM	V4GGC	GGC Guideline – note variation from National Midwifery Formulary Monograph. See local guideline and PGD. When Neokay capsules not available then Konakion Paediatric MM can be used as an oral solution if required. Oral prophylaxis in all healthy neonates including preterm babies who are not at particular risk of bleeding disorders and whose parents do not want IM vitamin K (Phytomenadione). Give 2mg (0.2ml) Paediatric Konakion MM by mouth at birth and repeat on day 7 and day 28 in accordance with local guideline. Doses must be administered by healthcare professionals.

Medicines used for Thrush Infections

Medicine as per BNF category		Arrangement for supply or administration	Legal status			Version of page	Greater Glasgow and Clyde Midwifery Formulary local arrangements
Miconazole 2% cream (neonate)		ME	POM			V1	In Patient or Out Patient. One pack of cream may be supplied on one occasion. Use in accordance with manufacturer’s instructions. Refer to a doctor if a repeat course may be required.
Nystatin oral suspension (neonate)		ME	POM			V2	In Patient or Out Patient. One original pack of oral suspension may be supplied on one occasion. Use in accordance with manufacturer’s instructions. Refer to a doctor if a repeat course may be required.

Immunological Products and Vaccines

Medicine as per BNF category	Arrangement for supply or administration	Legal status	Version of page	Greater Glasgow and Clyde Midwifery Formulary local arrangements
Introduction to monographs for medicines relating to Hepatitis B (neonate)			V3	Reader referred to table below introduction. Note included with table observing ‘NHS boards in Scotland may extend the criteria beyond those listed.’
Hepatitis B vaccine	ME	POM	V3	See local guideline. 0.5ml at birth IM in the anterolateral thigh. 1 dose by midwife, subsequent doses by Health Visitor or GP in accordance with Health Board Public Health agreed schedule of immunisations.
Hepatitis B immunoglobulin - human (HBIG)	ME	POM	V3	See local guideline. 200 international units as a single dose IM as soon after birth as possible. This is a high volume to give a neonate - ideally split the dose and site of administration. Administer at a separate site to hepatitis B vaccine. Potency varies by batch. The correct volume to give the stated potency is overprinted on the label.

Last reviewed: 27/01/2020

Next review date: 31/01/2022

Author(s): June Grant.

Version: 2020

Approved By: Heads of Midwifery