The effect of formula versus breast feeding and exogenous vitamin K1 supplementation on circulating levels of vitamin K1 and vitamin K-dependent clotting factors in newborns

Abstract

The influence of breast or formula feeding together with that of a single supplementation of vitamin K1 at birth, on the vitamin K1 level and vitamin K-dependent clotting factors were studied in 65 breast and 15 formula fed infants. All breast fed newborns without supplementation (n = 25) had very low serum vitamin K1 at weeks 1 and 6. Oral vitamin K supplementation (n = 22) or i.m. (n = 18) at birth resulted in high serum levels at week 1, while at week 6 the effect had disappeared. Formula fed infants had vitamin K1 values within the normal adult range at all study points. The low serum levels of vitamin K1 were not associated with haemorrhagic disorders or coagulation abnormalities. The mean values of vitamin K1 in maternal sera at weeks 1 and 6 were 2.3 nmol/l and 1.8 nmol/l and in breast milk 2.7 nmol/l and 2.0 nmol/l respectively. No correlation existed between the values in breast milk and maternal serum. To maintain serum levels of vitamin K1 within the adult physiological range, repeated administration of low doses is needed in breast fed newborns beyond 1 week of age.

Intracranial hemorrhage associated with vitamin K deficiency in a breastfed infant after intramuscular vitamin K prophylaxis at birth. Follow‐up at 18 months

“…Healthy neonates have relatively low circulating vitamin K concentrations, and even prophylactic vitamin K administration at birth is not always sufficient. In fact, the vitamin K content of human milk is very low compared with standard infant formulas (around 7,000 pg/mL) (11). Commercial infant formulas are supplemented with vitamin K and, consequently, formula-fed infants are at lower risk for developing VKDB than are breastfed neonates.…”

Prevention of Vitamin K Deficiency Bleeding in Newborns

“…In the absence of exogenous vitamin K during the first month of life, a deficiency can develop. As discussed below, this is also the case in children who receive a small oral dose of vitamin K at birth, in whom evidence of vitamin K deficiency will disappear immediately after treatment only to re‐appear during the first month of life if additional vitamin K is not provided (Cornelissen et al , 1992; Hogenbirk et al , 1993). A similar dose of vitamin K, given intramuscularly at birth, appears to prevent severe vitamin K deficiency during the first 6 weeks of life, possibly because higher vitamin K levels are achieved immediately, or more likely because intramuscular therapy results in a ‘depot’ effect with release of vitamin K from that site for weeks after injection (Loughnan & McDougall, 1996).…”

“…Other reports have indicated that formula feeding will prevent vitamin K deficiency in the first few days of life and also that adequate quantities of breast milk (approximately 500 ml in 3 d providing at least 15 μg of vitamin K) will also prevent vitamin K deficiency (Motohara et al , 1989). Formula‐fed infants maintain normal plasma vitamin K levels throughout the first 6 weeks of life, whereas breast‐fed infants have low levels (Hogenbirk et al , 1993).…”

Intracranial hemorrhage associated with vitamin K deficiency in a breastfed infant after intramuscular vitamin K prophylaxis at birth. Follow-up at 18 months

“…In fact, the vitamin K content of human milk is very low compared with standard infant formulas (around 7,000 pg/mL) (11). In fact, the vitamin K content of human milk is very low compared with standard infant formulas (around 7,000 pg/mL) (11).…”