What is vitamin K and why is it given after birth?Vitamin K plays an important role in blood clotting. A very small number of newborns (one in 10,000) suffers from a strong tendency to bleed due to vitamin K deficiency. This disease is called international VKDB (for ""vitamin K deficiency bleeding""). In German, it is called vitamin K deficiency hemorrhage or haemorrhagic neonatorum.
Children with CVDD bleed fast or spontaneously bruise. This can happen in the first 24 hours after birth, or there may be a ""late"" bleeding in the first few weeks after birth. The hemorrhages are in the mouth, nose, umbilical cord or come from the bottom (Demott et al 2006).
In half of all cases there is a ""late"" vitamin K deficiency bleeding in the first weeks after birth. It can also cause internal bleeding, which can be very dangerous. Cerebral haemorrhage occurs in more than half of these late cases and one in five babies dies (Demott et al 2006, DH 1998).
In the majority, late-onset vitamin K deficiency affects stillbabies with other physical problems, such as liver disease, which complicate the absorption of vitamin K in the body (Demott et al 2006). These sickly stillbabs are more susceptible to vitamin K deficiency bleeding than bottle children because infant milk is enriched with more vitamin K than natural breastmilk.
But the difference in vitamin K levels in baby food and breast milk is no reason to opt for breastfeeding. The first still milk, also known as colostrum, is very rich in vitamin K and the back milk (the high-fat milk delivered towards the end of each breastfeeding) has 1, 9 times more vitamin K than the milk in front (the thirst-quenching milk at the beginning of the breastfeeding session) (Von Kries et al 1987). Breastfeeding as needed right from the start will give your baby the same amount of vitamin K while enjoying the other benefits of breastfeeding.
Nevertheless, it is agreed that both nursing children and children after birth need an extra dose of vitamin K to prevent vitamin K deficiency bleeding (Demott et al 2006, Busfield et al ).
How is Vitamin K administered today?There are two ways to administer Vitamin K: Oral (ie in the mouth) or as an injection. In Germany, (almost) all hospitals have started to give vitamin K orally instead of injecting. Usually only premature babies get a vitamin K syringe, all other children get it in the form of drops.
The drops are administered in three doses during the first three screening examinations (U1 to U3).The baby gets two doses in the first week of life and another at the age of one month.
Which method of vitamin K administration is better?Vitamin K, whether oral or injected, is equally effective - provided, of course, that the dosages are taken as recommended.
In other European countries, syringes are preferred as the most effective and safest way to prevent vitamin K deficiency bleeding because it requires only a single dose to provide all-round protection (Busfield et al 2007, Demott et al 2006: 311-312). But as with any injection, one must also consider that it is a little painful and can cause redness or swelling. Some parents find it unbearable to see their baby suffer like that, even if it's only short.
For the oral vitamin K to be effective, all three prescribed doses must be administered. As with any drug, it is difficult to judge whether all children have actually received the prescribed amount or whether a dose has been forgotten. Studies of oral intake of vitamin K have shown that a baby is susceptible to late vitamin K deficiency bleeding from any missed, missed, or missed dose (Demott et al 2006: 311-312, Wariyar et al., 2000).
One conceivable solution to this dilemma is that you and your partner both assure that your baby has or will be getting vitamin K, in whatever form.
Why is not vitamin K reserved for risk babies?There are babies who should definitely get extra vitamin K. These include:
- premature births born before Pregnancy Week 37.
- Babies born with forceps, suction cups or Caesarean sections.
- Newborns who were injured at delivery.
- Babies who had breathing problems at delivery.
- Children who had liver problems after birth or were in poor health.
- Babies whose mothers had to take medication for epilepsy, tuberculosis or blood clots during pregnancy.
However, a third of children suffering from VKDB fall into none of these categories (DH 1998). Although a little bit of blood may warn the mouth or nose of VKDB early on, it is also possible that the first bleeding is already internal and therefore very dangerous or even fatal.
So if you were to give vitamin K only to high risk babies, more children would be affected by the deficiency. It is believed that in such a scenario, ten to twenty babies a year suffer brain damage and four to six babies die (DH 1998) … What arguments are against the use of vitamin K?
Some experts wonder if newborns actually have low vitamin K levels. You ask: Compared to whom or what? If babies have little vitamin K in the body compared to adults, then that's not surprising.So if it is not really ""little"", is it wise to increase the amount? And even if they are low, nature can not have thought something that we do not yet understand? Whatever newborns have low levels of vitamin K in their bodies, at six weeks of age they have about the same amount as adults and vitamin K has been shown to help minimize VKDB (Puckett and Offringa 2000).In the early 1990's, vitamin K as an injection (not oral!) Increased the risk of leukemia (blood cancer). Of course, the uproar was great because exactly what the kids were supposed to do was a new life-threatening risk.
Meanwhile, research worldwide has shown that there is no link between leukemia and vitamin K, either as a syringe or orally (Fear et al 2003, Roman et al 2002, Ross and Davies 2000, DH; 1998).
How can I form an opinion?
First, talk to your midwife or doctor about vitamin K. Ask for their opinion and get information leaflets. Talk to other parents about their opinions and concerns.
You have the following options:Not to give your baby vitamin K
To have your baby given an injection after birth (if the clinic offers it)
- Give your baby three doses orally: In the U1 after birth, the U2 in the first week of life and the U3 a few weeks after birth.
- Remember: There is a consensus that breast milk is the best food for your baby. A low vitamin K level should not be a reason for you to switch to artificial baby food.
- Whether you opt for or against the administration of Vitamin K: As soon as your baby has an unexplained bleeding, you should definitely take it to the doctor or hospital.
Busfield A, McNinch A, Tripp J. 2007. Neonatal vitamin K prophylaxis in Great Britain and Ireland: the impact of perceived risk and product licensing on effectiveness.
Archives of Disease in Childhood.
92: 754-758. Croucher C, Azzopardi D. 1994. Compliance with recommendations for vitamin K to newborn infants BMJ.
308 (6933): 894-895. www. bmj. com [Stand August 2010] Demott K, Bick D, Norman R, Ritchie G, Turnbull N, Adams C, Barry C, Byrom S, Elliman D, Marchant S, Mccandlish R, Mellows H, Neale C, Parkar M, Tait P., Taylor C. 2006 Clinical Guidelines And Evidence Review For Post Natal Care: Routine Post Natal Care Of Recently Delivered Women And Their Babies.
London: National Collaborating Center for Primary Care and Royal College of General Practitioners. www. nice. org. uk [pdf file 1. 03MB; As of August 2010] DH, CMO. 1998. Vitamin K for Newborn Babies and vitamin K deficiency bleeding (VKDB).
Department of Health, Chief Medical Officer.London: DH. www. ie. gov. uk [as of August 2010] Fear NT, Roman E, Ansell P, Simpson J, Day N, Eden OB. 2003. Vitamin K and childhood cancer: a report from the United Kingdom Childhood Cancer Study, British Journal of Cancer.
89 (7): 1228-31. Puckett RM, Offringa M. 2000. Prophylactic vitamin K for vitamin K deficiency bleeding in neonates. Cochrane Database of Systematic Reviews.
Issue 4. Art. : CD002776. www. mrw. inter science. wiley. com [as of August 2010] RCM. . Vitamin K.
Postion paper no. 13b. Royal College of Midwives. www. rcm. org. uk [as of August 2010] Ross JA, Davies SM. 2000. Vitamin K prophylaxis and childhood cancer. Med Pediatr Oncol
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