Vitamin K
The doctors gave my baby vitamin K at birth. What is that for?
Vitamin K can prevent a bleeding disease, which occasionally occurs in newborn babies. The bleeding is due to an abnormality of the blood coagulation system that may occur during the newborn period. This abnormality can be prevented by vitamin K supplementation.
Should my baby get additional shots of vitamin K later?
There is no evidence to date that this is necessary. Infant formula contains large amounts of vitamin K. Human milk contains much smaller amounts, but even these amounts appear to be adequate.
I heard of "K" being used as a symbol for potassium. What is the relationship between "K" and vitamin K?
There is no relationship other than that both are nutrients. "K" or potassium is a mineral, not a vitamin.
Why can't I take vitamin K tablets during my pregnancy, so that my baby does not have to receive a shot after birth?
Vitamin K crosses the placenta to your baby in very small amounts, and this may result in some additional vitamin K reaching the baby. There is no evidence, though, that this prevents the bleeding disease in newborns caused by vitamin K deficiency.
Why can't my baby receive an oral dose of vitamin K? Must he receive an injection?
Vitamin K is available in an oral form for infants. As newborn infants frequently spit up stomach contents, there is a chance that the vitamin K would be spit up too. If you wish your infant to take an oral vitamin K supplement, discuss this with your physician.
What if I do not want my baby to receive an injection of vitamin K?
There is no law that requires a vitamin K injection. You should discuss this with your doctor, including the possibility of an oral form.
What foods can I eat that contain large amounts of vitamin K?
I'm breastfeeding and I want to be sure that it gets to the baby. Spinach, broccoli, brussels sprouts, cauliflower, and watercress contain large amounts of vitamin K.
Is breast milk affected by my intake of vitamin K?
Yes. Although it is not affected very much by a normal dietary intake, extra tablets of vitamin K will greatly increase the vitamin K content of your milk.
Is there any danger if too much vitamin K is given at birth?
Vitamin K may be toxic if given in very large doses at birth, 50-100 times as much as normally given. Thirty-five years ago, when this very large amount of vitamin K was given to premature infants, it caused a dangerous form of yellow jaundice.
My sister lives in England. When her baby was born, vitamin K was not prescribed. Why is this?
Vitamin K injection is not universal for newborn infants. However, because of many reports of bleeding disorders in newborn infants related to vitamin K deficiency in some countries, its use in newborn infants is becoming more common.
Vitamin K is added to all formulas. I am breastfeeding. Does my baby get enough vitamin K?
Although breast milk contains very small amounts of vitamin K compared to formulas, healthy breastfeeding infants who have received their initial injection of vitamin K do not appear to develop vitamin K deficiency on a diet of human milk.
Will a vitamin K injection harm my baby in any way?
With the standard dose (1 mg), there is no apparent risk to your infant from vitamin K. Your baby will experience some discomfort from the injection. If given in the front part of the thigh muscle, there should not be any risk from the injection.
Are newborn babies ever allergic to vitamin K?
This has not been reported.
Does vitamin K deficiency with bleeding ever occur in infants who received vitamin K at the time of birth?
Yes, if there are medical problems which require long-term use of antibiotics and are associated with reduced ability to absorb vitamin K from the gut, including chronic diarrhea and diseases associated with poor absorption of fat (for instance, cystic fibrosis and hepatitis).
Does formula have extra vitamin K?
Yes, it contains approximately 50 times the amount in human milk.
Fifty times! Won't that be a problem?
No, most individuals on a normal diet would frequently consume more than this amount of vitamin K on any given day. No toxic effects of these quantities are known.
What about breastfeeding my baby? Do I have to give her additional vitamin K?
This is at present an area of controversy and is being studied. To date, there is no indication that extra vitamin K beyond the newborn period is needed for breastfeeding babies.
I heard that somehow bacteria makes vitamin K. Is that correct?
That is kind of odd; how does it affect the baby? Bacteria in the large intestine do make a form of vitamin K. There is presently no evidence that it is of any use to infants.
Are there foods high in vitamin K that I can provide to the baby?
Foods high in vitamin K include any of the green vegetables, as well as cauliflower.
How about cow's milk. Does it contain vitamin K?
It contains more vitamin K than found in human milk, but much less than in formula.
How do I know if my baby receives enough vitamin K?
The only obvious clinical signs of vitamin K deficiency are excessive bleeding and possibly bruising. If you suspect this is so, see your doctor immediately. However, there are many other causes for excessive bleeding besides vitamin K deficiency.
I hear a lot about other vitamins but very rarely about vitamin K. Is that because it is not really very important?
In children and adults, there is usually no special need to take vitamin K. A reasonable diet contains large quantities of vitamin K, and the vitamin K-synthesized bacteria in the large colon may be utilized. However, since the vitamin does not pass well across the placenta from the mother, its level is low in the blood of newborn infants. Therefore, we give vitamin K to newborns to make sure they have enough of the vitamin at this time.
We hear about vitamins A, B, C, D, and E. What happened to the rest of the alphabet before K? Are there vitamins F, G, H, and J?
Vitamin K was described in a Danish research laboratory. The letter K is the first letter of the German word for coagulation "Koagulation." Vitamin F is now known as the bioflavinoids and the essential fatty acids. Vitamin G is today known as riboflavin (B2). It was named vitamin G because of the requirement for growth. Vitamin H is now named biotin, and was named "Haut," the German word for skin, because of the effects of biotin on the skin. Other alphabet letters were used for vitamins also. Vitamin P was named for paprika, the source of its first isolation. Vitamin Q was named for its discoverer, Quick. Vitamin U is now known as S-methylmethionine. Vitamins P and U are not presently recognized as essential nutrients.
I have also heard that there is no recommended dietary allowance for vitamin K. Why is that?
There is a recommended allowance. It is 1 microgram per kilogram of body weight each day. In normal subjects on a normal diet, this recommended allowance is exceeded with a balanced diet. Therefore, we usually do not have to supplement diets with vitamin K.
I have heard that vitamin K is especially important in babies who are to be circumcised. Is that true?
Vitamin K is important for prevention of bleeding, which will cover any procedures that involve bleeding and blood coagulation, such as circumcision. At seven days of age, the coagulation factors in blood tend to be relatively normal, so it is a good time to perform circumcision. However, vitamin K is just one of the factors affecting coagulation, and its blood levels are quite low in infants (even at seven days of age) who have not received supplemental vitamin K at the time of birth.
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