Vitamin K guidelines for neonates need to be reconsidered

Created March 2018

Vitamin K deficiency: a case report and review of current guidelines.

Ital J Pediatr. 2018 Mar 14;44(1):36. doi: 10.1186/s13052-018-0474-0.

Marchili MR1, Santoro E2, Marchesi A3, Bianchi S3, Rotondi Aufiero L3, Villani A3.

* To prevent Vitamin K Deficiency Bleeding many countries inject or give Vitamin K orally to all newborns * Total doses range from 1 to 6 mg over several days - depend on country --- * I wonder why ALL infants get Vitamin K injections/oral * I wonder if this started when Vitamin K levels in maternal blood decreased ~40 years ago * due to decreased Vitamin K in dairy products (low-fat, etc.) * I wonder if K1 or K2 is used * I wonder why they do not continue to look at Vitamin K levels in infants/toddlers * I wonder why Vitamin K is given at birth to stop bleeding but Vitamin K is restricgted in elderly to prevent bleeding * I wonder why Vitamin D is not also given to infants * similar to East Germany 600,000 IU injections for many decades * Henry Lahore - founder of VitaminDWiki --- * Review of Micronutrients such as vitamin D for women and childhood – Aug 2013 * Overview Vitamin K and Vitamin D * Vitamins K1 and K2 are BOTH required for health– June 2017 * Vitamin K in full-fat dairy products – June 2017

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BACKGROUND:

Vitamin K, a fat soluble vitamin, is a necessary cofactor for the activation of coagulation factors II, VII, IX, X, and protein C and S. In neonatal period, vitamin K deficiency may lead to Vitamin K Deficiency Bleeding (VKDB).

CASE PRESENTATION:

We present the case of a 2 months and 20 days Caucasian male, presented for bleeding from the injections sites of vaccines. At birth oral vitamin K prophylaxis was administered. Neonatal period was normal. He was exclusively breastfed and received a daily oral supplementation with 25 μg of vitamin K. A late onset vitamin K deficiency bleeding was suspected. Intravenous Vitamin K was administered with complete recovery.

CONCLUSIONS:

Nevertheless the oral prophylaxis, our case developed a VKDB: it is necessary to revise the current guidelines in order to standardize timing and dosage in different clinical conditions.

PMID: 29540231 DOI: 10.1186/s13052-018-0474-0

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Tags: Infant-Child Vitamin K