Vitamin K Deficiency Bleeding and the Breastfed Infant
The exclusively breastfed infant has a 15 to 20 fold higher incidence of
late-onset VKDB than a baby fed formula. Healthy human milk from an
unsupplemented mother contains a small amount of vitamin K. Concentrations
of vitamin K-1, thought to be the major form of vitamin K in human milk,
vary widely among individual women and even vary from sample to sample in
the same woman. However, the vitamin K-1 content of breastmilk obtained
from mothers who had affected infants was found to be lower in only some
but not most cases when compared to samples from mothers of unaffected
infants.

A simple concentration difference between breastmilk and formula, although
extreme, is probably not the most important factor, due to the small amount
of vitamin K needed by the baby. However the volume of milk ingested during
the first days of life is extremely important. Studies have shown that VK
deficiency occurs primarily in babies receiving small amounts of breastmilk
or even small amounts of formula during the first days of life. Nursing
should begin at birth and continue every two hours or more often on demand.
Be sure that mothers understand that, although the volume of colostrum is
not great, it is the perfect food for their babies during the first days
and is very important to prevent classical VKDB. If the mother supplements
her diet with vitamin K, levels in breastmilk begin to rise almost
immediately and are dramatically increased by 12 hours.


Reprinted from Midwifery Today E-News (Vol 2 Issue 15 April 14, 2000)
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