Vitamin K
Vitamin K
Vitamin K
K2. A baby's bowel is 'sterile' when inside the uterus (meaning no bacteria) and
does not start producing vitamin K2 until after they are born. Once in the 'outside
world' the baby's bowel starts colonising the normal 'body-friendly' bacteria. This
is done by sucking on their hands, latching on the breast etc. starting the
production of vitamin K2. The vast majority of babies will increase their vitamin K
to adult levels by the time they are 6 weeks old.
While most newborn babies are able to create adequate Vitamin K2 to maintain
and increase their levels, occasionally a baby does not achieve this and may
experience Vitamin K deficiency. In rare cases a baby can take up to 6 months to
reach adequate levels of vitamin K2, and therefore be prone to bleeding up until
this time.
This condition for babies is called 'Vitamin K Deficiency Bleeding' or 'VKDB'
(previously known as Haemorrhagic Disease of the Newborn or 'HDN'). It is
diagnosed after the baby shows signs of bleeding with a blood test. Their blood
test shows longer 'clotting times', despite still having other normal levels of blood
clotting factors such as fibrinogen and platelets. The condition is confirmed once
the baby's blood clotting returns to normal soon after vitamin K has been given.
As a way of preventing VKDB in a few babies, all parents in Australia are
encouraged to give their newborn baby some form of supplement of Vitamin K
soon after the birth, just in case. Vitamin K supplements are aimed at preventing
a further drop in the baby's vitamin K levels, while they are building up their gut
bacteria in the early weeks or months after being born.
Vitamin K supplements are administered by your caregiver, either by one injection
within hours of the baby's birth or as 3 oral doses (by mouth) in the first month of
the baby's life. (This is the standard in Australia; other countries may have
alternative recommendations.)
Vitamin K supplements are administered by your caregiver, either by one injection
within hours of the baby's birth or as 3 oral doses (by mouth) in the first month of
the baby's life. (This is the standard in Australia; other countries may have
alternative recommendations.)
rare for a baby without a liver disorder to show signs of late VKDB after this time).
Konakion MM Paediatric is absorbed very well when given orally. When 3 doses are
given as scheduled in the first month, it has shown that 89% of babies will have
adequate Vitamin K levels at 56 days of age.
In Switzerland 95% of babies have received two oral doses (2mg) since 1995
(usually on days 1 and 4 after the birth). In a 3 year study looking at 247,000
babies, there was 1 case of classical VKDB (0.0004%) and 11 cases of late VKDB
(9 of these 11 babies had liver disease). Of the other 2 babies, 1 baby had no
Vitamin K and the other had the normal 2 doses (again an incidence of 0.0004%).
NOTE: If your baby vomits within 1 hour of having their oral Vitamin K the dose
will need to be repeated.
The Vitamin K should be recorded on your baby's personal health record book.
The advantage of an injection is that it is a one off dose and there is no need to
remember to give further doses. The disadvantage of an injection is that it can be
briefly painful for the baby, and holds small risks of bruising and infection at the
skin site of the injection (less than 1%).
The advantage of the oral doses is that it is not painful for the baby and does not
carry the small risks of the injection. The disadvantage of the oral doses is that
parents need to remember to give their baby all the doses. Usually the last one at
1 month is the most frequently missed, as the caregiver will normally ensure the
first 2 doses are given.