Role of Feeding and Vitamin K in Hypoprothrombinemia of the Newborn

Keenan, William; Jewett, Theodore C.; Glueck, Helen I.

doi:10.1001/archpedi.1971.02100150045001

Cited by 23 publications

(20 citation statements)

References 26 publications

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“…In the entirely breastfed newborn the incidence of bleeding due to vitamin K deficiency is 15-20 fold higher [69] and the levels of vitamin Kdependent clotting factors are lower [31] than in babies fed cows' milk-based formulae or who were given vitamin K. The fall in levels of vitamin K-dependent clotting factors can be prevented by feeding cows' milk [31]. The relationship between breast-feeding and classical HDN has recently been confirmed [26,37].…”

Section: Relation Of Breast-feeding To Hdn and Lhdn A) Breast-feedingmentioning

confidence: 99%

Vitamin K in infancy

1988

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Vitamin K has regained paediatric interest due to a recurrence of bleeding caused by deficiency of the vitamin in newborns and young infants. Increasing awareness of these clinical problems, the development of new methods for the detection of vitamin K deficiency and the direct measurement of vitamin K in tissues have stimulated research. Much new data obtained from these studies has proved helpful to the understanding of vitamin K deficiency in infancy. For example low concentrations of vitamin K have been found in fetal and neonatal livers. The implications of these findings with respect to manifest vitamin K deficiency and to new methods for detection of subclinical vitamin K deficiency are discussed. Breast-feeding is a major risk factor for classical haemorrhagic disease of the newborn and for late onset bleeding due to vitamin K deficiency in young infants. The interdependencies between breast-feeding and vitamin K deficiency are discussed on the basis of new data obtained from direct measurement of vitamin K in maternal milk. The review further focuses on pathophysiological concepts of bleeding due to vitamin K deficiency in infancy and current concepts of vitamin K prophylaxis.

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Section: Relation Of Breast-feeding To Hdn and Lhdn A) Breast-feedingmentioning

confidence: 99%

Vitamin K in infancy

1988

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“…This is probably due to the low vitamin K content of human milk (6,13). All the infants examined in this study were breast-fed.…”

Section: Discussionmentioning

confidence: 97%

The Intestinal Microflora of Infants: Fecal Flora of Infants with Vitamin K Deficiency

Benno

Sawada²,

Mitsuoka

1985

Microbiology and Immunology

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The fecal flora of 10 infants with vitamin K deficiency (VKD) and 10 healthy infants was examined. All the infants were breast-fed. In the infants with VKD, the total counts (P< 0.01) and the numbers of bifidobacteria (P< 0.001) were lower than in the healthy infants, whereas bacteroides, veillonella and enterococci were present in greater numbers in the feces of infants with VKD. The incidence of the Bacteroides fragilis group was higher (P< 0.05) in the infants with VKD than in the healthy infants. A significant reduction (P<0.05) in Bifidobacterium breve was shown in the infants with VKD. The data emphasize the abnormal flora in infants with VKD.

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“…In contrast, other workers have shown that single doses of 0-5-3mg can produce an increase in breast milk vitamin K (Haroon et al 1982;Von Kries et al 1987;Greer et al 1997). Gastrointestinal flora provide an endogenous source of this vitamin which, it has been suggested, make a greater contribution in babies fed formula than in breast fed babies (Keenan et al 1971;Conly et al 1994). …”

Section: Vitamin Kmentioning

confidence: 99%

Vitamin requirements for term infants: considerations for infant formulae

Powers

1997

Nutr. Res. Rev.

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Objective. To provide the informed health professional with an up to date evaluation of the current thinking regarding requirements for vitamins in infant feeds. Establishing criteria for adequacy. Vitamin adequacy in the neonate is currently defined in terms of circulating levels of a vitamin or of the activity of a vitamin dependent enzyme in the erythrocytes. Although these measurements have their value there is a need to develop biochemical, physiological or clinical markers of well defined specific function. For some vitamins there is a risk of deleterious effects of very high intakes: risk of toxicity needs to be taken into consideration when making recommendations for inclusion in infant formulae. Breast milk as the 'gold standard'. Breast milk concentrations of vitamins have been used as the criteria of adequate intake by neonates. This may not always be justified. Greater consideration needs to be given to differences in bioavailability of vitamins from breast milk compared with formula feeds, of the influence of season, and of stage of lactation, on the stated composition. Experimental approaches. Animal studies have provided limited information regarding effects of different levels of intakes on current status indices in the neonatal period. There are few reports of randomized controlled studies into the effects of different levels of vitamins and these rely heavily on biochemical criteria of adequacy. Recent developments. The inclusion of fl-carotene into formula feeds for premature babies is an issue of current interest. What is the justification for this? Are there potential benefits for the term infant? Riboflavin deficiency in the period around weaning may affect the normal structural and functional development of the gastrointestinal tract; some. of these effects may be permanent. Research to be done. A greater understanding of the absorption and metabolism of vitamins during infancy is required in order to help establish dietary requirements. The relative bioavailability of vitamins in human milk and formulae needs to be investigated. Criteria for vitamin adequacy should be extended to include measures of function. Information regarding the conversion factor from tryptophan to niacin in infancy would allow us to set niacin requirements with greater confidence. There is a particular lack of information about concentrations of biotin and pantothenic acid in breast milk and the relative biochemical status of infants receiving breast milk and formulae. Benefits of including fi-carotene into infant formulae need to be evaluated. The role of individual micronutrients in the structural and functional development of the gastrointestinal tract should be explored.

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Role of Feeding and Vitamin K in Hypoprothrombinemia of the Newborn

Cited by 23 publications

References 26 publications

Vitamin K in infancy

Vitamin K in infancy

The Intestinal Microflora of Infants: Fecal Flora of Infants with Vitamin K Deficiency

Vitamin requirements for term infants: considerations for infant formulae

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