If you check in the archives, the question of why there should not be
adequate vitamin K in breastmilk came up a couple of years ago. I'm
surprised nobody has actually asked that question. Is breastmilk inadequate?

I don't think so, but I think that nature didn't anticipate our super clean
environment. It also did not anticipate our hospitals.

1. Vitamin K is made by gut bacteria. In the exclusively breastfed baby in
Switzerland in the year 2000, these bacteria are present only in small
numbers. I would guess that exclusively breastfed babies in hunter gatherer
societies had a lot more exposure (like at birth) to a lot more bacteria and
that their gut was colonized by a lot more of these vitamin K bacteria.

Interestingly, the increased incidence of allergies in our affluent
societies has been attributed as well to a *lack* of exposure to bacteria in
the first few months of life, especially around birth (too clean and
obsessed about cleanliness). I always thought that allergies were a middle
class disease because the poor had more important things to worry about, but
maybe it is that we are overly obsessed with "germs".

2. Vitamin K is apparently present in greater quantities in colostrum.
Unfortunately, in most western countries, few babies get much colostrum,
because the baby is limited to x number of minutes no more than y number of
hours on the breast. And latched on poorly as well, so they suck, but don't
drink.

3. Actual bleeding does not occur often even in babies who are vitamin K
deficient. Thus, vitamin K deficiency probably did not significantly affect
infant mortality in hunter gatherer societies. However, it is soooo
unnecessary for a baby to die of vitamin K deficiency. One injection at
birth, that's *all* they need.

Jack Newman, MD, FRCPC

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