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Subject:
From:
Christine Betzold <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 13 Jun 1999 11:47:43 EDT
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  A study titled "Improving the vitamin K status of Breastfeeding infants
with maternal vitamin K supplements was published in Pediatrics 1997 Jan; 99
(1):88-92.  Its conclusion stated, " In exclusively breastfed infants who
receive intramuscular phylloquinone at birth, the vitamin K status as
measured by plasma phylloquinone and des-gamma-carboxy-prothrombin
concentrations is improved by maternal oral supplements of 5 mg/d
phylloquinone through the first 12 weeks of life.
 There is another study, " A new mixed micellar preparation for oral vitamin
K prophylaxis: randomised controlled comparison with an intramuscular
formulation in breastfed infants."  Arch Dis Child 1998 Oct; 79(4):300-5.
Its conclusion stated, Plasma vitamin K concentrations were at least equal or
significantly higher in babies given oral vit K supplements compared with IM
treated babies at the time points measured.  Through the first 8 weeks of
life, multiple doses of the new oral preparation (Konakion MM) maintain
haemostasis and vit K status in breastfed infants at least equal to that of
the IM prep.

  It is my understanding that this is being researched to prevent late
hemorrhagic disease of the newborn and or cancer from IM vit K.  I have some
questions.
1.      This is several times the RDA-What effect could this short-term
supplementation have on the mother, if any?  The prenatals I have contain 25
mcg, this is not routinely given and wouldn't be enough.
 2.     If late hemorrhagic disease is connected to high PIVKA values, why
don't we screen for it?  Is it too expensive?
  3.  If this has been connected to low vitamin K levels during pregnancy,
does this occur in mothers who are taking prenatal vitamins?  What about
checking mom's vit K levels prior to birth?
 4.  Do you think women should be routinely supplemented with Vit K based on
this study?
 5.  What about the new oral prep?  It sounds good to me and it may eliminate
the controversy over vit K and cancer.
  Thanks.  Christine Betzold  RNP MSN CLE

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