Dear Lactnet

I've looked in the Archives about Vit K  (aren't I a good little
Lactnetter?) and I haven't seen the following overview mentioned: MIDIRS
Midwifery Digest September 1997 (Vitamin K Prophylaxis, author Christine
Ruby). It's worth reminding ourselves of the research (included in the
overview) that confirmed the *only*  breastfed babies who seemed to be
deficient in Vit K  were ones whose access to breast milk had been
restricted (by hospital insistence on scheduled feeds or some other
situation). There is also some discussion about what might be the
physiological level of Vit K present in newborns in any case.  We are not
sure of what a low level or a deficiency might be, and whether in some
cases an *apparently* low level may confer some benefit to some babies.
Yes, it's true that a low level increases the risk of haemorrhagic disease
of the newborn - though it does not, of course, make HDN inevitable.

The Golding research in the early 90s linked intra-muscular Vit K with
childhood cancer . A number of subsequent studies have been unable to
support the findings, and this has restored confidence somewhat.  Yet
understandably,  there was confusion in British maternity wards for some
years. Parents and doctors were concerned about the Golding research (it
had been in all the newspapers) but the alternative oral product was
unlicensed. This led to a lot of professional anxiety, understandably, when
parents were asking for the oral product. In 1996 an oral product was
finally licensed, leaving the choice of oral or IM to the hcp and,
crucially,  the parents.

The MIDIRS piece points out that we still don't know enough about all of
this. We know that some 'at risk' babies benefit from proph. Vit K, but we
still don't know what, if any, are the implications of giving proph. Vit K
to all babies, breastfeds and bottle feds.

The consensus here, however,  is that Vit K is probably A Good Thing on the
whole...but that parents are entitled to have as much  information as they
want about the questions that have arisen over the past 10 years or so, and
then they can make their own choice. The vast majority choose to have it,
whether oral or IM, and that to me seems sensible, but that's only my
personal opinion. My information is that mostly, they do get asked,  which
is surely a good thing. My first two babies (1980 and 1981) were just given
it, no consult or consent at all...but that was the olden days.

all the best to you all

Heather

Heather Welford Neil
NCT bfc UK