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Vitamin K deficiency in breast-fed infants at one month of age
Insights
Two vitamin K doses for breast-fed infants significantly reduced protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels at one month. A single dose was insufficient, highlighting the need for a second vitamin K administration to prevent deficiency.
Area of Science:
- Pediatrics
- Neonatology
- Nutritional Biochemistry
Background:
- Vitamin K deficiency can cause severe bleeding in infants.
- Protein induced by vitamin K absence or antagonist-II (PIVKA-II) is a reliable biomarker for vitamin K status.
- Breast-fed infants are at higher risk for vitamin K deficiency.
Purpose of the Study:
- To evaluate the efficacy of different vitamin K prophylactic regimens in breast-fed infants.
- To assess vitamin K status at one month of age using PIVKA-II levels.
- To determine optimal vitamin K dosing for preventing deficiency in newborns.
Main Methods:
- Measurement of PIVKA-II levels in three groups of one-month-old infants.
- Group 1: Untreated.
- Group 2: Single 5 mg vitamin K dose at birth.
- Group 3: Two 5 mg vitamin K doses (at birth and 14 days).
Main Results:
- Significantly lower PIVKA-II-positive rates and levels in infants receiving two vitamin K doses (Group 3) compared to one dose or no dose.
- No significant difference in PIVKA-II levels between infants receiving one dose and no dose.
- A single vitamin K dose at birth may not provide adequate protection by one month of age.
Conclusions:
- A single prophylactic dose of vitamin K at birth is insufficient to maintain adequate vitamin K status in breast-fed infants by one month of age.
- Twice-daily vitamin K administration is necessary for complete prevention of vitamin K deficiency and associated bleeding risks.
- Further research into optimal vitamin K prophylaxis strategies for vulnerable infant populations is warranted.
Abstract:
PIVKA-II (protein induced by vitamin K absence or antagonist-II) was measured, as an indicator of vitamin K deficiency, in breast-fed infants of approximately 1 month of age. The infants consisted of three different groups: untreated (group 1); those given 5 mg vitamin K once at birth (group 2); and those given 5 mg twice, at birth and at 14 days after birth (group 3). At 1 month of age, the rate of PIVKA-II-positive infants and their PIVKA-II levels were significantly reduced in group 3 as compared with the levels of the other two groups, whereas these parameters were similar between groups 1 and 2. This observation suggested that vitamin K administration once at birth may be unsafe by 1 month of age. An additional administration of vitamin K seemed to be necessary for complete prevention of vitamin K deficiency, causing severe bleeding in breast-fed infants of approximately 1 month of age.