Vitamin K is a fat-soluble vitamin, a vitamin that dissolves in oils and fats. It helps build strong bones and helps form blood clots. Neonates do not have any vitamin K, so they are unable to form blood clots to prevent any potential hemorrhaging. If the mother is given vitamin K before delivery, not much gets passed to the fetus. Thus medical professionals administer 1 mg of vitamin K-1 at birth.
Vitamin K and Clotting
Vitamin K helps calcium bind to the bones and has an important role in the clotting process. Factors II, VII, IX and X, and proteins C and S, are all proteins that are needed to form clots, and all of them depend on vitamin K to function. Thus a low level of vitamin K will interfere with clotting. Vitamin K is actually made by bacteria located in the intestines, but neonates do not have this bacteria yet. As a result, they do not have enough vitamin K and can have problems forming clots.
Hemorrhagic Disease of the Newborn
Hemorrhagic disease of the newborn describes the disorder in which newborns, also referred to as neonates, suddenly start bleeding. It usually happens two to five days after birth in those newborns who have not received vitamin K, explains F. Gary Cunningham, M.D., in "Williams Obstetrics." The infants may bleed around the belly button, in the intestines or stomach, from areas where they receive a needle, from the nose or mouth or from the penis in boys who have been circumcised.
Early and Late Bleeding
An infant whose mother took certain antiseizure medications during pregnancy can suddenly bleed within 48 hours of being born if not treated with vitamin K. Most of the clotting proteins are made by the liver, and some antiseizure medications can cause the liver to make less clotting proteins. This along with an insufficient amount of vitamin K can result in bleeding. Not receiving vitamin K can cause a breastfed baby to start bleeding 2 to 12 weeks after birth because there is a low amount of vitamin K in breast milk.
Recommendation
The Committee on Fetus and Newborn of the American Academy of Pediatrics wrote a policy statement in the July 2003 issue of "Pediatrics" regarding the administration of vitamin K to neonates. They wrote that although there were some concerns that giving vitamin K could result in some types of childhood cancers, that association was not proven. They therefore recommended that all neonates be given 0.5 to 1.0 mg of vitamin K-1. They also recommended that medical professionals should educate those families whose infants only drink breast milk to receive vitamin K to prevent bleeding in the head.
References
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- Pediatrics: Controversies Concerning Vitamin K and the Newborn
- "Williams Obstetrics"; F. Gary Cunningham, M.D., Kenneth Leveno, M.D., Steven Bloom, M.D. et al.; 2010
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