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- Alyssa Stachowiak, MD, IBCLC, FAAP*
- Lydia Furman, MD, FAAP*
- *University Hospitals Rainbow Babies and Children’s Hospital and Case Western Reserve University School of Medicine, Cleveland, OH
AUTHOR DISCLOSURE
Drs Stachowiak’s spouse works for GenomOncology. Dr Furman serves on the editorial board and is an associate editor for Pediatrics, an American Academy of Pediatrics journal. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Fat-soluble vitamin K is a critical part of the activation of coagulation factors II (prothrombin), VII, IX, and X. Compared with adults and older children, newborns have much lower levels of vitamin K: approximately 40% to 60% of normal adult values, which are not typically reached until approximately 6 months of age. This phenomenon is multifactorial, driven in part by low transplacental transfer of vitamin K, low levels of vitamin K excreted in human milk, and a physiologic delay in the acquisition of gut microflora that synthesize vitamin K, which is actually active in several forms. Vitamin K1, or phylloquinone, is present in green leafy vegetables and is the most common source of vitamin K for humans. Vitamin K2, or menaquinone, is synthesized by bacteria and is found in some animal and fermented products.
Vitamin K was first discovered in 1929 by Henrik Dam, who observed hemorrhages in chicks fed fat-free diets. Edward Doisy identified the structure and forms of vitamin K in the 1940s, and both men received the Nobel Prize for their collective work on vitamin K in 1943. Because of its critical role in hemostasis, vitamin K deficiency can cause bleeding in the infant. Vitamin K deficiency bleeding (VKDB) was first described in the 1930s shortly after the compound’s discovery, with the first infants given vitamin K to treat clinical bleeding later that decade. Swedish researcher Jörgen Lehmann compared the use of oral and intramuscular (IM) vitamin K in the …
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