Of particular interest may be the Rothwell essay, 
and the Mendelsohn excerpts immediately below it.

There is also another long thread here, posted 29/6/2004: thread #3.
 

Hi all,

Just wondering if vitamin K comes with any problems &
what is it given for?

Respectfully
Anya

If you give me your email address, I will send you a copy of the package
insert for the vitamin K injection. Also, we have produced a vitamin K
information pack with lots of data on this issue. It costs $7.50 if you are
interested. 

Take care, 
Meryl 

I have gathered anecdotal evidence that the Vit K jab actually causes or at
least worsens jaundice.  Any scientific evidence that anyone has would be
good.   Having 5000 times the correct amount of this vitamin in a little
body after a jab really does not make any sense to me.

We have experienced anaphylactic reaction from Vit K (Konakion) jab, which
nearly claimed our now 3 year old daughter when she was 1hour and 40 minutes
old.

She has had nothing injected since the day she left hospital.

Cheers for now from,
Kevin
Sydney, Australia

:o)Huggies & Kissies;o)

                      ~Trem~

I know that mystical state, that's where we slipped up.  I had my responses
all learnt ready for the Hep B etc.  But what can a bit of extra vitamin do?
I even asked a nurse what the base of it was after the event and she said it
was 'water'.  I since learnt that it is oil based, peanut oil?  It is
routine like the serotonin jab in the mothers leg to speed up the birth of
the placenta because you cant pay staff to hang around for the birth of that
bit (sorry for being cynical, but I just find that the further I look, the
more it is about money and the less it is about the customer, in any
business that is not driven by human goodness)

Oh, and Tremora, it is not compulsory just routine, they will try to scare
the living daylights out of you saying your baby could die from haemorrhagic
disease, but just be ready with a comeback like, "and you could be hit by a
comet as you walk out of here!"

Cheers for now from,
Kevin M
Question everything
ffrogg@bigpond.com
 

Vitamin K, By Karin Rothville DipCBEd. 

Please find the essay at the above link. 
It has been off this thread mirror and to it's own page,
since it is such a substantial survey of the literature.

Original essay supplied on this thread by:
--------------------------------------------------------
Sheri Nakken, R.N., MA, Classical Homeopath 
Vaccination Information & Choice Network, Nevada City CA & Wales UK
$$ Donations to help in the work - accepted by Paypal account 
vaccineinfo@tesco.net  voicemail US 530-740-0561
(go to http://www.paypal.com) or by mail
Vaccines - http://www.nccn.net/~wwithin/vaccine.htm
Homeopathy course - http://www.nccn.net/~wwithin/homeo.htm
ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL
OR LEGAL ADVICE. THE 
DECISION TO VACCINATE IS YOURS AND YOURS ALONE.

******
"Just look at us. Everything is backwards; everything is upside down.
Doctors destroy health, lawyers destroy justice, universities destroy
knowledge, governments destroy freedom, the major media destroy information 
and religions destroy spirituality" ....Michael Ellner

From "How to Raise a Healthy Child in Spite of your Doctor" by Dr. Robert
Mendelsohn MD:

p. 46
"Many doctors routinely give vitamin K to newborn babies because they have
been taught that infants are born with a deficiency of this vitamin, which
influences how rapidly the baby's blood will clot.  That's nonsense, unless
the mother is severely malnourished; but most doctors do it anyway.
Administration of vitamin K to the newborn may produce jaundice, which prompts the
pediatrician to treat it with bilirubin lights (phototherapy).  These lights
expose the baby to a dozen documented hazards that may require still further
treatment and possibly affect him for the rest of his life."

p. 265 (in Author's References)
"The value of routine administration of vitamin K to newborn infants was
discounted by Drs. J.M. Van Doorm, A.D. Muller, and H.C. Hemker in The Lancet,
April 17, 1977: "We Conclude that healthy babies, contrary to current beliefs,
are not likely to have vitamin K deficiency... the administration of vitamin K
to the newborn is not supported by our findings..." "

If it helps, vitamin K administration started when bottlefeeding became
commonplace.  So, if you are breastfeeding, and don't have a family history of
any type of blood clotting disease, I would say that it's safe to forego. 

This is a good book to have; it also has some info on vaccines, the other
"routine" things done to newborns, and many other common health concerns.

Barbara 
--
Barbara A. Palansky
bap@cisco.com
Cisco Systems, Inc.
 

--------------------------------------------------------
Sheri Nakken, R.N., MA, Classical Homeopath 
Vaccination Information & Choice Network, Nevada City CA & Wales UK
$$ Donations to help in the work - accepted by Paypal account 
vaccineinfo@tesco.net  voicemail US 530-740-0561
(go to http://www.paypal.com) or by mail
Vaccines - http://www.nccn.net/~wwithin/vaccine.htm
Homeopathy course - http://www.nccn.net/~wwithin/homeo.htm
ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL
OR LEGAL ADVICE. THE 
DECISION TO VACCINATE IS YOURS AND YOURS ALONE.

******
"Just look at us. Everything is backwards; everything is upside down.
Doctors destroy health, lawyers destroy justice, universities destroy
knowledge, governments destroy freedom, the major media destroy information 
and religions destroy spirituality" ....Michael Ellner
 

The vitamin K injections used in Australia are of a SYNTHETIC nature, that
is what makes them so dangerous to newborns. Synthetic vitamins can cause
problems in children and adults. Its amazing to hear lots of naturopaths and
nutritional companies claiming there is no difference between a natural and
a synthetic vitamin, I suppose there is no difference between a natural
leather coat and a synthetic leather coat either, that is the mentality we
have to deal with these days, so it is not surprising that a synthetic
vitamin K is being used in the name of health,

Robert Kidd

Tremora
Just building on Kev M posting.

At the birth of my first in 1984 in California I was hit with the Vitamin K
propaganda-heavy, heavy in the US as you cannot remove your baby from the
birthing centre without the peadio's sign off.
It wasn't administered as I used the argument (proudly) that in our country
16million at that time had been born without this so bugger off
(over-simplification).

On research I could only find it had been originally developed for specific
cases, malniutrished, or drug addicted mum's (1980's research). So how did
we get here in 2003. $$$$$$$$'s and the known complete disregard for the
wellbeing of your kids.

Unfortunately the community at large cannot believe the medical/government
would do anything to harm our kids. Time for a paradigm shift.

In the name of all children.
Regards Kevin

"Vitamin K, other options?"
 

Hi,

I am pregnant with my 3rd child and we have decided to use homoeoprophylaxis
with this baby, I am unsure what to do with regards to vitamin K though? Is
there a natural way on top of breastfeeding to up my babes vit K intake?

Would anything like homoeopathy etc be of any use here?
 

Susan
 

Hi Susan, 

Congratulations on planning to become informed about your options before the
birth of your child! I would like to suggest the Australian Vaccination
Network's Vitamin K pack as an excellent source of referenced information on
this injection. You can access it on our website - http://www.avn.org.au, as
well as other information on lots of different topics. Also, that you make
sure that your diet includes lots of leafy, dark green vegetables as this
will naturally increase the level of vitamin K you have to pass on to your
baby. 

All the best to you, 
Meryl 

Susan
After five children without vitaminK jabs I commend you to trust nature.
Breast milk in a mum who isn't malnutrished is all that is required.
Vitamin K didn't exist in Australia till after 1985 so 17 million plus
Aussies got by without problems.

Breastfeeding is all we did. Relax and enjoy your birthing adventure. Above
all don't listen to the fear mongers-TRUST YOUR INSTINCTS.

In the name of all children.
Kevin W

Readig this email makes me really angry, the person that gave our newborn 
son his vitamin k injection told us it was compulsory as she stuck the 
needle in his arm, i was on anti-epileptic meds during pregnancy, she said 
it was something to do with them, but i was misinformed and my poor baby 
endured a needle for nothing.
 
 

:o)Huggies & Kissies;o)

                      ~Trem~
 

Thread 3 A long email post on Vit K

Subject: [AVN] Vit K - Very Long
Date: Mon, 28 Jun 2004 12:59:04 +0100
From: Sheri Nakken <vaccineinfo@tesco.net>
Reply-To: AVN@yahoogroups.com
To: avn@yahoogroups.com

All this is material out of my childbirth class handout on pediatric
options. Sorry it is so long, but Ii wanted to give you all of it. Most of
the sources are cited. Some of this material is from the fensende midwifery
list. - Kathy
--------------------

Vitamin K to Newborns
Breastmilk is low in vitamin K, but this is not a deficiency, nor is it a
hazard for the newborn. We were taught that the gut utilizes bacteria in
the synthesis of vitamin K. Because formula is extremely processed and
sterilized, etc. in its manufacture, it takes the formula-fed infant longer
to build up enough of these friendly bacteria than it does in the breastfed
infant. The substance lactoferrin in breastmilk helps the "digestive system
[to be] colonized with non-pathogenic bacteria" which are necessary for the
infant to synthesize her own vitamin K. My source for this is the "Resource
Notebook for the Breastfeeding Educator Program", 1995 edition, by Debbie
Bocar, RN, BSN, BSS, MEd, MSN, IBCLC (and probably Doctor of Education by
now; she was working on it last year at the time of the course). She gives
her source as Edwards 1994.
----
>From UNDERSTANDING DIAGNOSTIC TESTS DURING THE CHILDBEARING YEAR, 5th Ed.
pages 648, 649: "Other studies have shown that cord blood lacks detectable
vitamin K (Shearer, 1982). In addition, breast-milk from the unsupplemented
mother contains a small amount. Administration of 1 mg. IV vitamin K to
laboring women produces very low plasma cord blood levels. Is nature
insulating the newborn from hight levels of Vitamin K for reasons yet to be
discovered? Just because we haven't figured out why does not make this a
pahtological event. (Emphasis from the poster) We must always beware of
science's attempts to improve upon nature. Remember, that's how they sold
us on bottlefeeding and hospital birth in the first place!
Science has yet to answer why the newborn does not have adult levels of
clotting factors, why s/he receives low levels of maternal vitamin K both
before and after birth, and why the normal newborn may produce a clotting
inhibitor. (Some symptomatic babies, no doubt, suffer from high levels of
the heparin-like inhibitor. Unfortunately, no differential diagnosis is
done to determine if a baby is having clotting difficulties since all
babies are treated prophylactically.) What does vitamin K do to the vast
majority of newborns who do not have a hemorrhagic problem? The fact that
too much vitamin K may cause hemolysis evokes questions regarding vitamin
K's stress on the liver, and whether the production of certain clotting
factors are low at birth to facilitate the immature liver's metabolism of
bilirubin. (Perhaps vitamin K overrides the heparin-like inhibitor commonly
present, promoting what amounts to abnormal clotting for a newborn?)"
----
Could it be because the liver of a newborn is not yet ready to handle the
increased production of prothrombin? I definitely see an increase in
jaundice in the babies we give vit k.
----
Vit K - Newborns
First, I am opposed to most intervention that is done in hospitals when a
baby is born. My pen pal's cousin is a nurse in Ireland who has done
studies on vitamin K. My pen pal sent me an article her cousin wrote that
appeared in the July19/volume 9/number 43/1995 issue of NURSING STANDARD
magazine. The title is "K is for Knowledge: Alarmist literature prompts
Jane Wright to demand that pregnant women be told the full facts about
vitamin K". Also, my pen pal sent me an article from the British Medical
Journal volume 305 August 8, 1992 and BMJ volume 310 March 11, 1995 which
are studies that connect vitamin K to childhood cancers such as leukemia. I
also have an article from Pediatrics in Review volume 7 number 4 Oct 4 1985
that is in favor of vitamin K.
The allopathic authorities say that vitamin K prevents hemorrhagic disease
of newborns. Personally, I don't believe this is a great risk.Has anyone
ever heard of any newborn that has died of hemorrhagic disease? Was it an
epidemic at one time? I know that Jewish people wait 7 or 8 days to
circumcize their sons because there is a chance of hemorrhaging before that
time (at least I think this is the reason). Maybe because of all the
circumcisions that are done, the doctors push the vitamin K.
Another bit of info about vitamin K: too much of it can cause jaundice.
Also, the shot and the drops are available in England and parts of the U.S.
However, in the southern U.S. only the injection is available, or so they
will tell you. When we refused the shot, first they went haywaire and then
they miraculously came up with some drops the pharmacist cooked up. Then
our baby was stricken with jaundice. The pediatrician on call scared us
into thinking our baby was at risk because her body temp. was low. However,
the nurse (who hadn't communicated with the ped) came in and said it was
normal for some babies to have a lower body temp and it was no big deal.
However, by that time we had been scared into agreeing to the drops. I'd
like to hear from other parents who have had a similar experience. - Lisa
Jillani
_____________________

Why is Vit K given?

In the 1986 NAPSAC Summit video Doris Haire gives an excellent explanation
of how and why obstetric anesthesia/analgesia causes newborn hemorrhagic
conditions. Knowing the historical and current heavy uses of narcotics and
forceful delivery techniques (mighty vac, forceps, head pulling etc.) it is
my belief that the routine administration of Vitamin K has evolved out of
the need to protect newborns from iatrogenic conditions rather than
inherent problems of gently born babies. In this sense it is a simple,
effective and needed technology, however its risks (jaundice and some types
of childhood leukemia--injectable) may not be worthwhile when babies have
been born without trauma or drug exposure.
_________________________

Here's the scoop I was taught on Vit. K in nursing school, and verified in
many nutritional texts:
Vit K. is manufactured by BACTERIA in the LARGE INTESTINE and absorbed by
the body. NO KNOWN ORAL FORM EXISTS that has been shown to be effective
for adults. (Although they are constantly researching to try and make
one.) It is in LOTS of foods, it just doesn't get absorbed from the foods.
The vitamin gets destroyed in the acidic environment of the stomach.
Since newborns are sterile in every sense, it takes several months before
their intestines have enough live bacteria to manufacture this vitamin.
Breast fed babies actually have an advantage because momma's breast isn't
sterile, so they can begin to get their bacteria from there.
Vitamin K is a very extremely necessary part of blood clotting cycles. If
my child was going to have a circumcision, any type of forced extraction at
birth, vacuum, forceps, whatever, etc. than I would seriously consider this
SHOT. The oral forms make parents happier, but are generally less
effective. They are somewhat effective if given very early after birth,
because the baby's intestinal system is more "open" to absorbing things
during this time--also the reason antibodies from colostrum are less
beneficial and less absorbed after the first 48 hours.
To understand the necessity of these bacteria to vitamin K and blood
clotting, I had a patient who died from massive internal hemorrhage after
being on antibiotics for serious staph infection for 6 weeks. The staph
was still there, but all his "good" bacteria was dead and no longer
producing vitamin K, so he bled to death.
Don't waste money on any vitamin K pills or supplements, or believe anyone
who tells you their vitamin K can be absorbed. It is a lie. The pill
would have to travel through the highly acidic stomach and highly alkaline
small intestine without being altered, and then suddenly dissolve and be
absorbed in the nearly neutral large intestine.
Lisa Seuferer seuferer@netins.net fax: (515) 827-5945
________________________

http://www.nando.net/newsroom/ntn/health/011598/health1_11686_noframes.html
Vitamin injection suspected in raised cancer risk
Copyright © 1998 Nando.net Copyright © 1998 Reuters
LONDON (January 15, 1998 8:13 p.m. EST http://www.nando.net) - A vitamin
injection given to new-born babies in many Western countries may be
increasing their risk of developing childhood leukemia, British doctors
said Friday. Infants in Britain, the United States and most European
countries are given vitamin K shortly after birth to prevent a deficiency
of the vitamin, a rare condition that can cause hemorrhaging, brain damage
and death. But conflicting results of four new studies probing the link
between the vitamin and childhood cancers have cast doubt on its safety.
"We think there may be a risk. Intramuscular vitamin K looks like it may be
dangerous," Gerald Draper, the director of the Childhood Cancer Research
Group, told Reuters.
Two studies published in the British Medical Journal found no evidence of a
link. The results of a third were inconclusive but a fourth said the
vitamin injection could be associated with an acute form of leukemia. "We
all thought there really wasn't a risk but we can't be absolutely certain.
We can't exclude it on the basis of the data. The papers give very
disparate results but they don't absolutely exclude it," Draper added.
Research carried out by Dr. Louise Parker, of the Sir James Spence
Institute of Child Health in Newcastle upon Tyne, produced the most
startling results. She and her colleagues studied 685 children in northern
England who developed cancer before their 15th birthday and a control group
of 3,442 healthy children. They found no link with vitamin K and all
childhood cancers but they uncovered a raised risk for acute lymphoblastic
leukemia, the most common childhood cancer. "It is not possible, on the
basis of currently published evidence, to refute the suggestion that
neonatal intramuscular vitamin K administration increases the risk of early
childhood leukemia," she said.
Professor Jean Golding, of the University of Bristol in southwest England,
first raised the alarm about the possible dangers of vitamin K in a 1992
study, but most subsequent research failed to support her evidence. Some
doctors now suspect that if there is a link between the injection and
leukemia it could be due to the high levels of the vitamin inserted into
the blood. Others think it may be caused by another constituent in the
injection, rather than the vitamin K itself. "Vitamin K injection was a
relatively easy way of preventing a deficiency without any side effects.
Now people are worried that there may be a cost attached in terms of
cancer," said Draper.
Although there is no conclusive evidence, recent studies have raised enough
doubt for doctors to recommend oral supplements of vitamin K except in the
most serious cases of a deficiency. "Regular low dose oral
supple-mentation can be effective, making it unnecessary to give a form of
treatment over which doubt still lingers," said Parker.
Acute lymphoblastic leukemia, characterized by an increased number of white
corpuscles in the blood, accounts for about 85 percent of childhood
leukemia. There is no cure but medical advances have pushed survival rates
as high as 60 percent and remission rates have reached up to 90 percent.
By PATRICIA REANEY, Reuters
__________________

Treatise on Vitamin K

While looking up my reference on "late-onset hemorrhagic disease" I came
across several items of interest in this discussion. I hope I don't make
anyone angry by posting this, but I am not satisfied with the
non-conclusions we've not come to in this discussion. While reading the
following from my textbooks, I had these questions:
1. Re: the breast-fed infants with hemorrhagic disease: how soon and how
often are they breast-fed? How much colostrum do they receive? Are they
allowed to stay at the breast or is feeding time limited (how much hindmilk
do they receive)? What sort of birth trauma is present in these infants?
2. Why not only inject those infants who are at risk or who have
symptoms? Bleeding ceases in 2-4 hours, if one is watching the infant
closely, is this sufficient?
3. What about giving mothers supplementary vitamin K or having them eat a
diet high in vitamin K? Before birth? After birth?
4. If what we need is friendly bacteria in the intestinal tract, what
about acidophilus? Would it be possible to give the newborn acidophilus? Or
would giving it to the mother be helpful at all (I wouldn't think so...)?
5. If HDN is "completely prevented" by vitamin K injection, why do these
nursing texts give instructions (one even in the "Drug Guide" box) for
observation for symptoms? These texts assume that all infants are going to
receive vitamin K, yet they instruct watching for symptoms.
6. The second text, in chapter 32, says that vitamin K "may be obtained
from food" but is usually synthesized in the gut. So why wouldn't giving
mom plenty of vitamin K-rich foods work?

First of all, let me quote from NURSING CARE OF INFANTS AND CHILDREN, 4th
ed, Whaley & Wong (1991), p 372:
"Hemorrhagic disease of the newborn is a bleeding disorder that may appear
within 1 to 5 days of life as a result of a deficiency of vitamin K.
Newborn vitamin K stores are virtually absent, and there is a moderate
deficiency of prothrombin activity, which decreases until approximately 72
hours after birth when it begins to increase. Consequently, vitamin
K-dependent coagulation factors (II, VII, IX, X) are significantly reduced.
In addition, the newborn's sterile intestinal tract is unable to synthesize
the vitamin until feedings have begun. Breast-fed infants are particularly
at risk because human milk is a poor source of vitamin K. Hemorrhagic
manifestations rarely occur in infants fed fortified cow's milk formula
from the first day of life because this formula is an adequate source of
the vitamin.
"Signs and symptoms of hemorrhagic disease typically appear 24 to 72 hours
after birth and can include oozing from the umbilicus or circumcision site,
bloody or black stools, hematuria, ecchymoses on skin and scalp, epistaxis,
or bleeding from punctures. Diagnoses can be confirmed in the presence of
prolonged prothrombin time (PT) and partial thromboplastin time (PTT)
accompanies by normal platelet count and fibrinogen levels.
"A late form (late-onset hemorrhagic disease) appears at about 4 to 7 weeks
of age. This late-onset disease occurs in totally or predominantly
breast-fed infants. It appears to be related to a factor in breast milk
that inhibits vitamin K synthesis by the infant's bacterial flora.
Manifestations of late-onset disease are evidence of intracranial
hemorrhage, deep ecchymoses, bleeding from the gastrointestinal tract,
and/or bleeding from mucous membranes, skin punctures, or surgical
incisions.

THERAPEUTIC MANAGEMENT
"The goal of management is prevention of hemorrhagic disease of the newborn
with prophylactic administration of vitamin K. In the United States,
intramuscular administration of vitamin K (Aquamephyton, Mephyton) in a
dose of 0.5 to 1 mg once during the first 24 hours of life is a standard
practice. The use of prophylactic vitamin K is not routinely practiced in
all countries.
"In newborns with the disease, treatment is the same as the preventive
measures, except that the vitamin may be given intravenously to prevent a
hematoma at an intramuscular site. Bleeding usually ceases within 2 to 4
hours of vitamin K administration.
"Some have reported success with daily oral administration of vitamin K to
the infants (McNinch and others, 1985; Olson, 1987) or to the mothers
during the last month of pregnancy (O'Connor and Addiego, 1986). To prevent
late-onset disease it is recommended that mothers of breast-feeding infants
receive oral vitamin K supplementation (von Kries and others, 1987). None
of these is standard practice.
"Breast-feeding mothers are encouraged to increase their intake of foods
containing vitamin K, primarily vegetables. The best sources are green
vegetables, especially broccoli."

Also from MATERNAL NEWBORN NURSING: A FAMILY-CENTERED APPROACH, 4th ed,
OLDS, LONDON & LADEWIG (1992), p 889-890:
"A prophylactic injection of vitamin K is given to prevent hemorrhage,
which can occur due to low prothrombin levels in the first few days of life
(see the accompanying Drug Guide -- Vitamin K-1 phytonadione). The
potential for hemorrhage is considered to result from the absence of gut
bacterial flora, which influences the production of vitamin K in the
newborn (see Chapter 32 for further discussion). Controversy exists over
whether the administration of vitamin K may predispose the newborn to
significant hyperbilirubinemia. Cunningham et al. 1989 indicate there is no
evidence to support this concern as long as a standard dose of 1 mg is
given. Some people have questioned the need to give vitamin K to newborns
who have had a nontraumatic birth.
"A study by Von Kries (1988) looked at replacing parenteral vitamin K with
oral vitamin K to avoid injecting the infant. The study demonstrated a
considerably higher level of vitamin K present after intramuscular
administration than after oral administration. Thus, parenteral vitamin K
prophylaxis is a safer means of providing infants with high vitamin K load.
"The vitamin K injection is given intramuscularly in the middle one-third
of the vagus lateralis muscle located in the lateral aspect of the thigh
(Figure 29-4). An alternate site is the rectus femoris muscle in the
anterior aspect of the thigh. However, this site is near the sciatic nerve
and femoral artery and should be used with caution.

"DRUG GUIDE -- VITAMIN K-1 PHYTONADIONE (AQUAMEPHYTON)
"OVERVIEW OF NEONATAL ACTION "Phytonadione is used in prophylaxis and
treatment of hemorrhagic disease of the newborn. It promotes liver
formation of the clotting factors II, VII, IX, and X. At birth the neonate
does not have the bacteria in the colon that is necessary for synthesizing
fat-soluble vitamin K-1, therefore the newborn may have decreased levels of
prothrombin during the first 5-8 days of life reflected by a prolongation
of prothrombin time.

ROUTE, DOSAGE, FREQUENCY
"Intramuscular injection is given in the vastus lateralis thigh muscle. A
one-time only prophylactic dose of 0.5-1.0 mg is given in the birthing area
or upon admission to the newborn nursery. If the mother received
anticoagulants during pregnancy, an additional dose may be ordered by the
physician and is given at 6-8 hours post first injection.

NEONATAL SIDE EFFECTS
"Pain and edema may occur at injection site. Possible allergic reactions
such as rash and urticaria.

NURSING CONSIDERATIONS
"Observe for bleeding (usually occurs on second or third day). Bleeding may
be seen as generalized ecchymoses or bleeding from umbilical cord,
circumcision site, nose, or gastrointestinal tract. Results of serial PT
and PTT should be assessed.
"Observe for jaundice and kernicterus especially in pre-term infants.
"Observe for signs of local inflammation.
"Protect drug from light."
from Chapter 32 (p 1054): "Several transient coagulation-mechanism
deficiencies normally occur in the first several days of a newborn's life.
Foremost among these is a slight decrease in the level of prothrombin,
resulting in a prolonged clotting time during the initial week of life.
Vitamin K is required for the liver to form prothrombin (factor II) and
proconvertin (factor VII) for blood coagulation. Vitamin K, a fat-soluble
vitamin, may be obtained from food, but it is usually synthesized by
bacteria in the colon, and consequently a dietary source is unnecessary.
However, intestinal flora are practically nonexistent in newborns, so they
are unable to synthesize vitamin K.
"Bleeding due to vitamin K deficiency generally occurs on the second or
third day of life, but it may occur earlier in babies of mothers treated
with phenytoin sodium (Dilantin) or phenobarbital. These drugs impair
vitamin K activity, and bleeding may be seen at birth. Coumarin compounds
are vitamin K antagonists that can cross the placenta. Thus the baby
exposed to maternal coumarin can also manifest bleeding in the first 24
hours of life. Bleeding may also occur in babies receiving parenteral
nutrition without adequate vitamin K additives (1mg/week). Bleeding from
the nose, umbilical cord, circumcision site, gastrointestinal tract, and
scalp, as well as generalized ecchymoses may be seen. Internal hemorrhage
may occur.
"This disorder can be completely prevented by the prophylactic use of an
injection of vitamin K. A dose of 1 mg of AquaMEPHYTON is given as part of
newborn care immediately following birth, and consequently the disease is
rarely seen today. Larger doses are contraindicated because they may result
in the development of hyperbilirubinemia."
_______________________

Treatise 2 on Vitamin K

Hemorrhagic Disease of the Newborn (HDNB) can occur anytime in the 1st few
months of life. Early HDNB occurs in the 1st 24 hrs, Classical HDNB is at 1
to 7 days (most often at 2 to 5 days) and Late HDNB is usually between 2 &
8 wks, but can occur anytime in the 1st year. When the clotting factors get
too low the baby can develop spontaneous bleeding- anything from bruising
and umbilical bleeding, to intrathoracic, intra-abdominal, or intracranial
hemorrhage.
Newborns have only 20-50% of the coagulation activity of adults, including
the vit. k dependent clotting factors (prothrombin, proconvertin, &
others). Levels in premature babies are even lower. Vitamin K prevents HDNB
by increasing the activity of these K-dependent clotting factors. Incidence
of HDNB is 1:1200 if no vit k is given and 1:20,000 if k is given to high
risk babies only.
Risk factors include: Maternal: exposure to anticonvulsants, barbiturates,
aspirin, or antibiotics. Newborn: prematurity, low birth weight, difficult
births (forceps, shoulder dystocia, excessive molding, breech,
cephalhematoma), malabsorption conditions (e.g. bowel obstruction, cystic
fibrosis), exposure to any of the drugs listed under maternal risks
(including breastfeeding exposure), and, ironically enough, exclusive
breastfeeding. Breastmilk has about 2-15 mg/liter of vit. k, formula has
about 50 mg/liter. One study said that out of 198 cases of HDNB, 186 were
breastfed and only 3 were exclusively bottle fed.
Initial symptoms can include: vomiting, lethargy, pallor, loss of appetite,
fever, convulsions, unconsciousness, dyspnea, nodular purpura (widespread
deep ecchymosis), bleeding from circumcision or injection sites, or other
hemorrhage. Intracranial hemorrhage is seen in 50-80% of affected babies
and causes death or severe handicap in 50-70% of those babies.
Vitamin K is fat soluble. It comes from plants & vegetable oils (Type K-1)
and is also synthesized by bacteria in the gut (type K-2), but K-2 is not a
major source in the 1st 4-6 months of life. Food sources of K are leafy
greens (spinach, kale, turnip, etc.), cabbage, cauliflower, peas, kelp,
alfalfa, nettles, green tea, chlorophyll, dairy products, egg yolks,
safflower & other polyunsaturated oils, and fish liver oils. Vit. K is
destroyed by freezing & radiation.
Placental transport of vit. k is documented, but babies levels will be much
lower than moms. Cord blood has levels at 1/10th to 1/2 of maternal level.
There was, however, a significant decrease in intracranial hemorrhage in
preemies when their moms got IM vit. k 4-5 hrs before delivery.
Studies vary as to the effectiveness of oral vitamin k. Late HDNB seems to
still be a problem when K is given orally, so repeated doses are usually
recommended, though advice about when to give them & how much to give
varies. We don't seem to have oral K available in the US, but the
injectable form may be given orally (Double the dose- draw up 2 ampules,
remove the needle, and squirt into baby's mouth) The stuff tastes terrible,
and in my own personal experience babies react worse to the oral dose then
the injection, so I usually give it IM. I use a 27g needle and give it
while the baby is nursing. Most of them don't even cry.
If a mom doesn't want to give the baby vit. k, I recommend that she take
Vit. k during her pregnancy and the first few months of breastfeeding. It's
available in pill form at health food stores. It may not be as effective,
but it seems like an acceptable alternative for low risk babies. I've heard
of shepherds purse tincture being given instead of K, but I don't know much
about it.
________________________

Vitamin K Treatise 3

Vitamin K prophylaxis is primarily used to prevent late hemorrhagic disease
of the newborn (LHDN). Late onset LHDN is a syndrome of severe bleeding in
infants, between one and six months of age, commonly causing Intracranial
Hemorrhage with a 50% mortality rate. The incidence is 1:1200 in the UK. It
can be of idiopathic or secondary origin This occurs between 2 weeks and 6
months of age. It is due to impaired absorption of vitamin K in the
newborn's gut. This can be due to immature liver function, biliary atresia
or alpha antitripsin abnormalities. Often the infant has mild hepatitis
with no outward symptoms and recovers spontaneously. Recent research points
to temporary inability of the liver to produce the bile salts necessary to
absorb the fat soluble vitamin K. The early and classic versions of this
are far less common with the reduction in traumatic deliveries and with
proper care of women on anticonvulsant and anticoagulant RX. In Holland,
where LHDN is almost non-existent, the midwives provide 1 mg vit K po at
birth then the mothers give the baby 25 ug weekly po until 6 months. They
have a special oral vitamin K preparation.

I have experience of two cases of LHDN in Ontario in the last few years
Case 1: LHDN, Intracranial Haemorrhage, Winter 1992 Baby boy K, born at
home, spontaneous labour and birth at term. No molding or caput noted.
APGAR scores 9 at 1 and 5 minutes. Parents declined vitamin K prophylaxis.
Exclusively breastfed, thrived. At the age of 5 weeks the mother
accidentally cut the infant's finger when clipping his nails. She paged the
midwife to notify her that it took a long time to stop bleeding. The
following day she paged her midwife and stated that the baby was pale, had
a high pitched cry, wasn't feeding and was limp and floppy . The midwife
advised the mother to take the baby to the hospital. On admission he had
prolonged clotting times which normalised after parenteral vitamin K
administration. He remained in the hospital for several weeks. He has
residual motor and cognitive brain damage, the extent of which will not be
known until he is older.
Case 2: Late HDN? warning bleed, Spring 1994 Baby girl S. was born at home
in June, 1994 at 41 weeks gestation following an uncomplicated pregnancy
and labour. Her APGAR scores were 9 at one minute and 10 at 5 minutes,
birthweight 7 lb.. Molding 2+ of parietal and frontal bones was noted on
the newborn examination. At approximately one hour following the birth 0.5
mg of vitamin K was given orally. She received a further 0.5 mg of vitamin
K orally on day 10. She was exclusively breastfed. On day 12 her mother
reported blood and mucous in her stool. The midwife assessed Baby S at home
and reported as follows: Nursing vigorously Q 1-3 hours, alert, Resp. 41,
apical rate 136, temp 36.1C, skin-clear, dry and pink, eyes-clear, cord
stump healed, urine ++, stools-yellow curds with about 1 tsp. of mucousy
red blood, weight 7 lb 6 oz. In view of the increased risk of further
bleeding and after discussion with the parents, regarding the risks of Late
Haemorrhagic Disease of the Newborn (LHDN) vitamin K 1.0 mg was given
intramuscularly. Consultation with a neonatologist resulted in no further
treatment or investigations. Baby S has thrived since then.

Risks of Oral Vitamin K Prophylaxis
Research has demonstrated that the use of a single, oral dose of vitamin K
is not protective for the more severe mortality and morbidity of LHDN.
(Greer et al., 1988; Greer et al., 1995; McNinch and Tripp, 1991; Motohara
et al, 1987; Shinzawa et al., 1989; Von Kries et al., 1987a) In a recent
two year prospective study of 27 infants who were diagnosed with VKDB, six
had been given oral vitamin K. (McNinch & Tripp, 1991) Multiple oral dose
routines have problems with format of the preparation and compliance with
the routine.
In a United Kingdom National cohort study of all children born during one
week in 1970, vitamin K administration at birth was found to have a
significant association with childhood cancer. (Golding et al., 1990)
Golding et al. published a further case control study in 1992, which
demonstrated parenteral vitamin K administration and smoking as
independently significant factors in the subsequent development of
childhood cancer.
In examining this study I found a number of factors which may have
confounded the results or limit it's generalisability. Primarily, the
numbers of children studied was small, only 33 children with cancer were
used, this reduced the power of the study. Records of vitamin K
administration, both dosage and route were of poor quality and a large
number of assumptions were used to assign treatment to index cases and
controls. Intravenous (IV) and intramuscular (IM) administration of vitamin
K were combined. Significant differences in vitamin K levels in neonates
following IV and IM vitamin K have been demonstrated in a study by Loughnan
and McDougall (1995). Controls were matched to cases by age, parity and
social class. A more rigorous matching to include maternal smoking, type of
delivery and other potential confounding factors would have improved the
strength of the study.
Three other studies have been completed in the USA, Denmark and Sweden. The
American trial was a prospective case control study, while both the Danish
and Swedish were retrospective case control studies. While each of these
studies found the same difficulty with quality of record keeping re vitamin
K administration, the degree of missing information was smaller. The Danish
and Swedish studies relied on retrospective data and compared groups from
different time periods. Environmental and social differences over periods
of 30 years may not have been fully excluded from the results as
confounding factors. None of these studies has found any causal link with
childhood cancer and IM vitamin K administration.(Klebanoff, et al., 1993;
Ekelund et al., 1993; Olson et al., 1995)
----
Haemostasis 1990;20(1):8-14 - Medline

Vitamin K1 levels and coagulation factors in healthy term newborns till 4
weeks after birth.
Pietersma-de Bruyn AL, van Haard PM, Beunis MH, Hamulyak K, Kuijpers JC
Department of Gynecology and Obstetrics, Reinier de Graaf Gasthuis, The
Netherlands.

Vitamin K1 serum levels were assessed by means of an off-line
multidimensional liquid chromatography in 18 mothers, shortly after
delivery, and in their healthy term infants. Umbilical cord and venous
blood samples were assayed up to 4 weeks of life. Concurrently, levels of
coagulation factors II and X, antithrombin III and platelets were
established. Although the detection limit of the assay was as low as 22
pg/ml, vitamin K1 concentration appeared to be still beyond that level in
cord blood or in newborn serum within 30 min after birth, whereas
vitamin-K-dependent coagulation factors are already at a level of 40%,
without evidence for the presence of descarboxy prothrombin, in any of the
investigated neonates. After 3 days, breast-fed neonates had lower vitamin
K1 levels than formula-fed infants (0.76 and 1.44 ng/ml, respectively). The
levels of the vitamin-K-dependent coagulation factors II and X, however,
were comparable, regardless of the kind of feeding. After 28 days,
breast-fed neonates had even lower vitamin K1 levels (0.49 ng/ml, while the
formula-fed infants showed higher vitamin K1 levels (4.45 ng/ml). But even
then, the levels of vitamin-K-dependent coagulation factors II and X were
comparable, regardless of the kind of feeding. From this we conclude that
the serum levels of vitamin K1 in formula-fed neonates exceed those of
breast-fed infants from the moment of feeding (24 h and later) without a
concomitant rise in vitamin-K-dependent coagulation factors. A relationship
between vitamin K1 levels and vitamin-K-dependent coagulation factors could
not be established in healthy term breast-fed or formula-fed infants.
PMID: 2323682, UI: 90215547
_______________________

Br J Obstet Gynaecol 1996 Nov;103(11):1078-1084 MedLine

Vitamin K prophylaxis to prevent neonatal vitamin K deficient intracranial
haemorrhage in Shizuoka prefecture.
Nishiguchi T, Saga K, Sumimoto K, Okada K, Terao T
Department of Obstetrics and Gynecology, Hamamatsu University School of
Medicine, Shizuoka, Japan.

OBJECTIVE: To compare three methods of vitamin K prophylaxis for neonatal
vitamin K deficient intracranial haemorrhage.
DESIGN: We designed three strategies for vitamin K prophylaxis: 1.
therapeutic administration of vitamin K in a mass screening system using
the hepaplastin test; 2. routine oral administration of vitamin K to
newborn infants; and 3. administration of vitamin K to lactating mothers
during the late neonatal period in addition to the routine method. We
evaluated the efficacy of these methods by determining hepaplastin test
values at the first month of age.
POPULATION: 66,076 full term healthy newborn infants without any
complications.
RESULTS: Of 55,513 infants in the mass screening system, 3068 infants
received vitamin K therapeutically. At the first month of age, in the group
where vitamin K was administered therapeutically, 56 infants (1.83%)
exhibited low hepaplastin test values (< 40%) despite vitamin K
administration. But extremely low values (< 20%), indicating a very high
risk of neonatal intracranial haemorrhage, were observed in 34 (0.06%) of
52,445 infants who did not receive vitamin K. In the routine administration
system, oral administration of vitamin K twice within the first week of
life showed a lower incidence (0.19%) of low level cases than a single
administration (1.56%). An additional administration of vitamin K to
lactating mothers throughout the late neonatal period showed an effective
result.
PMID: 8916992, UI: 97074565
___________________
Kathy

Rev. Kathy Rateliff; Doula, childbirth & cord blood educator
Administrator, T2 Shepherd Ministries - Titus 2:1-8
http://www.geocities.com/Heartland/Ranch/4172
<mailto:Rateliff@fni.com>