Vit K for baby w/maternal blood clotting disorders? - Mothering Forums

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Old 08-17-2005, 12:20 AM - Thread Starter
 
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Hi,
I did a search here and looked at all of the threads on administering Vit K to newborns but this question didn't seem to be addressed.

I have a blood clotting disorder (where my blood tends to overclot) and I am on blood thinners for this pregnancy. I am thinking about whether or not to have Vit K given to my child when it's born (midwife assisted hospital birth) and am trying to gather info.

I actually have been discussing this with a pediatric hematologist who admits that there have been no studies on this issue at all- she is doing research to see what the protocol is in other countries and will give me her professional opinion (which seems balanced) and studies to read for myself so I can make a decision.

I was curious to know if anyone here has had experience with this-esp providers (pamamidwife?, mwherbs?, doctorjen? others?)

To clarify- my disorder is inherited (faulty gene), which means my child has a 50% chance of inheriting a tendency to overclot...my hunch is that Vit K would not be a good thing in this case. However, if there is some trauma during delivery...maybe it would be a good thing.

I am not comfortable consuming large quantities of Vit K during pg or pp since it isn't a good idea for my body.

The blood thinner I am on does not cross the placenta to the baby, fyi.

Any thoughts?

thanks in advance.
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Old 08-17-2005, 01:09 AM
 
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Hmm, I'd be interested to know if there is any good consensus on this one. It hasn't come up in my practice.
The vit K dependent factors are II, VII, IX and X. If your clotting disorder is not with one of those, I'm guessing the vit K may not make much difference either way, but I'm really not sure.
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Old 08-17-2005, 10:14 AM - Thread Starter
 
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Hey DJ- thanks for responding.

Yup, mine is II and there is absolutely no consensus on this in the field, that's for sure. That's why I'm looking for thoughts from a wide range of people and combining that with my gut feeling. The only thing is that for us to refuse I have to go through a whole lot of hoops (gotta love NYC for that) and I'll need a bit more documentation than my gut to not be put through those hoops, which is the last thing I'd want to deal with after the live birth of my 2nd child, kwim?

I just realized something- I only have one faulty gene, so between the 2 of us (parents) that's actually a 25% chance of inheriting the gene (assuming my dh doesn't have it, which we don't think he does). What's up with my math?
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Old 08-17-2005, 12:49 PM
 
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I've decided not to do vit K at all. From my research it looks like vit K is just to prevent an extremely rare sudden brain hemmorhage. And when you give a baby vit K, you trade this risk for an equal risk of leukemia when the child is older. I don't know about you guys, but I actually think I'd prefer my baby to die suddenly and young from brain hemmorhage than to have them suffer w/ leukemia later in life. Just my thoughts on the matter.

Oh, and we have the opposite going on here. My dh has von Willebrand Disease, type 1, where he doesn't make enough von Willebrand factor, which affects factor VIII. Ds2 inherited it from him. And when we were at the hematologists in Indy after a botched blood work at the local hospital (this hospital is SO friggin inept!), they were taking a full family history from me, as well, that necessitated a call to my dad. Basically, the local hospital realy screwed up ds's bloodwork and it came back looking like he had HEMOPHILIA! So the hematologist was like, with these times, your ds would have to have worse than vWD type 1, which is all he could have inherited from dh. So I called my dad, b/c his mom always said her dad had hemophilia, and my dad said that he in fact had a bleeding disorder as a child but had "outgrown it." (Not possible, but mild bd's are usuaslly less noticable in adult men than they are in boys and post-pubescent women b/c of the period factor.)

So now I found out that there is also a bd in MY family, that sounds an awful lot like vWD, which makes sense since it's the most common bd! So if I DO have it, our kids have a 1/4 chance of getting type 3, which is equivalent to hemophilia. Luckily ds2 just has type 1 (the local lab really screwed up b/c his clotting times came back normal at the hematologists, which is pretty normal for type1. It's very mild in most cases.), so we're still not sure if I have it. I can't be tested b/c factor levels go up during pregnancy and while nursing. ARG!

I'm still not doing the vit K.
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Old 08-17-2005, 01:06 PM
 
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We have no knowledge of genetic blood disorders, so this makes our decision-making on this topic a little easier. After reading an article from Midwifery Today on vitamin K we got from our midwife we decided that we are going to give the baby the oral drops rather than the injectable vitamin K, because the baby gets much less vitamin K this way.
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Old 08-17-2005, 03:43 PM
 
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I've got the Factor II mutation as well, though I've never had a clinically demonstrated clotting problem. I'm intrigued by the question. Hadn't thought about it that way before!

Quote:
Originally Posted by ST
I just realized something- I only have one faulty gene, so between the 2 of us (parents) that's actually a 25% chance of inheriting the gene (assuming my dh doesn't have it, which we don't think he does). What's up with my math?
Each parent gives the child one copy of each gene. So your original math was right. You have two copies, and you'll pass on one of them to this child. Your child has a 50% chance of inheriting the mutation from you and having the clotting disorder.

The math is a little different from other genetic disorders, because the most common Factor II mutation is dominant. That means you only need one faulty gene to be affected. Most of the commonly known genetic disorders are recessive, meaning that both parents need to be carriers in order for their child to be affected.

Carolyn
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Old 08-17-2005, 04:01 PM
 
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If your med. doesn't cross then you're in the same boat for vit. K as you would be if you weren't on the med, right? With the added possibility that your child will have the disorder too and clot MORE than they should....

-Angela
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Old 08-17-2005, 05:47 PM - Thread Starter
 
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My goodness Wendy, I've already had my first child die suddenly right before he was born so given your scenario, the possibility of childhood leukemia looks "good" to me.
Of course it doesn't...neither scenario is one that I'd like to make a choice of. From what I've read the leukemia study hasn't been replicated since the early 90's. Any more info on that connection I'd appreciate looking at. And there is the fact that many children get Vit K and don't get leukemia or other complications.

Zelda'sMom, yes, if you fall into the "normal" range, it's much easier to make these kinds of decisions. And the NCB community in general seems to have so little guidance for those of us who are here, but have particular complications/issues. Sigh.

Carolyn- my only "symptom" of the disorder was the stillbirth of my first son...unfortunately. I'm not sure I understand your explanation though--I am heterozygous so I have one copy of the gene. If my dh has none and I have 1, wouldn't that give my dc a 25% chance of getting it? If it's dominant are you saying that my 1 gene is strong enough to count as 2 for my dc? I think I should've listened better in HS bio. lol.

alegna, yup, that's pretty much what the situation is. I'm not sure if I'd refuse or accept it if I didn't have the disorder, so I'd be going through this exercise regardless just not posting about it, most likely.

At this point I'm leaning towards keeping my options open, seeing what happens with the birth (if there is trauma or anything that would warrant it) and listening to my gut.

I appreciate the thoughts and welcome more!
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Old 08-17-2005, 06:39 PM
 
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Quote:
Originally Posted by ST
If it's dominant are you saying that my 1 gene is strong enough to count as 2 for my dc?
Hmmm. How to explain.

Simplifying a bit, in each of a human's cells (except egg and sperm cells), there are two copies of every gene. One copy was received from mom and one was received from dad. But the egg and sperm cells are different from all other cells in the body. They have only one copy of each gene, so that if they join to form an embryo, that resulting embryo will have 2 copies of each gene.

Half of your egg cells carry the normal Factor II gene, and half of them carry the mutated Factor II gene. So whether or not your child has this clotting disorder is determined by which copy of the gene was carried by the egg that you ovulated when you conceived him.

If something is dominant, that means that one copy of the mutated gene is enough to override a normal copy of the gene. In this case, you (and I) both have one normal copy and one mutated copy. Both copies make Factor II protein. The normal copy makes normal Factor II protein, which functions normally. The mutated copy makes Factor II protein that is abnormal and that may clot under inappropriate circumstances. So even though you have normal Factor II protein in your blood, the abnormal Factor II protein is capable of screwing things up all by itself. That's why you need only one faulty gene to cause the clotting disorder.
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Old 08-17-2005, 06:45 PM
 
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If the disease is caused by a dominant gene, then I believe your little one would have a 50% chance of inheriting it. From DH, s/he would definitely get the "normal" gene. Then, from you, s/he could either get a normal gene or the mutated version. Essentially, 50/50. Your mutated gene doesn't count as "2" but your child will either get one or the other. I could be wrong, but this is what I remember from my genetics classes.

X x
x xX xx

x xX xx

If the diagram above shows the mutated gene (the disease causing gene) as X and the normal gene as x then you can see how the 50% chance works out.
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Old 08-17-2005, 06:46 PM
 
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Oops. LOL. jplain beat me to it.
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Old 08-17-2005, 09:30 PM
 
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The references I have are

Parker et al., "Neonatal vitamin K administration and childhood cancer in the North of England: retrospective case-control study," BMJ (England) 316, no. 7126 (Jan 1998): 189-93.

S.J. Passmore et al., "Case-control studies of relation between childhood cancer and neonatal vitamin K administration," BMJ 316, no. 7126 (Jan 1998): 178-84.

I have some more, but I am very pregnant and have a terrible cold and just don't feel like typing it all out right now.

I got the info mainly from Baby Matters. I had heard the controversy over vit K w/ my first 2, but I never really found quite enough info to make it seem very important to me either way. My first had the vit K shot and I had written that I didn't want my 2nd to, but honestly, I'm not sure if he did or not. I had a traumatic birth with him and the first hours after it kinda run together. Anyway, according to the author, babies who don't get the vit K shot have a 1.8 in 100,000 chance of having a permanent injury or death due to brain bleeding, which is a very very small chance, and usually happens to babies who are exposed to drugs or alcohol through their mother's milk, or have other health problems. Of the babies who DO get the shot, there are 1.5 more cases of childhood leukemia per 100,000, also a very small number, about the same as the risk for the brain bleed.

I forgot to say in my post that I will be taking vit K orally myself after the birth, most likely in the form of shepherd's purse, but I may take regular supplements. I'm talking about it w/ my mw on Friday when I see her to see what she thinks. This way, the baby will be getting the vit K he needs without getting a huge overdoes, which is what the amount American hospitals give babies is. This should greatly reduce the chance of the brain hemorrhage without giving the baby the huge overdose of vit K that causes cells to grow out of control.
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Old 08-17-2005, 09:36 PM
 
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And on the clotting disorder thing, vWD is also a dominant disorder, so you only need 1 gene to have it. So if I don't have it, our kids have a 2/4 (1/2) chance of getting the disorder because here's dh: Xx and here's me: xx, so all the different ways we can combine is Xx, Xx, xx, xx. But if I DO have the disorder, the baby has a 2/4 (1/2) chance of having type 1, which is Xx, and a 1/4 chance of having type 3, XX. (I would be Xx and dh would be Xx: XX, Xx, xX, xx.) Type 3 is serious as it is a complete absense of the factor needed. Does that make sense?
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Old 08-18-2005, 10:42 AM - Thread Starter
 
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Wendy, thanks for the link to the studies. And please, be thankful that you have the luxury of speaking in hypotheticals when it comes to which loss would be "worse". Trust me, if you experienced either loss I doubt you'd be so interested in trying to convince me or imagine for yourself which would be worse. They'd both be horrendous for different reasons.

Back to the topic at hand:
jplain and Nora, thanks for the info- it does make sense to me. I remember those gene charts from bio...but I also remember them not being that interesting to me at the time I appreciate you simplifying the explanation for my preggo brain.
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Old 08-18-2005, 12:29 PM
 
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Quote:
Originally Posted by wendy1221
Also, I have to say as the mother of a 6yo and a 2yo that I really think it would be easier to lose a young baby than an older child. Either one is a terrilble terrible thing and I am very sorry for your loss. I can only imagine how hard that was. I am 36 weeks right now and I know I would be devastated if I lost this baby. But the unconditional love you feel for your unborn baby grows tremendously the longer you get to know your child, nursing him at your breast, seeing his first smile, first words, as he grows into a little person with his own personality and has conversations with you. When he looks into your eyes and tells you he loves you. WHen he comforts you in hard times the way you've always comforted him. It becomes so much more than unconditional mother love. You love them in different ways, just like falling in love with your dh or a best friend. You still have that unconditional love you felt before they were born, but so many other kinds of love build on top of that. I don't know how else to explain it. I'm sure some day soon you'll understand exactly what I'm saying. I'm sure it's hard to believe as I couldn't imagine loving anyone more than my new baby when I was pregnant and just after he was born, but honestly, that loves grows tremendously.


I absolutely cannot believe that you just said that. I don't even know what to say to this.

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Old 08-18-2005, 12:46 PM
 
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Quote:
Originally Posted by wendy1221
Also, I have to say as the mother of a 6yo and a 2yo that I really think it would be easier to lose a young baby than an older child.
As someone who is the mother of a 4 year old DD and recently lost a baby, I can honestly say that the idea of it being "easier to lose her now" simply never occured to me. One of the most devastating things about losing a baby is that you ALSO lose the rest of their life, and all the hopes and dreams you had for their life and your family.

My older DD turned 4 the other day and on her birthday my thoughts were constantly on Leah and realizing that I would never watch her turn 4. I would never see her first steps or hear her first words. Every day my older DD reminds me of all the things that I am missing. Leah is a hole in my life and my heart that will never be filled. The idea that the grief of losing a child at any time is better than at any other time is just so.....I don't even know what to say.....

New WOHM to DD8 and DD3
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Old 08-18-2005, 01:04 PM - Thread Starter
 
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Well I'm glad to see that some people who read that felt compelled to respond here and to me privately regarding the incredibly ignorant and insensitive comments that were made.

egoldber, I am so sorry for your loss of Leah (and your other babes). I am almost 2 years past the loss of my ds and I cannot begin to tell you how much that hole will never be filled and the ways my life has been irrevocably changed by his death. My life is completely different in every way. I wish you peace and healing.
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Old 08-18-2005, 01:53 PM
 
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ok this is a complex one I have thought about this myself because treatment for clotting disorders has increased so much in recent times. Vitamin K has to do with clotting and anti-clotting factors the vitamin K-dependent blood coagulation factors (prothrombin, factor VII, factor IX, and factor X) and coregulators of blood coagulation (protein C, protein S, and protein Z) protein C and protein S are anti-clotting factors . besides clotting factors vitamin k also has a role in everything from laying down of calcium in bones, prevention of hardening of the arteries, insulin regulation to nerve generation.

you could do some searches of lit on pub med.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed

since you have a known genetic disorder it is a bit different that the presumed disorders of some women who have had multiple miscarriages

vitamin K is low in all newborns at birth and not much transfers between mom to baby during pregnancy- so probably the baby will be born with normal newborn levels of clotting factors. it is during postpartum where breastfed infants have been having problems with vitamin K levels being low -- so one consideration would be to give your baby oral vitamin K postpartum it is a multi-dose thing so if your baby didn't end up needing it you could discontinue giving it and not put the baby in danger , while you await test results.

this is an abstract about levels transfered in pregnancy--
Lancet 1982 Aug 28;2(8296):460-3

Plasma vitamin K1 in mothers and their newborn babies.

Shearer MJ, Rahim S, Barkhan P, Stimmler L

Plasma vitamin K1 (phylloquinone) was assayed in normal adults and pregnant women at term and their babies by a method based on high-performance liquid chromatography. The mean plasma concentration in 30 healthy, fasting adults was 0.26 ng/ml (range 0.10-0.66). 8 out of 9 healthy mothers at term had a mean K1 concentration of 0.20 ng/ml (range 0.13-0.29), but K1 was not detected in the cord plasma of their babies. 1 mg vitamin K1 given intravenously to 6 mothers shortly before delivery raised their plasma K1 to 45-93 ng/ml: K1 was then detectable in the cord plasma of 4 of the 6 infants but at a much lower concentration which did not exceed 0.14 ng/ml. The large concentration gradient between maternal and neonatal plasma suggests that vitamin K1 does not cross the placenta readily or that the uptake by fetal
plasma is low, perhaps because of low levels of a binding lipoprotein. The low levels of vitamin K in the cord plasma of the normal newborn would explain "physiological" hypoprothrombinaemia and suggest the need to reassess current clinical practice in respect of vitamin K prophylaxis in the early neonatal period.
----------------------------------------------------------------------------
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Old 08-18-2005, 03:03 PM
 
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Quote:
Originally Posted by wendy1221
Also, I have to say as the mother of a 6yo and a 2yo that I really think it would be easier to lose a young baby than an older child.
Wendy, I'm sure you didn't intend to come across as harshly insensitive, but you did. The "whose pain is worse?" game has no winners, only losers. I hope you'll reconsider your statements and apologize to the original poster.
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Old 08-18-2005, 03:53 PM
 
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Quote:
Originally Posted by jplain
Wendy, I'm sure you didn't intend to come across as harshly insensitive, but you did. The "whose pain is worse?" game has no winners, only losers. I hope you'll reconsider your statements and apologize to the original poster.

and a little shocked
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Old 08-18-2005, 04:00 PM
 
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Back on topic, the issue I'm interested in pursuing is whether or not an excess of vitamin K can stimulate/trigger clotting, or whether it is a necessary but otherwise inert co-factor. A follow-up question would be whether the answer to that question might be different for a person with a pro-clotting mutation in one of the vitamin K dependent clotting factors.

I'll try to dig up my hematology text, but I'll also contact my former supervisor and see if she can direct me to someone who knows.
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Old 08-18-2005, 04:11 PM
 
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Holy cow on the "easier to lose a newborn" comments. I would be devastated beyond belief to lose one of my living children (17, 10 1/2, 8, 2) But I would not for one second trade any of the joy of having had them with me for however long I've had them for the possibly "easier to get over" of losing them as a newborn even if that were true. I feel so lucky and blessed to have never had to deal with a loss of either kind.
You need to realize when you make such hypothetical comparisons that you are speaking to a mother who probably would give anything to have had 2 or 6 years with her beautiful son - and probably worries daily that it may not even happen with the baby she's expecting.
ST - I want you to know I think of you often and wish you never had to deal with any of this. Your little Nazir is not forgotten.

Now just musing out loud about vit K and clotting. Doesn't vit K at birth just jump start the availability of vit K for production of clotting factors? Does it really increase clotting above what is normal for, say, a 2 week old infant? Despite the prevalence of clotting disorders, thrombotic events in newborns are quite rare. Of course, bleeding events in newborns are quite rare, too. I think this is going to be a hard call. Hopefully, the peds hematologist can come up with at least a balanced review of the physiology for you that will be helpful in making a decision.
Do you get the genetic explanation now?
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Old 08-18-2005, 04:12 PM
 
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jplain, we cross posted - but yes, I think that's what I was trying to say is the key question (and you said it better,) if vit K increase beyond normal what the clotting ability is or not.
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Old 08-18-2005, 04:27 PM
 
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Nothing to add to the discussion aboud vit K.. just learning.
I just wanted to stop by and give ST a big I'm sorry for the insensitivity of others.
Egoldber, I dont' know you, but I'm so very very sorry for your loss

Mamato Ruby Violet joy.gif(6 with autism) and someone 1sttri.gif who should make him/herself known sometime in the next month.

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Old 08-18-2005, 04:38 PM
 
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we nearly cross posted as well
what I would say is like Dr Jen has said - excessive clotting in the newborn and thromboembolic events as a result is a far more rare event than reduced clotting--


----- I have similar questions though but for moms who have low levels of protein C or S -- if not auto-immune but just low levels would an increase in vitamin K foods help or not and there are no studies for this either


----------------
here is one related abstract perhaps these researchers may have some more info

Best Pract Res Clin Haematol. 2003 Jun;16(2):333-45.

Maternal thrombophilia and neonatal thrombosis.

Heller C, Nowak-Gottl U.

Paediatric Haematology/Oncology, University Hospital of Frankfurt, Germany.

In neonates and infants, numerous clinical and environmental conditions lead to
elevated thrombin generation and subsequent thrombus formation. Genetic
prothrombotic defects (protein C, protein S and antithrombin deficiency,
mutations of coagulation factor V and factor II, elevated lipoprotein (a)) have
been established as risk factors of thromboembolic events in neonates and
infants. The interpretation of the laboratory evaluation relies on age-dependent
normal reference values. Because appropriate clinical trials are missing in
these age groups, treatment recommendations are adapted from small-scale studies
in neonates and infants and from guidelines relating to adult patient protocols.
Secondary long-term anticoagulation should be administered on an individual
basis.
------------------------------------
Semin Thromb Hemost. 2003 Apr;29(2):227-34.

Neonatal thromboembolism.

Nowak-Gottl U, Kosch A, Schlegel N.

Pediatric Hematology/Oncology, University Children's Hospital, Munster, Germany.
[email protected]

In neonates and infants numerous clinical and environmental conditions such as
the use of central lines, cardiac diseases and polycythemia, renal diseases such
as congenital nephrotic syndrome and neonatal hemolytic uremic syndrome,
peripartal asphyxia, infants of diabetic mothers, dehydration, septicemia,
necrotizing enterocolitis, acute respiratory distress syndrome, and
extracorporeal membrane oxygenation lead to elevated thrombin generation and
subsequent thrombus formation. Genetic prothrombotic defects [protein C, protein
S and antithrombin deficiency, mutations of coagulation factor V and factor II,
elevated lipoprotein (a)] have been established as risk factors for
thromboembolic events. The interpretation of laboratory results relies on
age-dependent normal reference values. Because appropriate clinical trials are
missing in these age groups, treatment recommendations are adapted from
small-scale studies in neonates and infants and from guidelines relating to
adult patient protocols. Secondary long-term anticoagulation should be
administered on an individual basis.
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Old 08-18-2005, 05:18 PM
 
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OK, I think I have been severely misunderstood. If you read my first post, you will see that I said that I would rather have my child die suddenly of a brain hemorrhage than suffer with leukemia later. And I'm sorry, but that's the way I feel. I can't imagine putting an older child, who is very conscious of his pain and understands that he will probably die through something like that. (And I also know that not getting the shot is no guarantee. I am a scientist, I understand statistics.) I don't think it would be easy to lose ANY child, I didn't say that. I said I would be DEVASTATED if I lost this baby I am carrying. I said I thought it would easier to suddenly lose a newborn than to watch an older child suffer then die. Mostly because of the suffering aspect, but also because I KNOW this child. I have watched him grow up and his personality come out. And I STILL think that's true. That's the way I feel. You can disagree with me, but that doesn't make my feelings less vailid. Perhaps I didn't explain what I mean very well in my later post, but I did NOT in any way mean that I would rather lose any child. My mom lost a baby (who was full-term and was with my mom for a few days) before I was born and she still cries on her birthday almost every year. But I know for damn sure losing my sister last year was at least 50 times harder on her. ANd I don't think she'd disagree.
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Old 08-18-2005, 05:29 PM
 
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Wendy, you've completely missed the point. And I think we all read every word you wrote. Myself, I read it several times because I just couldn't believe what I was reading.

You are entitled to your opinions and feelings. But apparently you need to learn more about if, when, and how to express them.

What made you think THIS was an appropriate place to air that particular opinion? No one asked you about your thoughts on losing a child. I certainly hope that isn't your standard response to every woman you learn has lost a pregnancy or baby.
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Old 08-18-2005, 05:54 PM
 
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Again Wendy, I am completely shocked by what you are saying and don't even know how to respond to you.

wife - mother - midwife

CIRCUMCISION

The more you know, the worse it gets.

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Old 08-18-2005, 06:21 PM
 
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Wendy, I think you have been misunderstood too. I truly believe you did not intend any ill with what you said in your first post. My sense is that others are just giving you feedback about how your comments came across to them, and not necessarily saying that they think you had bad intentions.

Regarding the OP's situation and her disclosure that she lost a baby, I agree with those who have said it's not appropriate to to get into a discussion about how her loss isn't as bad as it could have been. I really think this my Holocaust is worse than your Holocaust stuff is not productive. It's not like we're a bunch of college kids staying up late shooting the breeze about hypothetical situations (in which case I think it would be totally fine to say I think x wouldn't be as bad as y). This woman really has lost a baby IRL, someting most of us, thank god, have never experienced. So I think we should be careful about appearing like we are telling her how she should feel about it.

I hope you don't feel attacked, as that is not my intention at all. I think it's harder to discuss this kind of stuff online in a way that feels respectful for everyone than it is IRL.
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Old 08-18-2005, 08:07 PM - Thread Starter
 
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Thank you to those who get my POV. Yes, there are sensitive people left on MDC. I really appreciate everyone who's offered me support (especially those of you who realize how difficult it is to even post about my loss as I'm very close in this pg when I lost my ds), and this really sums it up:
Quote:
Regarding the OP's situation and her disclosure that she lost a baby, I agree with those who have said it's not appropriate to to get into a discussion about how her loss isn't as bad as it could have been. I really think this my Holocaust is worse than your Holocaust stuff is not productive. It's not like we're a bunch of college kids staying up late shooting the breeze about hypothetical situations (in which case I think it would be totally fine to say I think x wouldn't be as bad as y). This woman really has lost a baby IRL, someting most of us, thank god, have never experienced. So I think we should be careful about appearing like we are telling her how she should feel about it.
Appropriate...NOT, especially when you haven't even been there. Yo' mama, yo' friend, nobody's experience is relevant in this case as far as truly understanding what burying a child at any age means.

OK, back to the Vit K issue...now we're cooking ladies. Thank you for those studies and thoughts. I am going to print them out and read them closely. The pediatric hemo that I'm waiting for a call back from is also looking into research in other countries so this is helpful to have lots of things to pull from in making a decision. I think this is a helpful thread for those of us who are struggling with a clotting disorder and this decision.
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