I'd love to talk about the various oral vitamin K protocols. Here are my disjointed thoughts on vitamin K.
Part of me wonders if we should routinely give vitamin K to newborns. If it doesn't cross the placenta well and it is found in only small amounts in breastmilk, perhaps there is a reason God created it to be this way. Should we be messing with newborn systems we don't fully understand?
On the other hand, there is no known risk to giving oral vitamin K (is there?) Yet there is a known and rare but very serious risk of NOT giving oral vitamin K. So it seems prudent to give the oral doses, no?
What I'm trying to determine is the best regimen to use. After doing tons of research, I'm wondering which of these is best.
Option 1: 2mg at birth, 2 mg at 4-7 days, 2mg at one month (some add 2mg at 6 or 8 weeks)
This seems to be the standard recommendation and is pretty effective, although not quite as effective as the shot or other oral regimen I talk about below. However, it is easy, just three drops, you're done after just a month, and the baby only receives 6mg total of vitamin K
Option 2: 2mg at birth, 1mg/wk for 12 weeks
This is the most effective oral route, and works well even in infants with biliary atresia/cholestasis. However, you have to do it for 3 months and the infant receives quite a bit of vitamin K, 14mg. Could there potentially be a risk to giving this much vitamin K to babies, almost all of whom don't need it? I know there is the worry over the proposed cancer/leukemia link of the shot. There was no link found with the oral drops, although I believe they only looked at 3x1mg regimens so the babies were only getting 3mg total (I'm not positive about that but it's what I remember in my research.) Could we be possibly increasing cancer/leukemia risk with large total oral doses of vitamin K like this regimen? Thoughts?
Option 3: Supplementing the nursing mother to increase levels in breastmilk
If moms take a supplement of 5mg/day, the levels in their breastmilk have about as much vitamin K as formula does, and VKDB is virtually unheard of in formula fed babies. I read one source that suggested the protection afforded to formula fed babies has more to do with their differing gut flora which produces vitamin K more effectively rather than the higher levels of vitamin K in the formula. ?? They cited that formula fed babies get 25-50ug/day of vitamin K (most other sources say it's about 50ug/day) and virtually never get VKDB but breastfed babies who get 25ug/day are not nearly as well protected. Would breastfed babies who got 50ug/day be as well protected? No studies on this as far as I know. Some suggest that if moms are going to do this, their babies still need the initial doses at birth and 1 week but do not need the subsequent doses.
Thoughts on all this? VKDB, especially late VKDB is so rare but it does happen so do you think we should supplement all babies and if so, how? Just go for what we know works in all babies (3 month regimen) even though it's more total mgs given and takes 3 months? Go for what's easy and sufficient for the vast majority of babies (3x2mg)? Or go for a more natural route of supplementing nursing moms, even though we're not quite sure how effective this is? Or something else entirely?
Part of me wonders if we should routinely give vitamin K to newborns. If it doesn't cross the placenta well and it is found in only small amounts in breastmilk, perhaps there is a reason God created it to be this way. Should we be messing with newborn systems we don't fully understand?
On the other hand, there is no known risk to giving oral vitamin K (is there?) Yet there is a known and rare but very serious risk of NOT giving oral vitamin K. So it seems prudent to give the oral doses, no?
What I'm trying to determine is the best regimen to use. After doing tons of research, I'm wondering which of these is best.
Option 1: 2mg at birth, 2 mg at 4-7 days, 2mg at one month (some add 2mg at 6 or 8 weeks)
This seems to be the standard recommendation and is pretty effective, although not quite as effective as the shot or other oral regimen I talk about below. However, it is easy, just three drops, you're done after just a month, and the baby only receives 6mg total of vitamin K
Option 2: 2mg at birth, 1mg/wk for 12 weeks
This is the most effective oral route, and works well even in infants with biliary atresia/cholestasis. However, you have to do it for 3 months and the infant receives quite a bit of vitamin K, 14mg. Could there potentially be a risk to giving this much vitamin K to babies, almost all of whom don't need it? I know there is the worry over the proposed cancer/leukemia link of the shot. There was no link found with the oral drops, although I believe they only looked at 3x1mg regimens so the babies were only getting 3mg total (I'm not positive about that but it's what I remember in my research.) Could we be possibly increasing cancer/leukemia risk with large total oral doses of vitamin K like this regimen? Thoughts?
Option 3: Supplementing the nursing mother to increase levels in breastmilk
If moms take a supplement of 5mg/day, the levels in their breastmilk have about as much vitamin K as formula does, and VKDB is virtually unheard of in formula fed babies. I read one source that suggested the protection afforded to formula fed babies has more to do with their differing gut flora which produces vitamin K more effectively rather than the higher levels of vitamin K in the formula. ?? They cited that formula fed babies get 25-50ug/day of vitamin K (most other sources say it's about 50ug/day) and virtually never get VKDB but breastfed babies who get 25ug/day are not nearly as well protected. Would breastfed babies who got 50ug/day be as well protected? No studies on this as far as I know. Some suggest that if moms are going to do this, their babies still need the initial doses at birth and 1 week but do not need the subsequent doses.
Thoughts on all this? VKDB, especially late VKDB is so rare but it does happen so do you think we should supplement all babies and if so, how? Just go for what we know works in all babies (3 month regimen) even though it's more total mgs given and takes 3 months? Go for what's easy and sufficient for the vast majority of babies (3x2mg)? Or go for a more natural route of supplementing nursing moms, even though we're not quite sure how effective this is? Or something else entirely?
