Many parents don't realize how important vitamin K is for babies. Vitamin K is a fat-soluble vitamin that plays an important role in blood clotting and bone metabolism. Since newborns do not have sufficient stores of vitamin K, additional intake is necessary.
Every infant needs vitamin K. But in what form and quantity should vitamin K be given to babies? In this article we provide information about vitamin K intake in babies. The article is intended as a source of information only and does not replace a discussion with a doctor.
the essentials in brief
- Vitamin K is a fat-soluble vitamin that the human body needs for blood clotting and bone metabolism, among other things.
- There is not enough vitamin K in human breast milk to provide newborns with an adequate supply. Artificial baby milk contains about twenty times more vitamin K.
- A vitamin K deficiency in infants can lead to so-called vitamin K deficiency bleeding (VKMB). These usually occur in the gastrointestinal tract, skin or brain and can be life-threatening.
Vitamin K for the baby: what you should know
We have collected the most frequently asked questions about vitamin K for babies for you and answered them below.
Before you move on to the solution approaches, you should read these questions carefully. This will give you background knowledge that will help you with the solution part.
How Does Vitamin K Work for Babies?
Vitamin K is an important vitamin for the blood clotting system. Newborns do not have their own stores of vitamin K. They are therefore dependent on an additional vitamin K supply after birth.
A vitamin K deficiency can lead to brain, skin and intestinal bleeding. The additional supply of vitamin K is important to prevent a deficiency.
Vitamin K is found in human breast milk. However, the vitamin is relatively low dosed there and, for example, significantly lower than in cow's milk.
How Much Vitamin K Do Babies Need?
Infants have a daily vitamin K requirement of about 4 µg (micrograms) per day. During pregnancy, the placenta supplies the child with vitamin K. However, the supply is low, which means that the vitamin K content in babies is very low.
To avoid life-threatening bleeding due to vitamin K deficiency, it is essential in terms of preventive health care that all newborns receive vitamin K1 as soon as possible after birth, i.e. while they are still in the delivery room (3).
Immediately after birth, while still in the delivery room, newborns are given vitamin K (Jonathan Borba / unsplash).
Human breast milk does not contain enough vitamin K. To prevent a vitamin K deficiency, the additional intake of vitamin K is strongly recommended. This significantly reduces the risk of bleeding. Vitamin K prophylaxis in newborns has been tried and tested for over 50 years.
Vitamin K prophylaxis for babies
Since the vitamin K content after birth and in breast milk is relatively low(10), an additional intake is recommended. The Society of Anthroposophic Doctors in Germany offers three options for babies to take vitamin K individually (1).
- Oral administration of 2 mg of vitamin K each. It is taken during the first (U1), second (U2) and third (U3) check-up. The vitamin is dripped into the infant's mouth in the form of drops. This vitamin L prophylaxis is supported by an initiative of the Federal Ministry of Food and Nutrition.
- It is also possible to give the baby a diluted solution with 25 or 50 µg of vitamin K daily. To prevent a vitamin K deficiency, 1 or 2 mg of vitamin K can be administered once in the first week of life.
- The breastfeeding mother pay attention to a diet rich in vitamin K.
The first variant is the most effective. The risk of brain, skin, or intestinal bleeding in newborns was significantly reduced between 1997 and 2002 (2).
Some parents are unsure whether vitamin K prophylaxis is really necessary for newborns. Finally, vitamin K drops are a high-dose vitamin supplement. With the recommended prophylaxis, the vitamin K intake is many times higher than through breast milk alone.
The infant receives vitamin K from the placenta in the womb. However, the supply both in the abdomen and later through breast milk is very low. For this reason, vitamin K prophylaxis is carried out as standard in Germany(7).
Vitamin K prophylaxis is advocated by numerous associations. This includes:
- Society for Neonatology and Pediatric Intensive Care Medicine (GNPI)
- German Society for Gynecology and Obstetrics (DGGG)
- German Society for Perinatal Medicine (DGPM)
- German Society for Pediatric and Adolescent Medicine (DGKJ)
- Professional Association of Pediatricians (BVKJ)
- German Association of Midwives
When is vitamin K useful for babies?
Every infant needs additional vitamin K. The additional intake significantly reduces the risk of bleeding(1). Newborns suffering from a congenital disorder of the hepatobiliary system are particularly at risk. The bile plays an important role in the absorption of vitamin K.
Human breast milk does not contain enough vitamin K to provide adequate nutrition for newborns (Dave Clubb/unsplash).
Any bleeding such as spot bleeding, nosebleeds, blood deposits on the stool or noticeable bleeding spots on the skin can be a sign of vitamin K deficiency. In this case, a doctor should be consulted as soon as possible.
How can I measure the vitamin K level in babies?
All newborns need an additional intake of vitamin K. The tests (U1 to U3) do not determine the vitamin K value. Vitamin K is given to the baby as a prophylaxis, i.e. as a precaution.
It only makes sense and is necessary to determine the vitamin K value in the blood if a vitamin K deficiency is suspected. In this case, the value is determined by a blood test at the doctor's.
What is a vitamin K deficiency in babies?
Due to the standard vitamin K prophylaxis in Germany, only one in 100,000 babies suffers from a vitamin K deficiency(9). However, this can have serious consequences.
Newborns who suffer from a vitamin K deficiency tend to have so-called vitamin K deficiency bleeding in the first few hours, days and weeks. The bleeding can occur in the brain, the skin or in the organs (4).
How does a vitamin K overdose manifest itself in babies?
Vitamin K overdose is very difficult to diagnose. Animal studies have shown that vitamin K overdose can lead to severe DNA changes and chromosomal damage(5).
However, an overdose of vitamin K in babies is very rare. Newborns have very low stores of vitamin K and are not yet able to synthesize vitamin K very well.
How much do high-quality vitamin K supplements for babies cost?
Vitamin K drops should be used to make it easier for babies to take vitamin K. These can simply be dribbled into the infant's mouth. It is easy to take because the baby does not have to swallow anything.
In the standard examinations U1, U2 and U3 after birth, the baby receives vitamin K as a standard for prophylaxis. This is administered directly by the doctor. The purchase of vitamin K is not necessary.
| Type | Price |
|---|---|
| 20 ml vitamin K drops | €15 |
| 50 ml vitamin K drops | €20 |
| Vitamin K + D3 drops | €30 |
In a few cases, the newborn should continue to take vitamin K, in consultation with the doctor. In this case, there is vitamin K in the form of drops in every pharmacy. Depending on the size, the preparation costs €15 to €30.
What are the risks of taking vitamin K for babies?
The additional intake of vitamin K greatly reduces the risk of bleeding and therefore speaks for the precautionary intake. However, as with any medication, undesirable side effects can occur.
Risks of the recommended vitamin K prophylaxis can be (6):
- Food intolerances can arise
- Diseases of the bile
- Adequate intake of vitamin K cannot be guaranteed (e.g. if the newborn spits the drops out again).
- Not every child receives vitamin K prophylaxis (e.g. children of asylum-seeking or socially disadvantaged parents).
- Vitamin K absorption can be impaired if, for example, the breastfeeding mother is taking medication that prevents absorption.
According to current medical knowledge, there are no other health risks associated with side effects.
What alternatives are there to vitamin K for babies?
Many parents worry about how they can guarantee their baby an adequate supply of vitamin K.
Increase vitamin K levels in breast milk
Human breast milk contains comparatively little vitamin K. 100 ml breast milk contains an average of 0.12 micrograms of vitamin K. With this type of prophylaxis, protection against vitamin K deficiency is not sufficiently secured.
The vitamin K content of breast milk can be increased if enough vitamin K is ingested through the diet. The following foods contain a lot of vitamin K:
| Groceries | Vitamin K content in micrograms per 100 grams |
|---|---|
| broccoli | 270 |
| Kale | 817 |
| chives | 380 |
| spinach | 305 |
| Edible quark, 40% fat in dry matter | 50 |
| herring | 25 |
| calf liver | 88 |
| grapeseed oil | 280 |
bottle feeding
Another way to provide the newborn with enough vitamin K is bottle feeding. In Germany, the special food for infants is always enriched with vitamin K. Usually in a dosage of 50 µg per liter.
Despite bottle feeding, the child should receive 1-2 mg of vitamin K immediately after birth. If the baby is then fed regularly from the bottle and not mother's food, an additional intake of vitamin K is usually not necessary(8).
Conclusion
The additional intake of vitamin K is necessary for infants and should not be neglected. A vitamin K deficiency can lead to life-threatening bleeding. To avoid this, it is worth taking additional vitamin K for babies.
Which type of vitamin K prophylaxis is carried out should always be discussed with the doctor treating you. This article is for information only and cannot replace a consultation with a specialist.
References
- The Society of Anthroposophic Doctors in Germany recommends three different ways for babies to take vitamin K.
- Oral intake of 2 mg of vitamin K in U1, U2 and U3 could greatly reduce the risk of bleeding.
- Recommendations for the prophylaxis of VKMB in newborns and infants.
- 0.6% of newborns suffer from vitamin K deficiency bleeding (VKMB) on the 2nd or 3rd day of life. The skin, gastrointestinal tract and brain are particularly affected. About 62% of children who have VKMB die.
- High levels of vitamin K can lead to an increased rate of DNA changes and chromosmal damage in fetuses.
- The significantly reduced risk of bleeding from vitamin K speaks in favor of taking vitamin K in newborns. However, as with any medication, side effects can occur.
- Vitamin K deficiency bleeding poses a serious risk to newborns and young children and is largely preventable with adequate vitamin K supplementation.
- Healthy newborns should receive either 1 mg of vitamin K1 at birth; or 3 × 2 mg vitamin K1 orally at birth, at 4 to 6 days, and at 4 to 6 weeks.
- When intramuscular vitamin K is administered, the risk of bleeding with vitamin K deficiency is reduced to 1/100,000.
- Newborns are at risk for vitamin K deficiency bleeding (VKDB) caused by inadequate prenatal storage and vitamin K deficiency in breast milk.