PEDIATRICS Vol. 81 No. 1 January 1988, pp. 137-140
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Vitamin K1 (Phylloquinone) and Vitamin K2 (Menaquinone) Status in Newborns During the First Week of Life

Frank R. Greer MD1, Linda L Mummah-Schendel BS1, Sharon Marshall BS, RN1, and John W. Suttie PhD1

1 From the Department of Pediatrics and Biochemistry, University of Wisconsin, Madison

Since 1961 the Committee on Nutrition of the American Academy of Pediatrics has recommended that prophylactic vitamin K be administered parenterally to all newborn infants, although the exact requirement for vitamin K in the newborn infant is unknown. There is little information about the vitamin K1 (phylloquinone, present in green vegetables) and vitamin K2 (menaquinones, synthesized by intestinal flora) status of newborn infants. In this study during the first week of life vitamin K status was assessed by measuring serum concentrations of phylloquinone in 23 mother-infant pairs at the time of birth. Maternal phylloquinone concentration (1.7 ± 1.0 ng/mL, mean ± SD) was significantly higher (P < .02) than cord serum concentration (1.1 ± 0.6 ng/mL). All infants were then given a standard 1-mg injection of vitamin K1. Ten infants were fed formula (containing 58 ng/mL of vitamin K1) and 13 were exclusively breast-fed. On day 5 of life, serum concentrations of vitamin K1 did not differ between breast-fed (21.0 ± 12.4 ng/mL) and formula-fed (27.5 ± 9.7 ng/mL) infants, reflecting the large amounts of parenteral vitamin K1 at birth. During the first week of life, formula-fed infants had much higher fecal concentrations of vitamin K1 (due to large oral intake) and more significant quantities (ge200 pmol/g of dry weight) of fecal menaquinones (reflecting differences in bacterial flora) than did breast-fed infants. Although there is uncertainty regarding the extent of vitamin K2 utilization in infants as well as the relative bipotency of the two forms of the vitamin, these data may have important implications for the worldwide problem of hemorrhagic disease of the newborn.

Key Words: vitamin K1 • vitamin K2 • newborn

Submitted on December 8, 1986
Accepted on March 10, 1987




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