PEDIATRICS Vol. 99 No. 1 January 1997, pp. 88-92 (doi:10.1542/peds.99.1.88)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Greer, F. R.
Right arrow Articles by Suttie, J. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Greer, F. R.
Right arrow Articles by Suttie, J. W.
Related Collections
Right arrow Blood

PEDIATRICS Vol. 99 No. 1 January 1997, pp. 88-92

Improving the Vitamin K Status of Breastfeeding Infants With Maternal Vitamin K Supplements

Received Jan 2, 1996; accepted Mar 4, 1996.

Frank R. Greer*, Dagger , Sharon P. Marshall§, Andrea L. Foleyparallel , and John W. SuttieDagger , parallel

From the Departments of * Pediatrics, Dagger  Nutritional Sciences, and parallel  Biochemistry, University of Wisconsin, Madison; and § Meriter Hospital, Madison, Wisconsin.

Objective.  To increase the phylloquinone (vitamin K1) concentration of human milk with maternal oral phylloquinone supplements such that both the phylloquinone intake of breastfed infants and their serum concentrations of phylloquinone would approach those of formula-fed infants who are known to be at much less risk for hemorrhagic disease of the newborn.

Design.  Two stages: stage I, longitudinal, randomized study of 6 weeks' duration; and stage II, longitudinal, randomized, double-blind, placebo-controlled study of 12 weeks' duration.

Setting.  Patients from a private pediatric practice in Madison, WI.

Patients.  Stage I: sequential sampling of 20 lactating mothers to determine the level of maternal supplementation needed in stage II. Ten mothers received 2.5 mg/d oral phylloquinone, and 10 mothers received 5.0 mg/d oral phylloquinone. Stage II: sequential sampling of 22 human milk-fed infants and lactating mothers. All infants received 1 mg of phylloquinone at birth. Eleven mothers received a placebo; 11 mothers received 5 mg/d phylloquinone.

Measurements and Results.  In stage I, both 2.5 and 5.0 mg/d phylloquinone significantly increased the phylloquinone content of human milk at both 2 and 6 weeks. As expected, 5.0 mg had a greater effect (mean ± SD, 58.96 ± 25.39 vs 27.12 ± 12.18 ng/mL at 2 weeks). In stage II, the vitamin K-supplemented group had significantly higher maternal serum phylloquinone concentrations, higher phylloquinone milk concentrations, and higher infant plasma phylloquinone concentrations at 2, 6, and 12 weeks compared with the placebo group. At 12 weeks infant phylloquinone intakes were significantly higher for the vitamin K group than the placebo group (9.37 ± 4.55 vs 0.15 ± 0.07 µg/kg per day). This corresponded to a plasma phylloquinone concentration in the vitamin K group of 2.84 ± 3.09 vs 0.34 ± 0.57 ng/mL in the placebo group. At 12 weeks, the prothrombin times did not differ between the groups, but the des-gamma -carboxy-prothrombin (partially carboxylated prothrombin thought to be a measure of vitamin K deficiency) was significantly elevated in the placebo group compared with the vitamin K group (1.48 ± 1.19 vs 0.42 ± 0.55 ng/mL).

Conclusion.  In exclusively breastfed infants who receive intramuscular phylloquinone at birth, the vitamin K status as measured by plasma phylloquinone and des-gamma -carboxy-prothrombin concentrations is improved by maternal oral supplements of 5 mg/d phylloquinone through the first 12 weeks of life.

Key words: vitamin K, phylloquinone, breastfeeding, infant, des-gamma -carboxy-prothrombin.




This article has been cited by other articles:


Home page
 PediatricsHome page
P. M. van Hasselt, T. J. de Koning, N. Kvist, E. de Vries, C. R. Lundin, R. Berger, J. L. L. Kimpen, R. H. J. Houwen, M. H. Jorgensen, H. J. Verkade, et al.
Prevention of Vitamin K Deficiency Bleeding in Breastfed Infants: Lessons From the Dutch and Danish Biliary Atresia Registries
Pediatrics, April 1, 2008; 121(4): e857 - e863.
[Abstract] [Full Text] [PDF]

Home page
 Molecular Cancer TherapeuticsHome page
S. Shukla, C.-P. Wu, K. Nandigama, and S. V. Ambudkar
The naphthoquinones, vitamin K3 and its structural analogue plumbagin, are substrates of the multidrug resistance linked ATP binding cassette drug transporter ABCG2
Mol. Cancer Ther., December 1, 2007; 6(12): 3279 - 3286.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
S P Pereira, M J Shearer, R Williams, and G Mieli-Vergani
Intestinal absorption of mixed micellar phylloquinone (vitamin K1) is unreliable in infants with conjugated hyperbilirubinaemia: implications for oral prophylaxis of vitamin K deficiency bleeding
Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2003; 88(2): F113 - F118.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. Kumar, F. R. Greer, D. M. Super, J. W. Suttie, and J. J. Moore
Vitamin K Status of Premature Infants: Implications for Current Recommendations
Pediatrics, November 1, 2001; 108(5): 1117 - 1122.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
U. Wariyar, S. Hilton, J. Pagan, W. Tin, and E. Hey
Six years' experience of prophylactic oral vitamin K
Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2000; 82(1): 64F - 68.
[Abstract] [Full Text]

Home page
 Arch. Dis. Child.Home page
F. R Greer, S. P Marshall, R. R Severson, D. A Smith, M. J Shearer, D. G Pace, and P. H Joubert
A new mixed micellar preparation for oral vitamin K prophylaxis: randomised controlled comparison with an intramuscular formulation in breast fed infants
Arch. Dis. Child., October 1, 1998; 79(4): 300 - 305.
[Abstract] [Full Text]