Nutrition Recommendations: Vitamin K

We continue a multi-part series on nutrition this week, specifically regarding vitamins and minerals.  These dietary elements are a very important part of your child’s growth, and while a varied diet can be difficult with picky eaters, hopefully this series will help you understand why it is important to keep fighting for healthy food choices for your child. 

Today we discuss Vitamin K. This week’s discussion will be a little different, as we will also discuss why Vitamin K administration is so important at birth. 

What does it do for your body?

Vitamin K is a fat-soluble vitamin, meaning that fat molecules are necessary for Vitamin K to be absorbed by the gut. It is necessary for blood clotting, strengthening bones through regulation of calcium. 

Where do you get it?

There are several food sources of Vitamin K:

• Leafy green vegetables (spinach, kale, broccoli)
• Vegetable oils
• Some fruits, including blueberries and figs
• Protein sources such as meat, cheese, and eggs. 
• Soybeans
• Multivitamins or Vitamin K supplements. 

How much do you need?

Birth-6 months: 2mcg

7-12 months: 2.5mcg

1-3 years: 30mcg

4-8 years: 55mcg

9-13 years: 60mcg

14-18 years: 75mcg

Vitamin K deficiency is rare in most people who have a varied diet. Vitamin K is also made from bacteria that naturally live in the gut, and the body absorbs this as well. However, there are particular diseases that are associated with Vitamin K deficiency through disruption of the normal absorption of fat, since it is a fat-soluble vitamin. These include cystic fibrosis, celiac disease, ulcerative colitis, short bowel syndrome, and those who have had bariatric surgery. Additionally, newborns who do not receive an injection of Vitamin K at birth are at risk of deficiency. 

Is too much dangerous?

Excess Vitamin K is not known to be dangerous. However, it can interfere with the way certain medications work in the body. This is particularly true for blood-thinners, such as Coumadin. It can also affect certain cholesterol medications and antibiotics. These interactions are usually not an issue with children but please check with your child’s specialist if they are on these medications and have a significant dietary change in regards to Vitamin K containing foods. 

Vitamin K in newborns

As mentioned before, Vitamin K is necessary for blood clotting. This is because it is necessary for synthesis certain components of the blood, called “factors.” Without these factors blood cannot clot appropriately. Vitamin K is undetectable in cord blood, meaning that it is not present in infants at birth. Additionally, the type of gut bacteria that infants are born with does not make Vitamin K, and breastmilk only contains a very small amount – not nearly enough needed to promote creation of blood factors. This all leads to a perfect storm that puts infants at an increased risk of Vitamin K deficiency and bleeding. Vitamin K Deficiency Bleeding (also known as Hemorrhagic Disease of the Newborn) can be devastating, causing bleeding in the GI tract, from circumcision sites, easy bruising, and bleeding in the brain. The risk for these bleeds occurs from birth until as late at 6 months, depending on the diet of the infant (exclusively breast fed infants remain at risk for longer periods).

The best way to prevent Vitamin K Deficiency Bleeding in newborns is to administer Vitamin K injections at birth. Unfortunately, there has been a trend in recent years of parents refusing this important intervention. The reasons for this are varied and include the following: 

• A lack of understanding of why Vitamin K is important. Many parents do not realize Vitamin K is necessary for blood clotting, or that we are not born with it. 
• A trend towards wanting things to happen “naturally,” and avoid what parents consider “unnecessary” interventions.
• Concern for increased risk of cancer. This stems from a study published in the British Medical Journal in 1990, which suggested an increased risk of Acute Lymphocytic Leukemia in babies who received Vitamin K. This has since been refuted by multiple studies in both Europe and the US, and the consensus among experts is that Vitamin K prophylaxis at birth is safe and NOT associated with cancer. 
• Concern for side effects. Vitamin K injection is very well tolerated and side effects are rarely reported. 

The trend away from Vitamin K prophylaxis is a concerning one for Pediatricians. I hope this has offered some insight on why it is so important for every newborn to receive. 

Final thoughts

Vitamin K is not a nutrient we think about much, unless you are a Pediatrician who cares for newborns or an expectant parent making decisions for your newborn. Deficiency is rare in older children and teens, but can occur in certain at-risk populations. Please speak with your child’s Pediatrician (or future Pediatrician if you are expecting a child) if you have further questions. 

Resources

https://ods.od.nih.gov/factsheets/VitaminK-Consumer/

https://med.stanford.edu/newborns/clinical-guidelines/vitamink.html

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