Why does breast milk not have vitamin K?

Understanding the Vitamin K Deficiency in Breast Milk
Breast milk is widely recognized as the optimal source of nutrition for infants, providing essential nutrients and antibodies that support healthy growth and development. However, one notable exception is its relatively low content of vitamin K, a crucial nutrient for blood clotting and bone health. This deficiency raises important questions about the implications for newborns and the recommended practices to mitigate potential risks.
The Nature of Vitamin K in Newborns
Newborns are born with very limited stores of vitamin K. This is primarily due to two factors: the minimal transfer of vitamin K across the placenta during pregnancy and the lack of gut bacteria in infants at birth, which are necessary for synthesizing vitamin K2. As a result, infants are particularly vulnerable to vitamin K deficiency, especially if they are exclusively breastfed.
Breast milk contains only small amounts of vitamin K, typically ranging from 1 to 9 micrograms per liter. This concentration is insufficient to meet the needs of a growing infant, particularly in the first few months of life when the risk of vitamin K deficiency bleeding (VKDB) is highest. The low levels of vitamin K in breast milk are consistent across different stages of lactation, meaning that even colostrum, the first milk produced after birth, does not provide adequate amounts.
Implications for Infant Health
The deficiency of vitamin K in breast milk can lead to serious health issues. VKDB is a condition that can cause uncontrolled bleeding in newborns, which can be life-threatening. The risk is particularly pronounced in exclusively breastfed infants who do not receive any supplemental vitamin K. To combat this risk, health authorities recommend administering a single intramuscular injection of vitamin K shortly after birth. This practice has been shown to effectively prevent VKDB and ensure that infants have sufficient levels of this vital nutrient.
Maternal Influence on Vitamin K Levels
Interestingly, maternal dietary intake of vitamin K does play a role in the vitamin K content of breast milk. While most mothers do not require supplementation to meet the recommended dietary intake during lactation, those who do take vitamin K supplements can increase the levels of this vitamin in their milk. However, even with supplementation, the amounts may still not be sufficient to fully meet an infant’s needs.
Conclusion
In summary, the low levels of vitamin K in breast milk are a significant concern for newborns, particularly those who are exclusively breastfed. The combination of limited placental transfer and the absence of gut bacteria at birth creates a scenario where infants are at risk for vitamin K deficiency. To safeguard against this, the administration of a vitamin K shot at birth is a critical preventive measure, ensuring that infants receive the necessary nutrients to support their health and development in those crucial early weeks of life.

Is vitamin K required by law for newborns?

As reported above, New York is the only state with a mandate for the use of IM vitamin K at the time of birth, and as expected, their incidence of IM vitamin K refusal and resultant VKDB is substantially lower than states in which its use is not mandated.

Why are parents refusing vitamin K?

Reported reasons for refusal were concern of harm from the injection, a desire to be natural, and a belief in alternative methods of prophylaxis. Parents who refused intramuscular vitamin K were more likely to refuse immunizations.

Why is breast milk low in vitamin K?

Vitamin K does not cross the placenta to the developing baby, and the gut does not have any bacteria to make vitamin K before birth. After birth, there is little vitamin K in breast milk and breastfed babies can be low in vitamin K for several weeks until the normal gut bacteria start making it.

What are the side effects of vitamin K injection in newborns?

Side effects of the vitamin K injection:

• Pain.
• Bruising/swelling.
• Few cases of scarring at the injection site.
• Elevated bilirubin (rare)
• One single case report described an allergic reaction in a newborn (Note: newborns are less likely to have severe allergic reactions due to their immature immune systems)

What vitamins does breastfeeding deplete?

Some breastfeeding mothers may not be able to absorb various vitamins and minerals, such as vitamin B12, folic acid (vitamin B9), iron, and calcium.

What are the side effects of vitamin K injections in newborns?

These include pain or even bruising or swelling at the place where the shot is given. A few cases of skin scarring at the site of injection have been reported. Only a single case of allergic reaction in an infant has been reported, so this is extremely rare.

Is vitamin K toxic to newborns?

Vitamin K is necessary for normal blood clotting. It is also needed for healthy bones and other tissues. The effects of vitamin K toxicity can include anemia due to rupture of red blood cells and jaundice. Jaundice in newborns can cause kernicterus (a type of brain damage).

Is colostrum high in vitamin K?

Colostrum is rich in developmental factors, such as epidermal growth factor, as well as immunologic components, such as secretory IgA, lactoferrin, leukocytes [7,8,9]. In addition, it contains high amounts of protein, vitamin A, vitamin B12, and vitamin K [10], and low levels of lactose.

Can babies get vitamin K through breast milk?

Formula adds vitamin K to their product, giving infants a direct source. Mothers who breastfeed, however, do pass on vitamin K to their babies, but there are very low doses in breastmilk(13). Though low, these doses are actually enough to sustain babies’ needs, so long as the infant is feeding regularly.

What vitamins are missing from breast milk?

Overall, human breast milk has been found to be low in certain nutrients in developed countries: vitamin D, iodine, iron, and vitamin K. Additional nutrient deficiencies have been documented in resource-poor countries: vitamin A, vitamin B 12, zinc, and vitamin B 1/thiamin.