Do exclusively breastfed infants have vitamin K deficiency? On the 20th anniversary of studying the background
Keywords:РIVKA-II, breastfeeding, prothrombin complex, vitamin K deficiency
Background. Are breast-fed infants vitamin K deficient? F.R. Greer raised this question in 2001 in his classic study. The purpose of the study was to determine the concentration of prothrombin induced by vitamin K absence II (PIVKA-II) and prothrombin complex indices as latent vitamin K deficiency markers in exclusively breastfed infants (first 6 months of life). Materials and methods. A total of 264 children aged 0 to 6 months were examined, they were in a satisfactory state and had unchanged general blood tests and hepatobiliary tests. Results. In the early neonatal period, 62 (83.8 %) of 74 children who did not receive vitamin K had PIVKA-II score above 40 mAU/ml. In 17 (77.3 %) of 22 babies aged 8 to 28 days who did not receive vitamin K after birth, PIVKA-II was within normal limits. In 92 % of 31 infants who received prophylactic vitamin K1 boluses, PIVKA-II was normal in the first week of life, in 12 (54.5 %) of 22 children aged 28 to 180 days who were examined after antibiotic treatment, PIVKA-II is higher than normal. The use of antibiotics in children was associated with elevated concentrations of PIVKA-II, which may indicate a latent acquired vitamin K deficiency or one, which is renewed after birth. The study of the prothrombin complex according to median and quartile estimates (Me, 25–75) in these children established a decrease in prothrombin content by Quick to 62 % (18–91 %), an increase in prothrombin time to 18 s (13–22 s), and an increase in international normalized ratio to 1.4 (1.1–2.6). Conclusions. Thus, children of this group developed hypocoagulation that together with other adverse conditions may lead to the development of late hemorrhagic disease.
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