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PubMed1962

Melena neonatorum.

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Hemorrhagic Disorders↗
PubMedDate not supplied

Effects of oral and intramuscular vitamin K prophylaxis on PIVKA-II assay parameters in breastfed infants in Turkey.

Protein induced by vitamin K absence (PIVKA-II) has been used for the evaluation of vitamin K deficiency in the newborn. Differing PIVKA-II detection rates in various studies on hemorrhagic disease of the newborn have not been explained satisfactorily. In this study we investigated the PIVKA-II values of 44 healthy breastfed infants, of whom 29 received vitamin K1 either orally (N = 13) or intramuscularly (n = 16), and the remaining 15 constituted the control group. PIVKA-II was detected in 15.3 percent (2/13) of the oral and 25 percent of the (4/16) intramuscular group on the third day of life. The detection rate was 93.3 percent (14/15) in the control group. However, at the one-month follow-up, there were no PIVKA-II positive infants. In conclusion, PIVKA-II positivity among breastfed Turkish infants on the third day of life was high compared to that in other studies, perhaps due to a delay in enzyme maturation related to racial, environmental and nutritional factors.

Administration, Oral↗
PubMed1996

Administration of Vitamin K to newborns: implications and recommendations.

The review by Drs. Brousson and Klein (see pages 307 to 315 of this issue) identifies controversies surrounding the administration of vitamin K to babies shortly after birth. Controlled studies comparing the effect of oral and intramuscular administration are unlikely to be conducted because of the large number of subjects needed. The evidence presented in the review should dispel concerns that intramuscular administration may be associated with childhood cancer. Oral administration of a single dose of vitamin K soon after is associated with significant biochemical vitamin K deficiency by 1 month of age, but the relation of biochemical abnormality to clinical manifestations of late hemorrhagic disease of the newborn is less clear. Epidemiologic studies indicate a small, but significant, increase in the incidence rate of hemorrhagic disease after oral administration of vitamin K (1.0 to 6.4 incidents per 1000 000 infants), compared with the incidence rate after intramuscular administration (0.25 incidents per 100 000 infants). Although repeated oral doses of vitamin K may be and effective alternative regimen, there is no approved oral vitamin K formulation, there are concerns about patient compliance, and there has been limited investigation of such regimen. Therefore, intramuscular administration of a single dose of 1.0 mg of vitamin K shortly after birth is recommended.

Administration, Oral↗
PubMed2003

Controversies concerning vitamin K and the newborn. American Academy of Pediatrics Committee on Fetus and Newborn.

Prevention of early vitamin K deficiency bleeding (VKDB) of the newborn, with onset at birth to 2 weeks of age (formerly known as classic hemorrhagic disease of the newborn), by oral or parenteral administration of vitamin K is accepted practice. In contrast, late VKDB, with onset from 2 to 12 weeks of age, is most effectively prevented by parenteral administration of vitamin K. Earlier concern regarding a possible causal association between parenteral vitamin K and childhood cancer has not been substantiated. This revised statement presents updated recommendations for the use of vitamin K in the prevention of early and late VKDB.

Administration, Oral↗
PubMedDate not supplied

Rectosigmoidoscopic findings during isolated rectal bleeding in the neonate.

This study describes a group of 34 infants under 1 1/2 months of age presenting with isolated rectal bleeding not related to hemorrhagic disease of the newborn or to campylobacter infection and with spontaneously favorable evolution. Systematic rectosigmoidoscopy showed the presence of mucosal alterations in the form of either longitudinally stretched ecchymoses lying on a normal mucosa or diffuse ecchymotic patches dispersed on a congestive and friable mucosa, rarely associated to visible micro-ulcerations. Biopsies showed mucosal hemorrhage, capillary vessel congestion, and epithelial erosions, as well as various grades of inflammation. Clinical data indicate that this hemorrhagic colitis is a heterogeneous group where dietary protein intolerance may account for some cases.

Enterocolitis, Pseudomembranous↗
PubMed1998

Vitamin K prophylaxis in less developed countries: policy issues and relevance to breastfeeding promotion.

Vitamin K prophylaxis prevents hemorrhagic disease of the newborn. The present review estimates the potential magnitude of this problem in less developed countries, assessing the need for prophylaxis, along with its cost-effectiveness and feasibility. Late hemorrhagic disease, occurring between 2 and 12 weeks, often leads to death or permanent disability. Its median incidence in developed countries is 7 per 100,000 births. Incidences in less developed countries may be much higher. Three incidence scenarios are proposed and the corresponding losses of disability-adjusted life-years (DALYs) calculated. Under the intermediate scenario, late hemorrhagic disease accounts for 0.1% to 0.2% of DALYs lost to children less than 5 years of age. Assuming a cost of +1.00 per injection, each DALY saved would cost +133. Decisions on prophylaxis must be made on a national basis, considering mortality levels and causes, health budgets, and feasibility. Comparison with the impact of diseases prevented by breast-feeding shows that concern with hemorrhagic disease should not affect breast-feeding promotion efforts, although strategies for supplementing breast-fed infants must be explored.

Breast Feeding↗