Prevention of Vitamin K Deficiency in the Early Neonatal Period
To prevent vitamin K (VK) deficiency-related hemorrhage in infancy, the Committie on Nutrition of the American Academy of Pediatrics has recommended the prophylactic administration of VK to all newborns since 1961 , and so intramuscular injection of VK immediately after birth has been widely accepted in the USA but has not been uniformly practiced throughout the world for fear of neuromuscular complications. Intravenous injection of VK may also cause shock probably due to its solvent (CHO 60) . Now in Japan, an oral administration of VK2 syrup (Kaytwo®, Eisai, Co., Ltd.) to newborns has been carried out since 1984. As a result, these ten years, the incidence of late hemorrhagic disease which occurs in infants after the first week from birth has decreased from 18/ 100000 deliveries to 2/ 100000 deliveries . But the classic hemorrhagic disease of the newborn, occuring between 1 and 7 days old, namely melena neonatorum which is rather mild, and whose incidence is one hundred times more than that of the late hemorrhagic disease [1, 4]. This disease is still seen because the immediate administration of VK after birth to newborns has not yet widely accepted because of the risk of necrotizing enterocolitis  due to the high osmolarity of the syrup . To prevent melena neonatorum, we have given mothers before delivery VK2 capsule orally (Kaytwo® capsule, Eisai. Co., Ltd.) containing 5mg of VK2, menaquinone-4 (MK-4), which was first put on the market in Japan in 1988. The present study was undertaken to evaluate the effect of prophylactic oral VK2-administration to the mothers according to the incidence of melena neonatorum and to redefine an effectively prophylactic dosage and administration time of VK2.
KeywordsBreast Milk Maternal Plasma Necrotizing Enterocolitis Prophylactic Administration Hemorrhagic Disease
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