Oral vitamin K is another option

Recently, I’ve written a number of articles focused on the health aspects of infants, such as the prevailing scientific theories behind why babies so rarely blink. It’s not because I recently gained an offspring of my own (okay, maybe that contributes a little), but because the human infant is a fascinating system to study — because they push the limit of how broken a human can be.

Consider that, as an infant, we are at the most vulnerable state of our lives. The human baby cannot survive on its own, cannot obtain its own food, and many of its biological systems are very underdeveloped.

Even the baby’s gut microbiome, the diverse collection of many trillions of different bacteria that lives in each of our lower intestinal tracts, is weak and underdeveloped. If a person’s microbiome is a lush tropical rainforest, a baby just has a few small trees and plants starting to take root on fresh, virgin soil.

And with an underdeveloped microbiome, babies are at extreme risks for a number of deadly conditions. One condition, vitamin K deficiency, prevents a baby’s blood from clotting and can quickly lead to death.

But we can solve this — with a single shot.

Here’s the power of a vitamin K shot.

The Koagulation vitamin
Vitamin K is a name for a family of fat-soluble vitamins, discovered in the 1930s, first shared publicly in 1939, and eventually leading to a Nobel Prize for its discoverers, Henrik Dam and Edward Doisy. The vitamin was first discovered because animals that didn’t receive it had frequent hemorrhages and bleeding; these animals needed this mysterious substance in order to stop the bleeding.

The vitamin’s existence was first published in a German scientific journal, where it was referred to as Koagulationsvitamin; this is how the name of “vitamin K” eventually came to stick.

(Strange fact: for decades, the only way that we could measure the amount of vitamin K in various foods was by feeding the food to a vitamin-K-deficient chicken and seeing how much the bleeding was reduced!)

As its name suggests, the vitamin plays an important role in blood coagulation. Specifically, there are certain proteins in our blood, such as prothrombin, that are involved in blood clotting, but they aren’t immediately active when they’re first produced. These proteins need vitamin K to help make modifications to them, transforming inactive prothrombin into active thrombin. Thrombin, in turn, converts proteins in our blood into long strands that help the blood form a solid clot.

The flow looks something like this:

Our liver produces inactive prothrombin.
Prothrombin is modified by a few different enzymes, including vitamin K, to create active thrombin.
Thrombin circulates in our bloodstream, watching, waiting…
When there’s damage to a blood vessel, platelets trigger the thrombin to make fibrin strands to help block the hole.
Without vitamin K, this whole process falls apart; it’s critical for our ability to make the active thrombin.

Where do we adults get vitamin K? What about babies?
We need a couple different types of vitamin K, usually labeled as K1 and K2.

Vitamin K1 is found in everyone’s favorite food, leafy green vegetables! Collard greens, spinach, kale, Brussels sprouts, broccoli. It’s also in some fruits and other vegetables, but at significantly lower concentrations than in green leafy vegetables.

Vitamin K2, on the other hand, is present in some animal products (goose meat, egg yolks, chicken meat), but a good portion of it is synthesized by our gut bacteria, and then absorbed from them by us! There are about 34 different species of gut bacteria that show the ability to synthesize a form of vitamin K2, spanning several different genera (groups).

Both of these are an issue for babies.

Newborns aren’t going to be eating any leafy green vegetables (although I did once have to stop mine from attempting to eat a handful of grass. See item? Item must go to mouth). And infants have two issues with their gut microbiome:

It’s underdeveloped and still solidifying in their first few months of life;
It’s formed almost entirely around digesting milk sugars. When babies switch to solid foods, their microbiome undergoes a radical, far-ranging shift.
Babies are born with a little bit of vitamin K, but not nearly enough. Most vitamin K doesn’t pass the placental barrier from the mother — and it’s not secreted in high amounts in breast milk, either, so they can’t pick it up from feeding.

This is where modern medical science has come in — with the vitamin K shot.

A quick shot to fill the K reservoir
Physicians have been giving vitamin K shots to babies since 1961; there have not been any serious side effects, and that single shot, usually with 0.5 to 1.0 milligrams of vitamin K, is able to stop excessive bleeding that otherwise has an approximately 20% mortality rate (1 in 5 babies with vitamin K deficiency bleeding die).

Oral vitamin K is another option, where several oral doses of vitamin K are administered (immediately after birth, after about 2 weeks, and after about 2 months). Overall, however, oral vitamin K is less efficiently absorbed by infants and it’s not suitable for some infants with bile duct issues.

That single shot is enough vitamin K to carry the infant to the 4–6 month mark. Once the baby reaches this stage, they’ll likely start eating solid foods, which are going to be more varied and will contain vitamin K1. Additionally, by this stage, their gut microbiome will be developed enough to also start synthesizing vitamin K2.

Even with the vitamin K shot, babies are not going to clot as well as an adult, but they will be able to avoid hemorrhaging and dying from continuous bleeding.

Oral vitamin K is another option

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