de Winter J Peter, Joosten Koen F M, Ijland Marloes M, Verkade Henkjan J, Offringa Martin, Dorrius Monique D, van Hasselt Peter M
Spaarne Ziekenhuis, afd. Kindergeneeskunde, Hoofddorp, The Netherlands.
Ned Tijdschr Geneeskd. 2011;155(18):A936.
Vitamin K-deficiency can cause haemorrhage in newborns and infants from the first hours up to several months after birth. These 'vitamin K deficiency bleedings' (VKDB) can be divided into 3 forms: early (occur in the first hours after birth), classic (first week after birth) and late (between the 2nd and the 12th week of life). The current Dutch vitamin K practice guideline consists of prophylactic administration of 1 mg vitamin K orally directly after birth and a daily dose of 25 μg from day 8 onwards. The current prophylactic treatment provides good protection against VKDB for healthy, breastfed infants. However, the current prophylactic treatment provides insufficient protection for a specific group of infants, namely breastfed infants with defective fat absorption (in cholestasis), leading to less efficient absorption of vitamin K by the body. Anually approximately 5 infants from this group suffer serious haemorrhage. After evaluation of current literature and advice from The Health Council of the Netherlands, vitamin K dosage was adapted for all breastfed infants from day 8 to 3 months (12th week of life) following birth: the daily dose was raised from 25 µg to 150 µg per day.
维生素K缺乏可导致新生儿和婴儿在出生后的最初几个小时直至出生后几个月内发生出血。这些“维生素K缺乏性出血”(VKDB)可分为3种类型:早期(出生后最初几个小时内发生)、经典型(出生后第一周)和晚期(出生后第2周至第12周)。荷兰目前的维生素K实践指南包括出生后立即口服1毫克维生素K进行预防给药,以及从出生第8天起每日剂量为25微克。目前的预防性治疗为健康的母乳喂养婴儿提供了良好的预防VKDB的保护。然而,目前的预防性治疗对特定组别的婴儿保护不足,即脂肪吸收不良(胆汁淤积)的母乳喂养婴儿,导致身体对维生素K的吸收效率降低。该组每年约有5名婴儿发生严重出血。在评估当前文献并参考荷兰卫生委员会的建议后,对所有出生后第8天至3个月(出生后第12周)的母乳喂养婴儿的维生素K剂量进行了调整:每日剂量从25微克提高到150微克。