State of the Art Vitamin K in Human Milk

Abstract

SummaryBreast‐feeding is the sole source of vitamin K for most of the world's children and breast‐fed infants are at risk for vitamin K‐responsive hemorrhagic disease of the newborn (HDNB). Recent advances in high performance liquid chromatography methodology have made possible the first quantitative studies of vitamin K in human milk. Although much progress has been made, much remains to be done. Innovative improvements in methodology are needed, as detection of nanogram quantities of vitamin K in milk is at the limit of current methodology. Additional studies are needed over the lactation period. A better understanding of colostrum is needed with regard to other nutrients as well as vitamin K. Vitamin K in the milk of mothers who gave birth prematurely has not been measured. The significance of menaquinones as a vitamin K source to the infant is undetermined. The mechanism regulating vitamin K secretion into milk has not been investigated. The localization of vitamin K in milk is undetermined as is the relationship of vitamin K to other milk lipids. The effects of fat‐soluble vitamins in the diet on vitamin K concentrations in milk is unknown. The pharmacokinetics of vitamin K supplementation of mothers is particularly important in cultures where vitamin K is not routinely administered at birth. Finally, most critical at this point is our ignorance about the relationship of the maternal vitamin K status to the vitamin K status of the infant. As breast milk is the sole source of vitamin K for most of the world's infants, HDNB remains a very real threat to the health of infants and warrants concentrated study.