All newborns require
phylloquinone after birth to prevent
vitamin K deficiency bleeding. Babies born prematurely may be at particular risk of deficiency without adequate supplementation during infancy. The main sources of
phylloquinone in preterm babies during the neonatal period are the prophylactic dose of
phylloquinone given at birth, and that derived from parenteral and/or
enteral feeding. This observational study formed part of a prospective, multicentre, randomised, controlled trial that examined the
vitamin K status of preterm infants after random allocation to one of three
phylloquinone prophylactic regimens at birth (0.5 or 0.2 mg intramuscularly or 0.2 mg intravenously). In this nutritional sub-study we quantified the proportional and total
phylloquinone intakes of preterm infants within the neonatal period from all sources. Almost all infants had average daily
phylloquinone intakes that were in excess of the currently recommended amounts. In infants who did not receive
parenteral nutrition, the bolus dose of
phylloquinone given at birth was the major source of
phylloquinone intake, whereas in infants who received
parenteral nutrition, the intake from the parenteral preparation exceeded that from the bolus dose by a ratio of approximately 3:1. Our study supports the concern of others that preterm infants who receive current
parenteral nutrition formulations may be receiving excessive
vitamin K.