Late-onset vitamin K deficiency bleeding in an extremely preterm infant fed an exclusively human milk–based diet

Vimal Vasu, Shaveta Mulla, Atisha Pandya, David Card, Martin J. Shearer, Paul Clarke

Research output: Contribution to journalArticlepeer-review


All newborns need extra phylloquinone (vitamin K1; K1) to prevent vitamin K deficiency bleeding (VKDB). In preterm babies, the main sources are prophylactic K1 given at birth and parenteral and/or enteral feeding thereafter. Preterm babies are at risk of late-onset VKDB if ongoing K1 supplementation is inadequate. For extremely preterm infants fed an exclusive human milk diet, the low K1 content of human milk may predispose them to vitamin K deficiency. Human milk fortification with either bovine milk–derived fortifier or human milk–based fortifier (HMF) made from pooled donor milk is a widely used strategy to improve the micronutrient and growth status of preterm infants. However, the K1 content of HMF is markedly lower than that of bovine-based preparations. We present an unusual case of late-onset VKDB in an extremely preterm infant who received an exclusive human milk diet and HMF and quantify total K1 intake prior to the bleeding.
Original languageEnglish
Pages (from-to)466-469
Number of pages4
JournalJournal of Thrombosis and Haemostasis
Issue number2
Early online date20 Nov 2023
Publication statusPublished - Feb 2024

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