Vitamin K Deficiency in Children: Risk Factors, Signs, and Food Sources

Written by Tarishi Shrivastava | May 24, 2024

Introduction

Vitamin K deficiency occurs when the body does not have enough vitamin K to support normal blood clotting. The liver uses vitamin K to produce proteins, including prothrombin, that help blood form clots. Vitamin K also supports bone health. Deficiency is uncommon in healthy older children who eat a varied diet, but newborns are at greater risk because they have low vitamin K stores at birth. Newborn vitamin K deficiency bleeding (VKDB) is a distinct concern that can occur during the first six months of life.

Vitamin K Deficiency Symptoms

Vitamin K deficiency symptoms mainly relate to problems with blood clotting. Possible warning signs include:

• Bruising easily or developing unexplained bruises.
• Frequent nosebleeds or bleeding gums.
• Cuts that bleed longer than expected.
• Blood in the urine or stool.
• Black, tarry stools or vomiting blood.
• Pale skin or unusual weakness associated with blood loss.

In babies, bleeding from the umbilical cord, unusual bruising, persistent bleeding or yellowing of the eyes after the first three weeks can be warning signs. Irritability, excessive sleepiness, repeated vomiting, seizures or a bulging soft spot may indicate serious illness.

5 Vitamin K-Dense Foods to Add to Your Child's Diet

Vitamin K is found mainly in green leafy vegetables, with additional amounts in certain vegetables and plant oils. The values below are approximate and depend on the variety, preparation and serving size.

Kale

Kale is a leafy green vegetable that provides vitamin K1, also called phylloquinone. One cup of raw kale contains approximately 113 micrograms (mcg) of vitamin K. For children who are not fond of its flavor, try adding finely chopped kale to dal, soups, vegetable parathas or mixed vegetable dishes. Cook it as part of a varied meal rather than relying on a daily smoothie or any single food.

Lettuce

Lettuce can add vitamin K to salads, sandwiches and wraps. One cup of shredded raw iceberg lettuce provides approximately 14 mcg of vitamin K. Romaine and other leafy varieties can contain different amounts. Add lettuce to a sandwich, serve it with a meal or combine it with other vegetables. Choose a variety of vegetables throughout the week instead of relying on lettuce alone.

Collard Greens

Collard greens are leafy vegetables rich in vitamin K. Half a cup of boiled collard greens provides approximately 530 mcg of vitamin K. Although they are less common in many Indian kitchens, you can use familiar leafy greens such as spinach or mustard greens as alternatives. Cook greens thoroughly and serve them in soups, dals or vegetable preparations suited to your child's preferences.

Broccoli

Broccoli provides vitamin K along with other nutrients. Half a cup of chopped, boiled broccoli contains approximately 110 mcg of vitamin K. Serve it steamed, roasted or mixed into vegetable pulao, pasta, soups or curries. Cooking methods and serving sizes can affect the amount of vitamin K in a meal, so the figure is a useful estimate rather than an exact value for every preparation.

Cabbage

Cabbage is an affordable vegetable that can be added to many family meals. One cup of chopped raw cabbage provides approximately 68 mcg of vitamin K, while half a cup of boiled cabbage provides about 82 mcg. You can prepare cabbage sabzi, add it to dal or vegetable soups, or use it in sandwiches and wraps. Combining cabbage with other vegetables helps provide a broader range of nutrients.

Food values are based on published nutrient composition data and may vary by preparation and variety. NIH Office of Dietary Supplements USDA nutrient data

More Food Sources of Vitamin K

Along with kale, lettuce, collard greens, broccoli and cabbage, children can get vitamin K from spinach, other leafy greens, soybeans and selected vegetable oils.

Vitamin K Deficiency Diseases List: Possible Complications

Vitamin K deficiency does not produce a long list of separate deficiency diseases. Instead, it can cause bleeding complications, collectively described as vitamin K deficiency bleeding, or VKDB. These may include:

• Easy bruising and prolonged bleeding:Blood does not clot normally.
• Gastrointestinal bleeding:Bleeding can occur in the digestive tract.
• Bleeding after injuries or procedures:Bleeding may continue longer than expected.
• Newborn vitamin K deficiency bleeding:Infants may develop bleeding under the skin, in the digestive tract or, in severe cases, inside the skull.

Risk Factors and Warning Signs

Vitamin K deficiency is more likely in certain situations:

• Newborns without vitamin K prophylaxis:Babies who do not receive the recommended vitamin K injection at birth have a higher risk of VKDB.
• Malabsorption conditions:Cystic fibrosis, coeliac disease and other conditions that interfere with fat absorption can reduce vitamin K absorption.
• Liver or bile duct disease:These conditions can affect vitamin K handling or contribute to bleeding problems.
• Certain medicines:Some antibiotics and medicines used to treat seizures may affect vitamin K status or its use in the body.

Diagnosis and Treatment of Vitamin K Deficiency

A doctor assesses symptoms, medical history, diet, medicines and possible absorption problems. Blood tests, including prothrombin time (PT) and the international normalised ratio (INR), help assess how well blood is clotting. Further tests may be needed to identify the underlying cause.

Treatment depends on the child's age, the severity of the deficiency and the reason it developed. A healthcare professional may prescribe vitamin K orally or by injection, depending on the clinical situation. Severe or active bleeding needs urgent medical care.

Foods rich in vitamin K support normal nutrition, but they cannot replace medical treatment for active bleeding. Do not give high-dose supplements or change prescribed medicines without professional advice. Newborn vitamin K prophylaxis is a separate preventive measure recommended at birth. Merck Manual CDC