Natal K Testing

Dr. Green Mom® Oral Natal•K™ has been extensively tested to meet and EXCEED all government rules and regulations. If you would like to know the exact breakdown of testing and results, the Certificate of Analysis, you may click here (2021 COA), here (Aug 2023 COA) and third party stability certification, August 2023.

Our oral Natal•K™ vitamin K contains just two simple ingredients:

  • 500mcg vitamin K1 (phytonadione)
  • Organic MCT Oil made from Organic Coconut

The following is NOT medical advice:

Now the big question: How do I dose this?

This is not a simple answer. Each country in the world that allows for oral vitamin K at birth has their own dosing instructions, based on what has been studied.

In my practice, I use the Denmark study:

  • 2 mg at birth (4 drops), followed by 1 mg (2 drops) weekly for 12 weeks. See the study 
  • MUST BE GIVEN AFTER A FEEDING FOR MAXIMUM ABSORPTION.
  • If there is reflux within one hour, dose again.

Denmark Study: https://pubmed.ncbi.nlm.nih.gov/12892158/:

“Aim: To evaluate oral vitamin K prophylaxis at birth by giving 2 mg phytomenadione, followed by weekly oral vitamin K prophylaxis; 1 mg was administered by the parents until 3 mo of age.

Methods: A total of 507850 live babies were born in Denmark during the study period, November 1992 to June 2000. Of these infants, 78% and 22% received oral and intra-muscular prophylaxis, respectively; i.e. about 396000 neonates received oral prophylaxis at birth. Weekly oral prophylaxis was recommended for all infants as long as they were mainly breastfed. A survey of possible cases of vitamin K deficiency bleeding (VKDB) was carried out by repeated questionnaires to all Danish paediatric departments and by checking the National Patient Register.

Results: No cases of VKDB were revealed, i.e. the incidence was 0-0.9:100000 (95% CI). The questionnaires were used to evaluate compliance with the regimen. Parents of 274 infants participated. A dose of vitamin K was regarded as having been given if the infant received a drop of vitamin K or was mostly formula-fed that week, and the prophylaxis was regarded as completed if the infant had received at least 9 doses. Compliance was good, with 94% of the infants completing the course of prophylaxis.

Conclusion: Weekly oral vitamin K supplementation during the first 3 mo of life was an efficient prophylaxis against VKBD. Parental compliance with the regimen was good.”

And to learn everything you’d ever want to know about vitamin K at birth please visit Evidence Based Birth.

The following are for reference purposes:
https://pubmed.ncbi.nlm.nih.gov/1428134/
“It is, therefore, concluded that oral Vitamin K is as effective as injectable Vitamin K and its usage is recommended in our country to reduce complications and costs of parenteral therapy.”
https://pubmed.ncbi.nlm.nih.gov/30919833/
“Administering PO vitamin K (2.0 mg at birth, repeated at 2 to 4 and 6 to 8 weeks of age), should be confined to newborns whose parents decline IM vitamin K”
https://pubmed.ncbi.nlm.nih.gov/18381514/
“One milligram of weekly oral prophylaxis offers significantly higher protection to these infants and is of similar efficacy as 2 mg of intramuscular prophylaxis at birth.”
https://www.cps.ca/en/documents/position/vitamin-k-prophylaxis-in-newborns
“Conclusions: Administering PO vitamin K (2.0 mg at birth, repeated at 2 to 4 and 6 to 8 weeks of age), should be confined to newborns whose parents decline IM vitamin K.”
https://pubmed.ncbi.nlm.nih.gov/11775338/
“Conclusions: Oral administration of vitamin K is as effective as the intramuscular route in the prevention of the hemorrhagic disease of the newborn.”
https://pubmed.ncbi.nlm.nih.gov/27109090/
“When compared with IM prophylaxis, a single oral dose of vitamin K increased the risk of VKDB (RR 24.5; 95% CI 7.4 to 81.0) but multiple oral doses did not (RR 3.64; CI 0.82 to 16.3). There is low-quality evidence from observational studies that routine IM administration of 1 mg of vitamin K at birth reduces the incidence of late VKDB during infancy. Given the high risk of mortality and morbidity in infants with late VKDB, it seems appropriate to administer IM vitamin K prophylaxis to all neonates at birth. Future studies should compare the efficacy and safety of multiple oral doses with IM vitamin K and also evaluate the optimal dose of vitamin K in preterm neonates.”
https://pubmed.ncbi.nlm.nih.gov/23192459/
“VKDB prophylaxis with 3 × 2 mg oral doses of mixed micellar VK seems to prevent adequately infants from VKDB. The main risk factors for VKDB in breast-fed infants are parental VK prophylaxis refusal or an unknown cholestasis.”
https://pubmed.ncbi.nlm.nih.gov/17537761/
“Late onset VKDB remains virtually confined to breast-fed infants who have received either no VK or just one oral dose. The effectiveness of oral prophylaxis regimens has improved over the last 15 years, but parental refusal of prophylaxis has become more problematic.”
https://pubmed.ncbi.nlm.nih.gov/32187975/
“Several epidemiological studies have shown that vitamin K oral administration is effective in the prevention of VKDB in infancy; however, the success of oral prophylaxis depends on the protocol regimen and parent compliance.”
IM to preterm –
https://pubmed.ncbi.nlm.nih.gov/29401369/
“Authors’ conclusions: Preterm infants have low levels of vitamin K and develop detectable PIVKA proteins during the first week of life. Despite being at risk for VKDB, there are no studies comparing vitamin K versus non-treatment and few studies that address potential dosing strategies for effective treatment. Dosage studies suggest that we are currently giving doses of vitamin K to preterm infants that lead to supraphysiologic levels. Because of current uncertainty, clinicians will have to extrapolate data from term infants to preterm infants. Since there is no available evidence that vitamin K is harmful or ineffective and since vitamin K is an inexpensive drug, it seems prudent to follow the recommendations of expert bodies and give vitamin K to preterm infants. However, further research on appropriate dose and route of administration is warranted.”