{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T06:33:55Z","timestamp":1773729235434,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>Exclusively breastfed infants with unrecognised cholestatic jaundice are at high risk of a vitamin K deficiency (VKD) bleeding. It is presently unknown whether (the size of) this risk depends on the degree of cholestasis. Since alpha-1-antitrypsin deficiency (A1AD) induces a variable degree of cholestasis, we assessed the risk of VKD bleeding in infants with cholestatic jaundice due to A1AD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods:<\/jats:title>\n                  <jats:p>Infants with a ZZ or SZ phenotype born in The Netherlands between January 1991 and December 2006 were identified from the databases of the five Dutch diagnostic centres for alpha-1-antitrypsin phenotyping and\/or genotyping. We determined the risk of VKD bleeding upon diagnosis of A1AD in breastfed and formula fed infants and searched for correlations between serum levels of conjugated bilirubin and the risk of bleeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>A total of 40 infants with A1AD were studied. VKD bleeding was noted in 15\/20 (75%) of breastfed infants, compared with 0\/20 of formula fed infants with A1AD. The relative risk for VKD bleeding in breastfed versus formula fed infants was at least 15.8 (95% CI 2.3 to 108). Conjugated bilirubin levels at diagnosis did not correlate with the risk of VKD bleeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>The risk of VKD bleeding in breastfed infants with A1AD was high and did not correlate with serum level of conjugated bilirubin at diagnosis. A similar absolute risk was previously reported in breastfed infants with biliary atresia under the same prophylactic regimen. This confirms that\u2014without adequate prophylaxis\u2014the risk of VKD bleeding is uniformly high in exclusively breastfed infants with cholestatic jaundice, irrespective of underlying aetiology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/adc.2008.148239","type":"journal-article","created":{"date-parts":[[2009,5,4]],"date-time":"2009-05-04T20:12:53Z","timestamp":1241467973000},"page":"F456-F460","source":"Crossref","is-referenced-by-count":17,"title":["Vitamin K deficiency bleeding in cholestatic infants with alpha-1-antitrypsin deficiency"],"prefix":"10.1136","volume":"94","author":[{"given":"P M","family":"van Hasselt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Kok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A D M","family":"Vorselaars","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"van Vlerken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Nieuwenhuys","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T J","family":"de Koning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R A","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R H J","family":"Houwen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,5,3]]},"reference":[{"key":"2025090511083244000_94.6.F456.1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00445922"},{"key":"2025090511083244000_94.6.F456.2","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/j.1365-2141.1970.tb01444.x","article-title":"Absorption and excretion of an oral dose of tritiated vitamin K1 in man.","volume":"18","author":"Shearer","year":"1970","journal-title":"Br J Haematol"},{"key":"2025090511083244000_94.6.F456.3","doi-asserted-by":"publisher","DOI":"10.1136\/adc.60.9.814"},{"key":"2025090511083244000_94.6.F456.4","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1093\/jn\/112.6.1105","article-title":"The content of phylloquinone (vitamin K1) in human milk, cows\u00e2\u0080\u0099 milk and infant formula foods determined by high-performance liquid chromatography.","volume":"112","author":"Haroon","year":"1982","journal-title":"J Nutr"},{"key":"2025090511083244000_94.6.F456.5","doi-asserted-by":"publisher","DOI":"10.1136\/fn.88.2.F109"},{"key":"2025090511083244000_94.6.F456.6","doi-asserted-by":"publisher","DOI":"10.1007\/PL00014352"},{"key":"2025090511083244000_94.6.F456.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-003-1327-3"},{"key":"2025090511083244000_94.6.F456.8","doi-asserted-by":"publisher","DOI":"10.1136\/fn.82.1.F64"},{"key":"2025090511083244000_94.6.F456.9","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1055\/s-0037-1614494","article-title":"Vitamin K deficiency bleeding (VKDB) in infancy. ISTH Pediatric\/Perinatal Subcommittee. 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Administration of vitamin K to neonates and infants. Ned Tijdschr Geneeskd 1990;134:1642\u00e2\u0080\u00936. (In Dutch.)"},{"key":"2025090511083244000_94.6.F456.16","doi-asserted-by":"publisher","DOI":"10.1542\/peds.99.1.88"},{"key":"2025090511083244000_94.6.F456.17","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00062305"},{"key":"2025090511083244000_94.6.F456.18","doi-asserted-by":"publisher","DOI":"10.1080\/08035250310002858"},{"key":"2025090511083244000_94.6.F456.19","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1136\/bmj.308.6933.894","article-title":"Compliance with recommendations for giving vitamin K to newborn infants.","volume":"308","author":"Croucher","year":"1994","journal-title":"BMJ"},{"key":"2025090511083244000_94.6.F456.20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1055\/s-2008-1046519","article-title":"Late form of vitamin K deficiency bleeding in Germany.","volume":"207","author":"Sutor","year":"1995","journal-title":"Klin Padiatr"},{"key":"2025090511083244000_94.6.F456.21","doi-asserted-by":"publisher","DOI":"10.1007\/s003830050033"},{"key":"2025090511083244000_94.6.F456.22","first-page":"328","article-title":"Idiopathic late hemorrhagic disease of newborn and conjugated hyperbilirubinemia.","volume":"16","author":"von Kries","year":"1993","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2025090511083244000_94.6.F456.23","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199911000-00023"},{"key":"2025090511083244000_94.6.F456.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80704-8"},{"key":"2025090511083244000_94.6.F456.25","doi-asserted-by":"publisher","DOI":"10.1136\/adc.60.6.512"},{"key":"2025090511083244000_94.6.F456.26","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S0140-6736(94)90052-3","article-title":"Identification of infants with biliary atresia in Japan.","volume":"343","author":"Matsui","year":"1994","journal-title":"Lancet"},{"key":"2025090511083244000_94.6.F456.27","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.10.1177"},{"key":"2025090511083244000_94.6.F456.28","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22182"},{"key":"2025090511083244000_94.6.F456.29","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.104752"},{"key":"2025090511083244000_94.6.F456.30","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1136\/bmj.319.7208.471","article-title":"Screening of newborn infants for cholestatic hepatobiliary disease with tandem mass spectrometry.","volume":"319","author":"Mushtaq","year":"1999","journal-title":"BMJ"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/adc.2008.148239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:32:56Z","timestamp":1757097176000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/adc.2008.148239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5,3]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2009,10,21]]},"published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1136\/adc.2008.148239"],"URL":"https:\/\/doi.org\/10.1136\/adc.2008.148239","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5,3]]}}}