NeoKay (Vitamin K1) Drops

NeoKay general information

What is NeoKay used for?

NeoKay Oral Drops are a Vitamin K supplement for newborn babies used to prevent bleeding due to vitamin K deficiency.  Vitamin K deficiency-related bleeding, also known as hemorrhagic disease, is a bleeding disorder which can be rapidly corrected by vitamin K supplementation.  Vitamin K is a procoagulation factor and plays an important role in the blood coagulation cascade that results in blood clotting to prevent bleeding. 

There are two forms of vitamin K; the main source is K1 (phylloquinone) that is obtained from the diet mainly from leafy green vegetables, and K2 (menaquinone) that is synthesised by the normal intestinal “good” bacteria that are not yet present in the intestine of babies at birth.  Vitamin K1 is a fat soluble vitamin that does not easily cross the placenta from mother to baby during pregnancy; also breast milk contains only low amounts of Vitamin K1.  For these reasons, babies are born with low amounts of vitamin K in their blood, making them prone to Vitamin K deficiency and increasing risk of Vitamin K deficiency-related bleeding.  Therefore, it is recommended that babies, particularly those exclusively breast-fed, are supplemented with vitamin K during their first three months (formula milk is already supplemented), to reduce their risk of this bleeding disorder until the normal blood clotting system matures between 3-6 months^{1, 2, 3, 4}. 

Although all newborn babies are at risk of hemorrhagic disease, some babies are at greater risk including premature babies, babies born with birth asphyxia (lack of oxygen), obstructive jaundice (obstructed flow of bile into the intestine) or difficulty swallowing; also babies whose mothers have been taking certain medications during pregnancy, such as anticoagulants and antiepileptics.  NeoKay Oral Drops provides daily source of Vitamin K in comparable amounts to formula feed, and is an alternative to intramuscular injection for vitamin K supplement for babies, that easy to use and does not need to be administered by a health professional, to reduce risk of hemorrhagic disease⁵.

How does NeoKay work?

NeoKay Oral Drops is a nutritional supplement containing Vitamin K that is used to prevent Vitamin K deficiency in newborn babies.  Vitamin K is an essential co-factor needed for the synthesis by the liver of several blood coagulation factors and works by carboxylation of glutamate residues in these proteins, which enables them to bind calcium, which is essential for their normal function within the coagulation cascade.  Vitamin K dependent clotting factors include prothrombin (factor II) and factors VII, IX and X.  Vitamin K is also required for synthesis and function of the coagulation regulators protein C and protein S.  The amount of Vitamin K dependent factors increase rapidly following administration of Vitamin K supplement.  Vitamin K in NeoKay Oral Drops supplements the Vitamin K deficiency that all babies are born with, and if administered by mouth at birth protects healthy babies from the risk of bleeding due to vitamin K deficiency in the first week of life.  

What does NeoKay contain?

NeoKay Oral Drops contains the active ingredient Vitamin K (50 mcg) dissolved in 0.25ml of pure fractionated coconut oil.  NeoKay Oral Drops also contains Vitamin E (125mcg) as antioxidant and does not contain preservatives, artificial colours or flavours.  Each bottle of NeoKay Oral Drops contains 25ml, which is enough for 100 days.

Treating Vitamin K deficiency in babies with NeoKay

NeoKay Oral Drops contains Vitamin K that is used as a supplement for newborn babies to prevent bleeding due to vitamin K deficiency.  Babies are born with low amounts of vitamin K in their blood, as Vitamin K1 does not easily cross the placenta from mother to baby during pregnancy; also breast milk contains only low amounts of Vitamin K1, which makes them prone to Vitamin K deficiency and increases risk of Vitamin K deficiency-related bleeding.  Therefore, it is recommended that babies, particularly those exclusively breast-fed, are supplemented with vitamin K during their first three months (formula milk is already supplemented), to reduce their risk of this bleeding disorder until the normal blood clotting system matures between 3-6 months.  Vitamin K is an essential co-factor needed for the synthesis and normal function of several blood coagulation factors including prothrombin (factor II) and factors VII, IX, X.  The amount of Vitamin K dependent factors increase rapidly following administration of Vitamin K supplement.  Vitamin K in NeoKay Oral Drops supplements the Vitamin K deficiency that all babies are born with, and if administered by mouth at birth protects healthy babies from the risk of bleeding due to vitamin K deficiency in the first week of life.  NeoKay Oral Drops provides comparable amounts of Vitamin K as formula feed milk.

What are the side effects of NeoKay?

No side effects have been associated with oral administration of NeoKay Oral Drops, however, if any are noticed they should be report them to a health professional.

When should NeoKay not be used?

You should not use NeoKay Oral Drops if your baby:

• is allergic to Vitamin K or any ingredients in NeoKay
• is not well enough to be fed within a few hours of birth
• has protein C or protein S deficiency and/or is currently being given warfarin, without discussion with your doctor
• has a bleed, such as from the umbilical cord stump, or shows signs of bruising, consult your doctor immediately
• is taking medicines that interact with NeoKay, including coumarin anticoagulants like warfarin

What medications interact with NeoKay?

NeoKay Oral Drops should not be given to your baby if you are breastfeeding and you are taking antiepileptics like carbamazepine, phenobarbital and phenytoin, the antibiotic rifampicin or the anticoagulant warfarin.

How should NeoKay be taken?

You should give your baby 0.25ml NeoKay Oral Drops using the calibrated dropper provided, dropwise, daily before or after feeds.  To give NeoKay Oral Drops to your baby, squeeze the bulb of the dropper and draw up the liquid to the 0.25ml mark and then drop into the baby’s mouth.  Avoid contact of the dropper with the baby’s mouth or with food, to prevent contaminating the contents of the bottle.  You should continue to give your baby NeoKay Oral Drops each day starting on the second day following birth until up to and including the third month of their lives, particularly if your baby is wholly or largely fed with breast milk or is premature.  Once your baby is transferred onto a formula milk product or weaned onto solid foods, you can stop giving NeoKay Oral Drops to your baby, following advice from your doctor.

How long should you take NeoKay?

You should continue to give your baby NeoKay Oral Drops each day starting on the second day following birth until up to and including the third month of their lives, particularly if your baby is wholly or largely fed with breast milk or is premature. 

Missed dose of NeoKay

If you miss a dose of NeoKay Oral Drops give it to your babay as soon as you remember, unless it is time to give the next dose, then skip the missed dose.  Do not give a double dose.

How should NeoKay be stored?

You should store your NeoKay Oral Drops at room temperature but below 25°C in a cool dry, dark place and do not place in the refrigerator or freeze. 

References

1. Lippi G, Franchini M. Vitamin K in neonates: facts and myths. Blood Transfusion. 2011;9(1):4-9.
2. Greer FR. Vitamin K status of lactating mothers and their infants. Acta Paediatr Suppl 1999 Aug;88(430):95-103.
3. Puckett RM, Offringa M.  Prophylactic vitamin K for vitamin K deficiency bleeding in neonates. Cochrane Database Syst Rev 2000;(4):CD002776.
4. Wariyar U, Hilton S, Pagan J, Tin W, Hey E. Six years’ experience of prophylactic oral vitamin K. Arch Dis Child Fetal Neonatal Ed 2000; 82: F64-F68.
5. Strehle EM, Howey C, Jones R. Evaluation of the acceptability of a new oral vitamin K prophylaxis for breastfed infants. Acta Paediatr 2010 Mar;99(3):379-83.