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Dispelling Myths: Vitamin K Injections For Newborns

When a baby is born, parents want nothing more than to love and protect their child. Part of that protection starts right after birth with the administration of a vitamin K injection. Babies are not born with sufficient vitamin K levels and cannot get adequate amounts of vitamin K from breast milk, so this injection, given within the first hour after birth, is crucial because it helps a baby’s blood to clot normally, which prevents vitamin K deficiency bleeding (VKDB) in newborns.  A recent CDC report confirmed that there has been a nationwide increase in parents refusing the vitamin K shot for their newborns--- and this dangerous trend, often based on inaccurate information found online and faulty science, is causing more babies to experience hemorrhaging that is preventable and may cause brain damage or even death in some cases. In the United States, administration of intramuscular vitamin K at birth to prevent all forms of VKDB has been standard practice since first recommended by the American Academy of Pediatrics in 1961. Without the shot, the incidence of early and classical VKDB ranges from 0.25% to 1.7% of births and the incidence of late VKDB ranges from 4.4 to 7.2 per 100,000 infants. The relative risk for developing late VKDB has been estimated at 81 times greater among infants who do not receive intramuscular vitamin K than in infants who do receive it. Early VKBD usually presents in previously healthy appearing infants as unexpected bleeding during the first two weeks of age, usually between the second and fifth day after birth.  The bleeding can present as oozing from the umbilical cord area, bleeding from the circumcision site, persistent oozing from puncture sites, gastrointestinal hemorrhage, and/or bleeding into the brain, which can result in significant neurological complications that have a lifelong impact on a child. Late VKDB is an indication of severe vitamin K deficiency and presents as unexpected bleeding, including brain bleeds in infants 2-12 weeks of age.  Complications of late VKDB may be severe, including death. It classically presents in exclusively breastfed infants who received either no or inadequate neonatal vitamin K. It can also present in infants with intestinal malabosorption defects. One myth about vitamin-k injections is that they are linked to leukemia, but studies show absolutely no relationship between getting vitamin K as a baby and an increased risk of leukemia. Another myth is that the vitamin K injection increases the risk of jaundice---which is inaccurate.  Jaundice associated with vitamin K has been observed only in high risk babies (such as premature babies) in doses 30-60 times higher than the dose we give. Some parents also argue that injections cause babies pain, but this pain is very brief and the benefits of the injection are very much worth a short period of discomfort. Parents are encouraged to mitigate this brief uncomfortable experience by holding baby skin to skin before and after the injection or allowing the baby to breastfeed before, during and/or after getting the injection. In the not so distant past, infants and children had high rates of dying early in life.  During the 20th century alone, the infant mortality rate declined greater than 90% and the maternal mortality rate declined 99%!  Much of this is due to advancements in modern medicine.  While it might seem nice to do things completely naturally, modern medicine has saved the lives of countless mothers and babies. Update: For more information on this subject, Dr. Lauren Marcewicz, a pediatrician with CDC’s Division of Blood Disorders, speaks about vitamin K deficiency bleeding in infants, the importance of vitamin K prophylaxis at birth, and how healthcare providers can provide the best information to their expectant parents. Listen to the podcast by clicking here now.
Dr. Tiffany McKee-Garrett, Neonatologist