Physicians have noticed an increasing and concerning trend of parents refusing vitamin K shots for their newborn babies. Vitamin K, or rather the lack of vitamin K, is a real medical issue. One of the major roles of vitamin K is helping the blood to clot. Without supplementing vitamin K, babies are at risk of developing vitamin K-deficient bleeding (VKDB) which may occur within the first week of life and up to 12 weeks of age.
What are the risks and consequences of withholding newborn vitamin K?
As many as 6-12% of babies without supplementation can be expected to have some kind of bleeding during the first week and the risk of late VKDB (from 2 to 12 weeks) is around 4-7 per 100,000 children.1 If your baby does not get the vitamin K shot, his or her risk of developing severe bleeding is 81 times higher than if he or she got the shot.2 Of the infants who develop late VKDB, about half of them have bleeding in their brains, which can cause permanent brain damage.2 Diagnosis and treatment of VKDB often involves many painful procedures, including repeated blood draws and transfusions and can result in disabilities or death. Only one case of a serious allergic reaction to the vitamin K injection has ever been recorded.2 Clearly, the vitamin K supplement is less dangerous than bleeding due to vitamin K deficiency.
The decision to withhold the vitamin K injection has similarities to the anti-vaccine movement. A study published last year found that the 0.3% of parents who refused vitamin K shots were also 14.6 times more likely to have refused all vaccines for their children of up to 15 months old.3 Like vaccine refusals, vitamin K refusal stems from the idea that natural is always better and babies are healthier without anything “artificial“ in their bodies or that the injections present a higher health risk for their babies than the diseases or conditions they will prevent. For vitamin K, this is simply not true – it has been scientifically established that vitamin K does not cross the placenta in adequate amounts and, as a result, babies are born with a natural deficiency.
What about getting vitamin K from food and breast milk?
Since most vitamin K does not pass through the placenta, this deficiency occurs even if you supplement yourself with vitamin K during pregnancy.4 Since vitamin K does not easily transfer into breast milk, vitamin K deficiency is more common in babies who are exclusively breastfed. Repeated oral supplementation of vitamin K for babies has been tried and rejected as being not as stable nor as effective as the one-time intramuscular injection given at birth.5,6 Side effects are mostly mild and related to the injection site; serious side-effects are very unlikely.2 And most health care providers will allow you to hold or to nurse your baby so that you can comfort your baby when they get their shot.
Truth or consequences?
Some parents may be declining the shot for their babies due to the sharing of less-than-scientific opinion pieces about vaccines and the vitamin K injection on some websites, suggesting that it would be safer for their baby to forgo the shots. One common myth on these websites is that the vitamin K shot causes childhood leukemia. This association was suggested by one study but has since been thoroughly disproven by additional and better-quality studies, which is the scientific method of determining truth from coincidence. As a result, the American Academy of Pediatrics has concluded that there is no link between the vitamin K injection and leukemia.7
Within a recent eight-month period, Vanderbilt University physicians identified 5 infants who had not received vitamin K at birth and who had intracranial (within the skull) bleeding. Two of them needed urgent neurosurgery and will almost certainly have neurological complications as a result.1
How to make the decision for yourself and your baby
One of the first tasks of new parents is to make decisions about newborn care – breastfeeding, circumcision, vitamin K, etc. As with all health decisions, it is important to find several sources of information about the issues, talk to your trusted health care providers, and weigh the benefits and risks. In the case of vitamin K, we think the decision is very clear.
The vitamin K shot is safe, non-toxic and will protect your baby from bleeding for up to 6 months. True, the chance of your baby having serious bleeding in the brain or elsewhere is low if you choose not to supplement with vitamin K, but why risk it when preventing it is safer?
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- Shulte R, Jordan LC, Morad A, Naftel RP, Wellons III JC, Sidonio R. Rise in late onset vitamin K deficiency bleeding in young infants because of omission of refusal of prophylaxis at birth. Pediatric Neurology. 2014:50:564-568.
- Centers for Disease Control. Frequently Asked Questions (FAQ’s): Vitamin K and the Vitamin K Shot Given at Birth.
- Sahni V, Lai, FY and MacDonald SE. Neontal vitamin K refusal and nonimmunization. Pediatrics. 2014. 134(3):497-503.
- Pichler E, Pichler I. The neonatal coagulation system and the vitamin K deficiency bleeding – a mini review. Wien Med Wochenschr. 2008;158(13-14):385-395.
- Greer FR. Are breast-fed infants vitamin K deficient? Adv Exp Med Biol. 2001;501:391-395.
- Buck ML. Vitamin K for the prevention of bleeding in newborns. Pediatr Pharm. 2001;(7):10.
- American Academy of Pediatrics Policy Statement. Controversies concerning vitamin K and the newborn. Pediatrics 2003.112(1):191-192.