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.eBooks from Mommypotamus The Busy Mama’s Guide to Getting Dinner On The TableSubscribe to my newsletter and receive this FREE GUIDE along with exclusive coupons, links to recommended products, and much more! I'm Heather, aka The Mommypotamus.
I’m a wife, mom, real food lover, research geek, and amateur homesteader. Don’t miss these popular posts Why I Ditched Meal Plans For Real PlansSafe Essential Oils For Babies And ChildrenMTHFR Gene Mutations: A Beginner’s GuideHow To Really Increase Happiness In 5 Minutes A Day15 Ways To Be Kind To Your AdrenalsThis article covers:Background of vitamin K after birthAre some babies at higher risk of HDN?What are the effects of giving vitamin K by injection?What are the effects of giving vitamin K orally?Why were breastfed babies thought to be at increased risk?Should women take vitamin K?Possible vitamin K deficiency symptoms to watch out for In the UK, parents of new babies are routinely asked if their baby is to have supplementary vitamin K by injection or oral supplement, which is needed to make blood clot and prevent excessive internal bleeding. Compared with adults, newborn babies are born with low levels of vitamin K but the amount is normally sufficient to prevent problems.
Some babies are at risk, however, because they don’t have sufficient vitamin K, and they have an increased risk of Haemorrhagic Disease of the Newborn (HDN), also known as Vitamin K Deficiency Bleeding (VKDB). While some babies are at a higher risk than others (see below), some babies who are at risk of bleeding don’t show any risk factors and, for this reason, the Department of Health recommends all babies are given vitamin K soon after birth, usually by injection. However, it is your choice as a parent to decline, if you wish; you can also opt for vitamin K to be given by mouth instead. HDN is a rare but very serious disease. Half of all babies who have HDN have a haemorrhage into their brain (intracranial bleeding). This often causes brain damage, and the baby may die. In the 1950s and 1960s, it became standard practice for all babies to have an injection of vitamin K into a muscle. Later, in the 1980s, some health professionals and parents wondered if it was necessary to give vitamin K injections to every newborn baby.
Instead, single doses by mouth became popular, and some babies, if they were not deemed to be at higher risk, were not given the supplement at all. A UK study published in 1991 confirmed that HDN was rare. The babies who had HDN were more likely to have liver disease or be breastfed. Then, in 1990 and 1992, studies were published that suggested a possible link between injected vitamin K and childhood cancers including leukaemia. This meant more babies were given vitamin K by mouth. The number of babies with HDN went up slightly as a result, perhaps because oral vitamin K is slightly less effective than when it is given by injection. Since then, further studies have failed to find any link between injected vitamin K and childhood cancers of any type and, in 1997 an expert body for the UK Department of Health concluded that this was no longer a concern. Babies at increased risk of HDN include: This means that about a third of babies are at increased risk. Some studies suggest that many of the babies who develop bleeding have unseen problems with their liver.
It is hard to spot these babies before they bleed, so vitamin K can be preventive. Giving vitamin K by injection probably keeps levels higher for longer, compared with vitamin K by mouth, as it remains stored in the muscle where it was injected. Problems from the injection are very uncommon but may happen, as with any injection. Babies can feel pain and, on rare occasions, may have an infection at the place where the injection goes in, or bleeding and bruising in the muscle. Mistakes are very occasionally made with the injection, and the wrong dose or drug may be given. Oral vitamin K is given in three separate doses, over the first month of life. Studies have shown that sometimes, a dose is omitted, probably because it’s forgotten about, and this means full protection is not given. According to studies, HDN was more common among breastfed babies. We know vitamin K levels are higher in colostrum (the first milk you produce) than in mature milk. In the past, babies were not breastfed till some time after birth, and strict feeding routines were usual;
this probably meant that babies got less vitamin K than nature intended. Nowadays, babies are usually breastfeed soon after birth, and they feed frequently for as long and as often as they want. This means they get more colostrum than they used to, reducing the risk of HDN. Formula milk has vitamin K added to it. Giving vitamin K to mums before and after they have their babies has been tried in small-scale studies. Vitamin K does go across the placenta and into breastmilk, but it does not seem to be sufficient to prevent HDN. If your newborn bleeds, for example, if you find blood oozing from the cord stump, or if bleeding continues for some time after the ‘heel prick’ blood test, or if your baby has a nose bleed or unexplained bruising, then talk to your doctor or midwife. They need to be checked in case this bleeding is a sign of HDN. If your baby has jaundice lasting longer than two to three weeks or is producing pale poos and dark urine, you should raise it with your doctor or midwife, because this may be a sign of liver problems, which increases the risk of abnormal bleeding.