Vitamin K in newborns: The facts, risks and benefits
Let’s set the stage:
Baby is born, they’re the most perfect little thing in the whole world and you can’t believe you ever knew life without being their mom. You get some snuggles, see how much they weigh, how long they are then the question, “We’re going to give your baby the medications, okay?”
The question that really isn’t a question often times, moreso statement. Other times it is not even asked, just routinely given unless the parents expressed their wish to decline ahead of time.
But we want you to know what these medications are and what they are for. Because you are the parents you have the rights to know the facts, risks and benefits of anything that is given to your child.
The three typical medications offered after birth in the US (typically in hospital births) are:
Vitamin K Injection
The Vitamin K injection is the most controversial of the group. We will get into facts, risks and benefits of the other two medications another time, but now it’s just vitamin K.
It’s just a vitamin? People have been birthing and nourishing babies from their bodies for centuries, why do we give newborns more vitamins?
Postpartum & newborn nurses here to break it down for you:
What is vitamin K?
“Vitamin K is a vitamin we need to clot blood. We do not make Vitamin K ourselves, and we get most of our Vitamin K from plants. Babies are born with very small amounts of Vitamin K. It is named after the German word for clotting—Koagulation.” Source: Evidence Based Birth
There are 2 types of vitamin K:
Vitamin K1- sourced from plants
Vitamin K2- sourced from in the gut bacteria
Why is vitamin K given?
Vitamin K is given to prevent a rare but possibly deadly brain bleed in the first 6 months of life. The benefit is protection against bleeding in the brain and stomach Babies are born with very limited amounts of Vitamin K. Their levels are lowest at days 2-3 and do not reach adult levels until about 6 months of age.
How is vitamin K given?
Injection is the most common and hold one regulated by FDA at this time.
Vitamin K injection is given in the upper thigh muscle in a one-time, slow-release dose.
AAP (American Academy of Pediatrics) recommends to be given within 6 hours of birth (up to 72 hours has still been shown to have similar efficacy)
Indicated in any type of birth, to all newborns 3.5 pounds or greater
Can be given in hospital, at pediatrician's office or at home (by a provider)
Photo credit Lamaze.org
Is vitamin K a vaccine?
No, vitamin K injection does not trigger an immune response. It is not a vaccine
When vitamin K is given:
PROs:
Prevention of potentially fatal vitamin K deficiency bleeding
CONs:
Pain at injection site
Bruising
Swelling
Ingredients can obtain preservatives
When vitamin K is not given:
PROs:
No pain, swelling or bruising at injection site
Oral alternatives available
CONs:
Spontaneous of bleeding can happen at 3 stages of life
1. After birth,
2. In the first week of life
3. From week two until 6 months (late bleeds are most serious and life threatening)
Are there vitamin K alternatives?
Yes and no
Here are two alternatives some parents choose
1. Oral dose given in three parts may be available if supplied yourself, but none are regulated by FDA currently
2. Exclusively breastfeeding mother take vitamin K supplement herself after birth. (is shown to increase vitamin K levels in the breastmilk and may improve vitamin K levels in breastfeeding infants, but not enough evidence to show maternal supplements are a safe alternative for newborn supplements.
- There is a preservative free version of the vitamin K injection as well. Evidence Based Birth lists the ingredients, here they are for you too:
1 mg of Vitamin K1, a fat-soluble vitamin derived from plants
10 mg of Polysorbate 80, which helps Vitamin K1 (a fat-soluble Vitamin) dissolve in liquid for the injection. Polysorbate 80 is made from natural sorbitol and plant-based oleic acid, is used in a wide variety of foods, medicines, and vitamin supplements, and is included in the Handbook of Green Chemicals.
10.4 mg of Propylene glycol, which helps absorb extra water and maintain moisture in certain medicines. Propylene glycol has been recognized as safe by the FDA for use in food products.
0.17 mg of Sodium acetate anhydrous, a mixture of salt and bicarbonate, that is used to adjust the pH of the injection
0.00002 mL of Glacial acetic acid, also known as vinegar, that is used to adjust the pH of the injection
Other considerations:
Some pediatricians will require your baby received vitamin K injection in order to be under their care
Delayed cord clamping does not increase vitamin K in baby from mom like it does with iron. Vitamin K is store in the liver primarily, not the bloodstream.
Vitamin K deficiency bleeding later is virtually not reported in babies who are formula feeding. Formula has nearly 100 times more vitamin K1 than breastmilk.
Pregnancy and birth are perfect and all sustaining. But with more research and then data, we learn more. The administration of vitamin K started in 1961 when the AAP started recommending its administration
If there is underlying liver or gallbladder disorders, the vitamin K injection may not prevent vitamin K deficiency bleeding.
When it comes down to it, we now know more than we did in years past, and we know how to prevent rare but serious brain bleeding.
Like so much in newborns, there are rare but serious issues we don’t have prevention for. But for this one we do.
We mean it when we say, we want what you want. It is a lot to consider. Neither decision may feel right. We’re here for you for 1:1 virtual RN calls. Or catch us for out baby care basics class, and stay for the postpartum prep course.
If you want more information on this topic, Evidence Based Birth has an incredible amount of information for you.
** we are RNs and the ones administering this medications when ordered and consented by the parents, but not the ones prescribing or filling the medication. Please seek the counsel of your pediatrician or a pharmacist for specifics on this medication.
