Vitamin K and Newborn Babies
You may have been asked in the Antenatal Clinic to consent to some injections for your baby when it is born. Vitamin K is one of the injections.
Vitamin K in general plays an important part in making our blood clot. A very small number of newborn babies (between 5 and 20 in 100,000) would suffer from Vitamin K deficiency bleeding (VKDB) if no prevention was available. A baby with a deficiency of Vitamin K may spontaneously bruise or bleed. This can happen within the first 24 hours of birth or in “classic” cases within the first week of birth. They may have nose or mouth bleeds, or start to bleed from their umbilical stump or their bottom (Demott et al 2006). Some babies can have very severe bleeding – sometimes into the brain, causing significant brain damage. This bleeding is called Haemorrhagic Disease of the Newborn (HDN). Vitamin K whether given orally or via injection is given to help prevent this from happening.
Babies have very little Vitamin K in their bodies at birth. Vitamin K does not cross the placenta to the developing baby, and the gut does not have any bacteria to make Vitamin K before birth. After birth, there is little Vitamin K in breast milk and breastfed babies can be low in Vitamin K for several weeks until the normal gut bacteria starts making it. This is why we give a Vitamin K injection or oral drops at birth to increase the Vitamin K in the baby’s system, until its little body makes enough for itself.
For more than 20 years, all newborn babies have been given Vitamin K at birth, by injection. Although the program was in place to give the injections, most parents did not get any information about the injection and why it is given. In this day and age, informed consent is expected and information and education should be given to all parents before any medication is given to their newborns. Hopefully this blog will help give you some knowledge on the Vitamin K injection to help you make that informed consent. In the end the decision is yours, and you should not feel pressured in your decision, whatever your decision is.
There are two ways that your baby can be given Vitamin K: by mouth or by injection. The number of doses needed depends on the method used and whether your baby is breastfed or bottle-fed. It is recommended that your baby has either:
- A single injection of Vitamin K given shortly after birth.
- Vitamin K given by mouth. Your baby will need two or three doses:
Dose 1: at birth
Dose 2: usually three to five days later
Dose 3: in the fourth week, if your baby is fully breastfed. (If your baby is mostly fed with formula, she may not need the third dose).
If your baby is unwell when they are due for a dose of Vitamin K or she vomits within one hour of giving her the dose, see your doctor. She may need to have another dose or to have the Vitamin K by injection (NHMRC 2010 b).
Vitamin K, whether given by injection or by mouth, is equally effective at preventing VKDB, provided that the doses are given as they should be.
WHAT ARE THE ARGUMENTS AGAINST GIVING VITAMIN K?
In the early 1990’s there were fears that there may be a link between giving Vitamin K by injection and childhood leukaemia (a blood cancer). Naturally, there was concern that something which was designed to protect babies from one disease might be putting them at risk of another.
Since then, and as a result of research from around the world, experts have concluded that there is no link between Vitamin K and childhood leukaemia, whether the vitamin is given by injection or orally (Fear et al 2003).
The first thing to do is to talk to your midwife or doctor about Vitamin K. Ask them their opinion and ask if they have any leaflets that you can read. Talk to other parents to see what their feelings are.
Your choices are:
- not to give Vitamin K at all
- for your baby to have one injection of Vitamin K at birth
- for your baby to have three doses of Vitamin K by mouth, the third one several weeks after his birth, if he is exclusively breastfed.
Obviously no parent wants to see their baby cry from having a needle, but a great little tip is to have your Midwife give the Vitamin K injection whilst your baby is breastfeeding. Your breastmilk has natural pain killers in it for the baby, so if the needle is given whilst your baby is breastfeeding it will help minimize the pain that the needle may cause.
Whether or not you decide to give Vitamin K to your baby, and how, make sure that you report any unexplained bleeding to your Doctor or Midwife immediately.
(This article contains general information only and is not intended to replace advice from a qualified health professional. All information is written from the experience and knowledge of the person writing the post).
Demott K, Bick D, Norman R, Ritchie G, Turnbull N, Adams C, Barry C, Byrom S, Elliman D, Marchant S, Mccandlish R, Mellows H, Neale C, Parkar M, Tait P, Taylor C. 2006 Clinical Guidelines And Evidence Review For Post Natal Care: Routine Post Natal Care Of Recently Delivered Women And Their Babies. London: National Collaborating Centre For Primary Care and Royal College Of General Practitioners. www.nice.org.uk
Fear NT, Roman E, Ansell P, Simpson J, Day N, Eden OB. 2003. Vitamin K and childhood cancer: a report from the United Kingdom Childhood Cancer Study, British Journal of Cancer. 89(7):1228-31.
NHMRC. 2010b. Vitamin K for newborn babies, information for parents, National Health and Medical Research Council. www.nhmrc.gov.au