HCA Midwest Health - July 15, 2015
by Michaela Galimba, Certified Nurse Midwife, The Women’s Healthcare Group

In the swirl of controversy and debate surrounding vaccines, there is one shot of critical importance to newborns that has recently come under scrutiny by misinformed parents: the vitamin K shot. Vitamin K is an essential fat-soluble vitamin needed for blood clotting. We don’t produce vitamin K ourselves, and don’t store it very well in our body. Our Vitamin K1 (also known as phylloquinone) supply comes from leafy green vegetables (spinach, kale, swiss chard); we can also get Vitamin K2 (menaquinone) from bacteria living in our intestinal tracts.

A baby is born with limited amounts of vitamin K; levels are lowest at days two - three and typically don’t reach adult levels until about six months of age. The levels are low because very little vitamin K1 transfers from the mother to the baby through the placenta. In addition, babies don’t enough have bacteria in their intestines to make Vitamin K2.

Vitamin K has routinely been a one-time dose administered to newborns to aid in blood coagulation. In the first few hours of life, babies receive an injection of vitamin K, which helps blood clot and bones form.

Although the Vitamin K shot is safe, has been the standard of care since the 1960s and is recommended by the American Academy of Pediatrics, some parents decline the shot due to rumors, myths, perceptions and non-evidence-based information about its safety. This misinformation puts babies at risk for dangerous bleeding, which can lead to brain damage and even death. Newborns not receiving the shot can develop vitamin K deficiency bleeding (VKBD), presenting vague symptoms for this condition and providers aren’t always aware they didn’t get the shot in the first place.

According to the CDC/National Center on Birth Defects and Developmental Disabilities-Division of Blood Orders:

VKDB can be classified according to the time of presentation after birth into early (0–24 hours), classical (1–7 days) and late (2–12 weeks) VKDB. Early VKDB is severe, and is mainly found in infants whose mothers used certain medications during pregnancy that interfere with vitamin K metabolism, such as certain anticonvulsants or isoniazid. Classical VKDB is typically characterized by bruising or bleeding from the umbilicus. Late VKDB is the most concerning type— this bleeding occurs up to 6 months of age in previously healthy infants, and between 30–60% of late VKDB presents as an intracranial bleed. This life-threatening complication tends to occur in exclusively breastfed infants who have received no or inadequate vitamin K prophylaxis; warning bleeds before an initial severe event are rare.

It’s important to know this fact: Vitamin K is not a vaccine. As a healthcare provider, I offer prenatal education to my patients on how vital this simple injection is to their child’s health and well-being. According to the CDC, infants who do not get the vitamin K shot at birth are at 81 times greater risk for developing VKDB than infants who do get the shot. VKDB is effectively prevented by the vitamin K shot—incidence of late VKDB, the most concerning type, falls to less than 1/100,000 infants when vitamin K is given at birth.

Here are some common myths and facts you should know about the vitamin K shot if you’re pregnant and want the best for your baby.

Myth

The vitamin K shot increases risk for leukemia.

Fact

Following 24 years of studying the possibility of a link between vitamin K and childhood cancer, researchers came to the conclusion in 2009 that there is no evidence supporting a relationship between vitamin K and leukemia or other childhood cancers.

Myth

The vitamin K shot exposes infants to toxins because of its ingredients.

Fact

Although the ingredients in the vitamin K shot are safe, one way to alleviate this concern is to ask your healthcare provider if they have the preservative-free version of Vitamin K.

Myth

Breastfeeding will give my baby adequate vitamin K.

Fact

Breast milk has very tiny amounts of vitamin K.

For more information, visit https://www.cdc.gov/ncbddd/vitamink/facts.html.

-Michaela L. Galimba, Certified Nurse Midwife, The Women’s Healthcare Group/Overland Park Regional Medical Center