Good information about vitamin K is key for every parent.
In most countries, one of the first decisions that parents need to make for their baby is whether or not they want their baby to have vitamin K. If they do, it’s usually given within the first hour of birth.
It’s your decision whether or not your baby has vitamin K. It’s also up to you to decide which kind of vitamin K (oral or injection) you want your baby to have. So you’ll want to weigh up the pros and cons, as with every decision you’ll make for your child.
I have been researching vitamin K for more than twenty years, and I have written several books and information leaflets on this subject. Here’s the most recent. I have written this summary of information about vitamin K that you might want to consider when making your decision. It’s based on the information in my book, and you might also want to visit my vitamin K information hub, which brings together all of my information about vitamin K.
1. Vitamin K is offered in order to prevent a rare but serious blood clotting problem.
Vitamin K is needed in the human body for several key processes. One of the most important is that it helps blood to clot. This is why it is offered to newborn babies. Without it, a small number of babies will develop a rare but serious blood clotting problem. We used to call this problem haemorrhagic disease of the newborn (HDN). It is now more commonly known as vitamin K deficiency bleeding (VKDB).
2. The likelihood of the problem is low, but it can be serious.
Exact figures vary, but the chance of a baby experiencing VKDB if they don’t have vitamin K is about 1 in 11,000. Most babies who have VKDB will recover, especially if they receive treatment quickly. This is why it is important to be vigilant if you decide to decline vitamin K. A small number of the babies who experience VKDB will experience long-term damage and, sometimes, a baby will die. The actual chance of death from VKDB is very low, but if we give vitamin K to all babies, it’s even less likely.
3. Vitamin K can be given by mouth or by injection.
Vitamin K can be given by injection, or your baby can have oral drops. The drops may be given in several doses over the first few weeks of your baby’s life. Oral drops are not as effective as the injection, but some parents prefer to give vitamin K that way. The timing and amount of vitamin K that is given orally can vary between areas of the world. Vitamin K is also added to formula milk.
4. Vitamin K is very effective, especially when given by injection.
We do not have a randomised controlled trial into vitamin K. However, other studies, audits and long experience suggest that vitamin K is very effective at preventing VKDB when given by injection. Oral vitamin K is less effective than vitamin K given by injection. But oral vitamin K is more effective than no vitamin K. We don’t have good data on exactly how effective oral vitamin K is.
5. Vitamin K is very safe, but there are a few downsides.
Compared to some drugs, vitamin K is considered very safe. The injection of vitamin K will occasionally result in infection (at the injection site), bruising or bleeding (as with any injection). It can cause pain to the baby when it is being given. There have been cases of the wrong drug being injected, but these are rare. Some people are concerned about other possible downsides to vitamin K, because it hasn’t been well researched. We have given vitamin K to millions of babies for many years because we know that it prevents almost all cases of VKDB. But we don’t know why babies have a relatively low level of vitamin K (compared to adults). It may be that this is beneficial to them in some way. No research has been done into this, and not enough research has been carried out into possible side effects. The fact that so much is unknown makes the decision difficult for some parents.
6. There are alternatives; it’s not always ‘all or nothing’.
As with many birth and parenting decisions, it’s not always an ‘all or nothing’ decision. For instance:
You may decide to have oral vitamin K rather than the injection. In this situation, be aware that Vitamin K is fat soluble. So in order to be properly absorbed by the baby’s body, it should be given with or just after a feed. Also be aware that it tastes bitter. Many babies will try to spit it out again and you might want to have your finger ready to scoot it back in!
You may decide to wait and see and make a decision according to your situation. There are a few key vitamin K information issues to consider. If your baby is breastfed and is slow to feed or has feeding problems, the chance of VKDB is higher and you may want to reconsider. If you or your baby have antibiotics, this can increase the chance of VKDB. Again, you may want to take that into account. Likewise if your baby has a procedure such as a tongue tie division or circumcision.
It is good to look into all aspects of this decision to make sure that you are fully informed.
7. It’s up to you
As I said at the beginning of this blog post, this is your decision. You have the right to have good information and make the decision that is right for you and your baby. I hear from midwives and others in some areas of the world (notably the USA) that parents are sometimes told that it is illegal to decline vitamin K. This may not be true, so please check what your rights are. It is also the case that, unfortunately, some parents are put under pressure to accept vitamin K. In some situations, senior professionals are brought in to try to persuade parents to accept it.
If you are thinking of declining vitamin K, I really would recommend that you look further into this area. Here’s a link to my book if you’d like to get more depth. We have an entire information hub on this topic, with links to several more articles and blog posts. And if you are thinking of declining vitamin K, please take a look at this information in particular.
If you’re a midwife or other birth worker and you’d like to learn more about vitamin K and discuss how to best share information with parents-to-be with colleagues from around the world, we are offering Sara’s Vitamin K and the Newborn online course from June 12-19. Just so you know: this will be the only run of this course in 2020.
Or see details of our other online courses!