Our bodies require a variety of vitamins, minerals, and other essential nutrients to function properly. In most cases, kids and adults get everything they need from a healthy diet and from the bacteria that live in our guts. While babies obtain most of the nutrients they need during gestation through the placenta, Vitamin K doesn’t pass through as easily. All babies, regardless of circumstance, are born with low levels of Vitamin K, putting them at risk of a potentially deadly bleeding disorder. Pediatricians recommend that all newborns receive a Vitamin K injection at birth as part of a standard set of preventative treatments.
What does Vitamin K do, and why is it needed?
Vitamin K’s most important role, especially in early life, is to help blood clot and stop bleeding. It was first identified and described in the early 20th century, earning scientists Henrik Carl Peter Dam and Edward Adelbert Doisy the 1943 Nobel Prize in Physiology or Medicine.
In the 1960s, the American Academy of Pediatrics (AAP) published a paper on the use of Vitamin K in children, particularly as a treatment for Hemorrhagic Disease of the Newborn (HDN). Once the disease and its treatment were understood, it acquired a new name and became known as Vitamin K Deficiency Bleeding (VKDB). Since the AAP began recommending Vitamin K injection at birth, incidents of VKDB have dropped dramatically.
Why aren’t babies born with enough Vitamin K?
Every single baby is born with a Vitamin K deficiency, though some are more or less deficient than others. Without a Vitamin K shot, newborns are at increased risk of VKDB throughout the first six months of life.
Newborns typically have low levels of Vitamin K at birth, even if the expectant parent was getting enough Vitamin K in their diet, because only small amounts make it across the placenta and to the baby. Vitamin K deficiency can be worsened if the parent is deficient themselves or is taking medications that impact Vitamin K metabolism. Additionally, newborns haven’t yet developed a robust gut microbiome, which will help produce Vitamin K for them later on. It takes approximately 6 months for babies to reach the point where they can sustain their own Vitamin K stores without external help.
Are Vitamin K shots safe?
Yes! Vitamin K shots have been used for more than 60 years as a standard treatment for preventing excessive bleeding in newborns. The dosage is based on the infant’s weight at birth and is typically administered as a single injection into the thigh muscle within the first six hours of life.
Since the introduction of Vitamin K injections, the number of VKDB cases has decreased significantly. However, instances of VKDB have risen in recent years, primarily due to an increase in the number of parents refusing Vitamin K injections at birth. Part of the problem may be that treatment has so effectively minimized the risk that many parents have never heard of Vitamin K deficiency, let alone that it’s worth being concerned about.
Vitamin K injections are made primarily of, you guessed it, Vitamin K, with a few other ingredients to help facilitate delivery. One ingredient keeps Vitamin K dissolved in liquid, another controls the pH to prevent it from becoming acidic, and another serves as a preservative. The benefits of Vitamin K injections are well documented, and undesired side effects are minimal. The most common side effects are redness, bruising, or swelling at the injection site.
The AAP has reaffirmed its stance on Vitamin K treatment in recent years, citing decades of successful prevention of VKDB.
What is Vitamin K Deficiency Bleeding, and what are the signs?
Without an injection of Vitamin K at birth, newborns are at increased risk of developing Vitamin K deficiency. Early-onset VKDB can occur as early as the first day of life, but it typically presents between the second and seventh days of life.
Signs of VKDB include, but are not limited to, bruising easily, pale skin, and blood in the stool. In some cases, newborns can develop unseen internal bleeding or excessive external bleeding following an injury. Dangerous internal bleeding can occur in the brain and organs, leading to severe symptoms, including brain damage and death.
VKDB is a serious and potentially life-threatening condition. One in every five babies with VKDB will die, according to the CDC. Worst of all, internal bleeding can occur without any outward sign, delaying treatment and leading to lifelong complications, even if your baby survives. A Vitamin K injection administered within the first few hours of life is an effective and low-risk method to prevent VKDB until your baby’s body can produce its own Vitamin K.
Can my newborn take oral Vitamin K instead of a shot?
Some parents ask about oral delivery of Vitamin K instead of a shot. We understand that nobody wants to cause their baby pain, even the minimal and brief discomfort of an injection. However, when we intervene to prevent serious medical complications, we want to treat with the most effective option possible, which is Vitamin K given intramuscularly. This single injection will keep your child’s Vitamin K stores stocked up for the first five months of life. Some of it goes directly into the bloodstream to protect your baby for those first few days. The rest is released slowly over the course of months, topping up the reserves so your baby’s levels never get too low.
The FDA has not approved oral Vitamin K treatments for children. Multiple studies have shown oral delivery to be less efficient. It also requires multiple doses over several months to achieve the same benefit as a single injection after birth.
Does breastfeeding give my baby Vitamin K?
Yes, but not as much as they need. While breastfeeding provides a high level of nutrition, it’s relatively low in Vitamin K. Even if a breastfeeding parent supplements their diet with Vitamin K, it doesn’t make a measurable difference in what gets into the breast milk.
Baby formula is typically enriched with additional Vitamin K, but even that isn’t enough to keep your baby’s Vitamin K levels afloat. Regardless of your baby’s diet, a Vitamin K injection is recommended for all newborns.
Can I get my baby boy circumcised without getting the Vitamin K shot?
If you elect for a newborn circumcision, an injection of Vitamin K is required to reduce the risk of bleeding. Before Vitamin K shots were available, male children had a dramatically increased risk of severe bleeding after circumcision, with approximately one in nine patients experiencing severe and persistent bleeding.
A single, small injection administered right at the starting line can prevent much more complicated treatments and potentially dangerous consequences of a common newborn clotting disorder. Vitamin K injections are a low-risk and highly effective preventative measure, practically eliminating the risk of Vitamin K deficiency in newborns.
You can rest easy knowing it’s one of the best things you can do to give your newborn their best start in life. As always, if you have any questions or concerns, your care team at Wee Care Pediatrics is here to guide you and your family through those exciting early hours, weeks, and months.
