Vitamin K Shot – Essential in Preventing Serious Bleeding in Newborns

What’s the Problem?

Vitamin K deficiency bleeding, or VKDB, occurs when babies cannot stop bleeding because their blood does not have enough Vitamin K to form a clot, which would prevent bleeding out and major blood loss. Babies are born with very low stores of vitamin K and without the Vitamin K shot, which is traditionally given in the form of a shot to a baby a few hours after birth, they do not have enough Vitamin K in their blood to form a clot.

Aside from the Vitamin K shot, there is no other way for a baby to get Vitamin K. Babies cannot get Vitamin K from breastmilk, and it’s only at 4-6 months, once they begin eating regular foods which contain Vitamin K, that the baby will have enough Vitamin K in their body.

A baby who does not get the Vitamin K shot is at risk of spontaneously bleeding into his or her intestines or brain, which can lead to brain damage and even death.

Who’s at Risk?

All infants, regardless of sex, race, or ethnic background, are at risk for VKDB until they start eating regular foods which provide Vitamin K, usually at age 4-6 months. Late VKDB, the most severe kind, occurs in 1 in 1,000 to 1 in 25,000 infants ^(1–3).

Can VKDB Be Prevented?

The good news is that VKDB is easily prevented by giving babies a vitamin K shot into a muscle in the thigh. Babies are typically given this shot of vitamin K in the first few hours after birth. This has been recommended by the American Academy of Pediatrics since 1961. Recently, some parents have begun to say “no” to the shot because they have been led to believe that the shot is dangerous and that VKDB is not that severe or is unlikely to happen. A number of social media websites and some holistic providers –– promote viewpoints suggesting that only babies who have birth trauma or circumcision are at risk for bleeding, or say that cases of vitamin K deficiency bleeding are otherwise rare and not really a problem. They lead parents to believe wrongly that there is a greater risk from the “toxic” effects of the shot than there is from bleeding. What the evidence shows us is that: (a) the vitamin K shot is safe – it has not been linked with cancer or other disease and it has levels of preservatives far below the levels that cause harm – and (b) the vitamin K shot prevents VKDB – an infant who doesn’t get the shot is 81 times more likely to develop VKDB than an infant who does get the shot. Further complicating this issue is the variability state-to-state pertaining to neonatal vitamin K prophylaxis. Prophylaxis refers to the prevention or protection of a disease or health condition. In this case, the Vitamin K shot prevents babies from having uncontrolled bleeding because they are unable to clot their blood to stop the bleeding. While AAP has had recommendations on vitamin K for over 60 years, state laws governing neonatal vitamin K prophylaxis are highly variable and inconsistent with the AAP guidance. Further, 20 states lack any relevant laws related to neonatal vitamin K prophylaxis and there was significant variability in the framework for administrating vitamin K amongst the 30 states that have existing statutes.

The Bottom Line

• VKDB can occur when a baby does not have enough Vitamin K. Bleeding into the intestines or brain can occur suddenly, without warning, and, can lead to brain damage or death. Newborns who do not receive the vitamin K shot can develop VKDB up to 6 months of age.
• VKDB is easily preventable with just a single vitamin K shot at birth.
• The Vitamin K shot is safe.

Case Example

Baby Brown is a healthy 7 week old infant boy, born at a local hospital. The parents received their prenatal care at a midwives’ clinic because they preferred to do everything naturally without the use of any drugs. For the birth of their baby they decided to go drug-free and forgo any anesthetics or medical drugs either for the mother or the baby.

The birth went well and baby Brown and his mother went home two days later. Baby Brown only drinks breast milk; he sleeps on his back and has been gaining weight as a healthy baby boy. Yesterday, his mother noticed that he was sleeping more than usual and wasn’t eating much. Then overnight baby Brown really stopped eating, he wasn’t waking for his normal feeds, and seemed to sleep through everything. His parents started to get really worried, and when they were not able to wake him, they brought him to the emergency room at 1 in the morning.

In the emergency room, everyone worried that baby Brown had a life-threatening infection. Doctors ordered blood, urine and spinal fluid tests and an emergency cat-scan of the brain. The brain scan showed a large collection of blood on the right side of his brain which was pushing the brain over and down and causing all the other symptoms.

The Browns were informed their baby needed emergency brain surgery to remove the blood from his brain. Doctors and nurses started asking questions about whether anyone else had been with the baby, and had anyone shaken him, or whether they had any bleeding disorders in their family? The family answered no to all of those questions. The bleeding studies were very abnormal – something was wrong with baby Brown’s ability to make clots. He would need a blood transfusion and a transfusion of clotting factors prior to the surgery for the surgery to not cause an even further loss of blood. Doctors asked whether he had received the Vitamin K shot when he was born?

After the surgery, he was transferred to the intensive care unit. Although the surgery was successful and baby Brown survived the life-threatening brain bleed, neurologists informed the Browns that it is now just a waiting game as to how fully baby Brown will recover. Although an infant’s brain is quite adaptable, baby Brown’s brain was damaged by the bleed…while he may recover, it will still take a lot of attention and rehab, and even then he may still have lifelong disabilities.