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So Why Does My Baby Need that Vitamin K Stuff Anyways?

4/25/2017

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If your baby is born in the hospital, they are usually offered three things: Erythromycin ointment in their eyes to prevent infection, their first Hepatitis B vaccination, and Vitamin K.  So what is Vitamin K?  Vitamin K is a fat-soluble vitamin that serves as a building block to help blood clot.  Our bodies cannot make Vitamin K and it is something we get from leafy green vegetables and the bacteria that live in our intestinal tracts.  Without Vitamin K, blood coagulation can be affected and this can cause us to bleed spontaneously.  Babies are born with low stores of vitamin K (because it does not cross the placenta well) and there is not much available in breast milk (because our own bodies don’t store it well).  In 1961, the American Academy of Pediatrics recommended that newborns receive a Vitamin K shot to prevent babies from bleeding spontaneously into their skin, head and abdomen.  Babies who received Vitamin K had a 5-fold reduction in the risk of bleeding to death in the first week of life!  It was estimated that for every 100,000 infants, Vitamin K would save the lives of 160 infants.  Also remember that babies that did survive after a head bleed, 40% of those infants had long term brain damage.

Parents have many concerns about the Vitamin K shot.  These are probably the most common ones that I hear:

1.  "Can the Vitamin K shot cause leukemia?"  No. Researchers have studied this for 20+ years and found no link between Vitamin K and childhood cancer. 

2.  "I am worried about the pain an intramuscular injection will cause my infant.  Why can’t you give my baby the oral version of Vitamin K?"  In the US, the preferred method of giving vitamin K is a shot for several reasons: First, it is absorbed more easily than the oral version.  Second, when the shot (IM) version is given, the chance of developing late Vitamin K deficiency bleeding is nearly zero.  Third, the oral version has to be given in a three-dose regimen (at birth, 1 week, and 6 weeks). While it lowers the chance of bleeding, it does not eliminate it.


3.  "I am worried about the toxins in the shot."  Just ask for the preservative free version of Vitamin K.  Any allergic reactions to the Vitamin K shot have occurred with the intravenous version which is rarely given in the newborn period except when the baby is already bleeding heavily.


4.  "Why will my pediatrician not perform the circumcision until my baby receives Vitamin K?"  First, most babies are circumcised within the first week of life and this is when their Vitamin K levels are the lowest. Second, circumcision sites are also a common site of bleeding for infants with Vitamin K deficiency bleeding. I have yet to meet a pediatrician that will perform a circumcision without a Vitamin K shot.


5.  "If I increase my intake of leafy green vegetables, will this increase vitamin K in my breast milk?  What if I take Vitamin K supplements?" The number one risk factor for Vitamin K deficiency bleeding in newborns is breastfeeding.  Increasing your intake of Vitamin K will not provide enough Vitamin K to your baby via breastfeeding to prevent Vitamin K Deficiency Bleeding. 


So, unless your baby is born with a full set of teeth to chomp some spinach (and if so, so sorry for mom!), then he or she would definitely benefit from Vitamin K supplementation.  Regardless of your decision, be sure to discuss Vitamin K administration with your pediatrician so they can be aware of your preference.

Dr. Pam ​
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