Is the Vitamin K Shot Right for Your Newborn?

When your newborn is welcomed into the world, he or she may be subjected to a variety of medical interventions. One of these is the vitamin K shot, which is designed to prevent newborn hemorrhage. As with any medical procedure, there are risks associated with the vitamin K shot, and it may not be the best choice for every baby. However, in the United States, the vitamin K shot is routinely administered to most babies unless the parents refuse to consent.

Why is the vitamin K shot routinely administered at birth?

Vitamin K is necessary to promote normal clotting function in all adults and children. In some newborns, a vitamin K deficiency can lead to Hemorrhagic Disease of the Newborn (HDN), in which internal bleeding occurs, often in the brain or other organs. This hemorrhage can cause serious injury or even death. While these cases are rare (statistics vary depending on the source, but there is about a 0.25% to1.7% incidence according to http://pediatrics.aappublications.org/cgi/content/abstract/91/5/1001), vitamin K supplementation has been shown to slow or stop bleeding and help prevent death and injury in at-risk newborns. As a result, many health care providers choose to administer the vitamin K shot to every newborn as a preventative measure, whether or not risk factors are present.

What risk factors contribute to HDN and dictate the use of the vitamin K shot?

There are a number of risk factors that can increase your newborn's risk of developing HDN. These risk factors include:

- preterm delivery

- low birth weight

- premature clamping/cutting of the umbilical cord

- the use of forceps or a vacuum extractor during delivery

- mother's use of antibiotics, anticoagulants, anticonvulsants, and some other medications during pregnancy

- undetected liver disease in the newborn

- extremely fast or extremely prolonged labor, especially during the "pushing" phase

- delivery by c-section

If your infant displays any of these risk factors, the vitamin K shot may be well-advised to prevent HDN. However, most infants who have none of these risk factors can be perfectly healthy without the shot, and many can receive vitamin K from other sources with fewer risks than the shot. Refusing the shot for an infant who has none of the risk factors for developing HDN may be a wise choice for parents who want to avoid some of the risks associated with the vitamin K shot.

Risks associated with the Vitamin K shot

As with any medical procedure, the vitamin K shot does carry risks. Infants who receive the vitamin K shot have an increased risk of developing newborn jaundice. Many babies who receive the shot develop severe jaundice and require light therapy and other treatment to protect their health. Some studies also suggest a possible link between the vitamin K shot and an increased incidence of developing leukemia and other childhood cancers. While some studies refute these findings, the risk of developing childhood leukemia may be increased by up to 80% with the administration of the vitamin K shot (http://www.babyreference.com/VitaminKinjectORnot.htm). Introducing levels of vitamin K in excess of normal newborn levels may also interfere with proper cell division and growth (http://www.babyreference.com/VitaminKinjectORnot.htm). The shot is also painful for the baby, and for many parents, this is enough to refuse the vitamin k shot.

How can you ensure that your newborn gets enough vitamin K without administering the vitamin K shot?

One of the best ways to ensure that your newborn has enough vitamin K is to breastfeed from birth. Colostrum, the special "newborn milk" that the mother's body produces during pregnancy and in the days following delivery, is especially rich in nutrients that a newborn needs, including vitamin K. Even if your child exhibits risk factors for HDN which may dictate the necessity of the vitamin K shot, such as preterm delivery, breastfeeding will only boost those anti-hemorrhagic benefits, as well as providing many other nutrients essential for newborn survival. Remember to take your prenatal vitamins during pregnancy and while nursing to replenish your own stores of vitamin K and other essential vitamins and minerals. Avoid taking antibiotics and other medications during pregnancy and labor unless absolutely necessary (antibiotics should never be overused, but this is especially important during pregnancy). Do not use alcohol or other drugs during pregnancy in order to decrease your child's risk of developing liver disease. Avoid c-section and insist on a vaginal birth if at all possible. If your child is at risk for HDN, it may be possible to treat him or her with the oral version of the shot, which carries fewer risks. Talk to your doctor about this possibility.

Is the vitamin K shot right for your newborn?

Only you and your doctor can determine if the vitamin K shot is necessary for your baby. It is not a decision that should be made without carefully weighing the risks and benefits to your child. Talk to your doctor and examine your child's unique risk factors before determining if the vitamin K shot may be necessary.

RESOURCES:

http://www.gentlebirth.org/archives/vitktop.html

http://www.babyreference.com/VitaminKinjectORnot.htm

http://www.birthingnaturally.net/barp/vitk.html

http://pediatrics.aappublications.org/cgi/content/abstract/91/5/1001

http://www.cps.ca/english/statements/FN/fn97-01.htm

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