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In the United States, within a few hours after a baby’s birth, a pediatric nurse or the hospital pediatrician will do a newborn screening exam. This full-body exam includes the administration of the Vitamin K shot. Universally given on the day of birth, this injection protects against the small chance a child has such low vitamin K levels that their blood can’t clot, causing them to develop serious internal bleeding.
Although the Vitamin K shot is quite common, it is important for parents to be fully informed about the risks and benefits of this and all medical interventions so they can make fully informed choices for themselves and their children.
What is Vitamin K?
Vitamin K is a fat-soluble vitamin we normally absorb from the food we eat.
There are two different types of Vitamin K in our diet. 90% of our Vitamin K comes in the form of Vitamin K1 (phylloquinone) which is found in green, leafy, and cruciferous vegetables, as well as in several types of fruit and in soybean oil. The second type, called Vitamin K2 (menaquinone), is present in animal products and some fermented foods. Additionally, a small amount of Vitamin K2 is absorbed from good bacteria lining our intestinal tracts.
Why Do We Need Vitamin K?
Vitamin K1 aids in blood clotting, bone health, and regulating calcium levels. Studies have also shown it also improves cognitive health and helps keep our hearts pumping freely.
For reasons not yet fully understood, newborn babies have very low levels of Vitamin K at birth. Even though a mother may eat plenty of foods high in Vitamin K while pregnant, only a small amount passes through the placenta, and not much is stored in the baby’s body. The Vitamin K shot, containing synthetic Vitamin K1 or phytonadione, is administered as a preventative measure since newborn levels are low, and because their blood clotting factors have not yet been activated. Babies who do not receive the shot have up to 81 times the chance of developing bleeding issues than those who do get the shot.
While breastfeeding provides a host of other benefits, in this instance, breastfed babies are most at risk. Breastfeeding mothers pass a small amount of Vitamin K to their infants via their breastmilk, but it’s not enough to help prevent bleeding if their infants have this disorder. Colostrum has been found to only contain 2 mcg per liter, while mature breastmilk has even less at 1 mcg per liter. For this reason, it’s difficult for a breastfed infant to receive adequate Vitamin K without supplementation.
In contrast, formula fed infants are not at risk for low Vitamin K, although the same shot is still administered to all infants regardless of how they are being fed. Formula companies add approximately 55 mcg per liter to their product, affording a higher level of protection to non-breastfed babies.
What is VKDB?
Vitamin K Deficiency Bleeding or VKDB is the term used when an infant suddenly begins bleeding internally, usually in the brain or intestines, without the awareness of the parents or the infant’s doctor.
VKDB is not only seen in babies who have had difficult births or have been involved in an accident or a fall, as one might assume. The potential for this condition to occur starts at birth and extends up until the child is about 6 months old, when their Vitamin K levels rise higher as they begin eating solid food.
- Early VKDB occurs in the first 24 hours of life.
- Classical VKDB occurs between days 2-7. The incidence of Early and Classical VKDB are 1 in 60 to 1 in 250 infants.
- Late VKDB happens after the first week of life, most commonly during weeks 3-8, but has been seen up to 6 months of age. This is much more rare, occurring in 1 in 14,000 to 1 in 25,000 infants
Brain damage or other serious and possibly life-threatening health issues can occur by the time the bleeding is detected. Since there’s no way to know whether or not your child has this clotting disorder, the Vitamin K shot is highly recommended by most medical professionals.
First studied in 1894, the condition was originally termed “Haemorrhagic Disease of the Newborn” (HDN). Then, in 1961, after several decades of research, the American Academy of Pediatrics came out with their recommendation that all babies should receive the Vitamin K shot within 6 hours of birth. This has been the standard of care since that time. In 1999, the name HDN was updated to VKDB, reflecting the knowledge that it was caused solely by a Vitamin K deficiency.
What’s in the Shot?
Health-conscious parents wonder what ingredients are in the medicines prescribed by their pediatricians, including vaccines, just like they carefully read the labels of the food and drink products they bring home from the grocery store.
The main ingredient in the shot is 1 mg of synthetic Vitamin K. Although some critics wonder why such a high dose is given, doctors state that the excess is stored in the muscle tissue and liver, releasing over time. It can thereby provide longer term benefit and prevent late onset VKDB.
Besides Vitamin K, the shot also contains phenol, polysorbate 80, propylene glycol, glacial acetic acid (vinegar), benzyl alcohol, sodium acetate anhydrous, hydrochloric acid, GMO soy lecithin, castor oil, preservatives, and trace amounts of aluminum.
The FDA views these ingredients as “generally regarded as safe” (GRAS) in many other foods and medicines, including injections. As an alternative for at least one ingredient, parents can ask for a version of the shot without preservatives.
What About the Oral Vitamin K Supplement?
The Oral Vitamin K supplement is a liquid supplement containing natural Vitamin K that can be ordered online and given in the hospital after the birth. It is administered by placing drops in the appropriate dosage into the infant’s mouth. This supplement is not approved for use in the US as a replacement for the shot, but it is widely used in other countries with success. For example, daily small doses are administered after birth in the Netherlands with no rise in the instances of late onset VKDB.
Pediatricians in the US feel that since there is no way to know if the infant has absorbed enough of the vitamin through their digestive tract, it is more reliable to administer the shot instead. However, some parents opt for the oral protocol after weighing the risks and benefits of each option.
Is There an Increased Risk of Leukemia?
While researching the pros and cons of the Vitamin K shot, some parents have read online stories detailing the possible increased risk of leukemia or other childhood cancers in children who received the shot. However, multiple studies over the past 20 years have not substantiated this claim. For example, in one large comparative study done in 2003 in the UK, researchers did not find an increased risk of cancers in children who had received the shot.
Why Do Newborns Have Low Vitamin K?
Low Vitamin K in newborns does seem to be a health puzzle. Why would infants be born with such low levels if it puts them at serious risk of hemorrhage? Several theories have been written about in holistic health circles, proposing that low levels of Vitamin K in newborns may actually be evolutionarily protective. One concept centers around the idea of free flowing newborn stem cells, seen in abundant quantities in babies at birth, which can then migrate wherever they are needed in the infant’s thinner blood, bringing healing to those areas. Another theory argues that this “deficiency” protects the infant from damaging substances that may have gotten through the placenta.
What’s a Parent To Do?
As noted above, VKDB is a complication of dangerously low Vitamin K levels in infants and is a concern for parents. Given the potentially dire consequences of not supplementing at all, parents must do their research and either consent to the shot, or procure the oral drops for administration starting on the day of birth. Thankfully, we now know that this simple step can be taken to protect babies from serious harm, and give them the best start towards a healthy, happy life.
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