The Pros & Cons of the Vitamin K Shot for Infants

Cornelia Mazzan

Cornelia Mazzan

Program Director, Focus for Health | BIO

One day old newborn baby with his mother
At a Glance:
  • Vitamin K is a fat soluble vitamin absorbed from food.
  • The Vitamin K shot is an injection given to newborns within hours after birth.
  • Mothers pass a small amount of this to their babies via breastmilk.
  • The shot is meant to prevent the small risk of internal hemorrhage which can occur if the child has dangerously low levels of Vitamin K.
  • The shot contains a synthetic form of Vitamin K1 along with other ingredients, including aluminum.
  • Low Vitamin K in babies is considered by the medical community to be a deficiency, but it may have evolved to be a protective measure.
  • An oral Vitamin K supplement is an alternative to the Vitamin K shot.
  • Parents should be aware that they have a choice and can accept or refuse any of the newborn procedures offered at the hospital.
  • The Vitamin K shot is not currently mandated in all states.

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.

Food is source of potassium. Various natural food rich in vitamins and micronutrients.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.

Young mother breastfeeding her babyWhile 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?

Blackboard with the chemical formula of Vitamin KVitamin 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?

Brown Eye Dropper BottleThe 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?

Embryonic stem cellsLow 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.

For more information:

Cornelia Mazzan

Program Director, Focus for Health

Cornelia joined the Focus for Health team as Program Director in July of 2018. She specializes in the maternal and infant health field. In addition to her concentration on research, writing, and social media, she brings along her experience as co-founder of Fearless Parent where she helped to guide the organization, raise awareness about children’s health, and foster community. For the past 6 years, Cornelia has been a birth and postpartum doula working with families across New Jersey. She is eager to bring this expertise to FFH, helping to expand their maternal and infant-related content, as well as increasing the number of associated grantees. In addition to her work as a doula, Cornelia is a certified yoga instructor, and a Reiki practitioner. She is co-leader of NJ BirthNetwork, a former Holistic Moms Network chapter co-leader, and the past president of Real Mama, Inc. Cornelia has a degree in Fine & Studio Arts from Montclair State University and is a web and print Visual Designer with over 20 years of experience in the internet industry.

5 Comments

Shelley Tzorfas

I have read that the Vitamin K is from the German word Koagulent and that the reason that newborns started to bleed is from the Hepatitis B shot that they get at birth. Getting a Hepatitis B shot at birth is highly problematic. It is to prevent an illness that babies can get if they are having Sex or are drug abusers sharing IV needles-None of which are likely. If the mother has it-then she could accidentally spread it to the newborn but doctors test the moms for this and few are at risk. Vaccine companies can no longer be sued if your baby is injured or dies and so it became a financial bonanza to give this to newborns and so the Vitamin K shot was piggy-backed onto newborns. Together they provide up to 500 Mcg of Aluminum which is seen as a cause for Alzheimer’s Disease.

Reply
L

None of those things are true. Which peer-reviewed medical journal did you read that in?

Reply
Karin

Which peer reviewed journal literatures are you referring to in support of your accusation that Shelly is incorrect?. There are some problems with the Vitamin K shot, however I could find no problems with orally administered vitamin K in newborns. It seems to me that either something indirectly related that is not recognized as of yet may be causing the hemorrhaging in newborns, or one of the “inert” ingredients may be a problem with certain individuals with a predisposed genetic makeup. Either way, oral K in daily small doses for a prescribed length of time seems to be safer given the current data.
Serious hypersensitivity reactions, including anaphylactoid reactions and death have been reported with use of injectable phytonadione. The majority of these cases were associated with use of intravenous phytonadione.

Other side effects reported with use of injectable phytonadione include:

flushing,
injection site pain or discomfort,
taste disturbances,
dizziness,
rapid or weak pulse,
profuse sweating,
low blood pressure (hypotension),
shortness of breath, and
cyanosis.
Serious hypersensitivity reactions, including anaphylactoid reactions and death have been reported with use of injectable phytonadione. The majority of these cases were associated with use of intravenous phytonadione.

Other side effects reported with use of injectable phytonadione include:

flushing,
injection site pain or discomfort,
taste disturbances,
dizziness,
rapid or weak pulse,
profuse sweating,
low blood pressure (hypotension),
shortness of breath, and
cyanosis.
Serious hypersensitivity reactions, including anaphylactoid reactions and death have been reported with use of injectable phytonadione. The majority of these cases were associated with use of intravenous phytonadione.

“Other side effects reported with use of injectable phytonadione include:

flushing,
injection site pain or discomfort,
taste disturbances,
dizziness,
rapid or weak pulse,
profuse sweating,
low blood pressure (hypotension),
shortness of breath, and
cyanosis.”

https://www.medicinenet.com/vitamin_k-injection/article.htm#what_is_the_dosage_for_vitamin_k-injection

Reply
Megan

Bleeding in newborns primarily happens in countries where people follow high-protein, low plant food diets, and all the research shows that this bleeding does not occur in newborns who are formula fed. Every article I’ve read mentions the formula fact, but the authors fail to really grasp what that means, the obvious answer is that pregnant women in the western world are not eating enough plant foods and are therefore not taking in enough vitamin K to nourish their babies. Daily serving recommendations for vegetables in the united states are dismally low compared to healthier cultures and the diets of other primates, and we don’t adjust those recommendations for pregnant women, so the average pregnant women is likely not meeting her vitamin K needs even if she tries to follow a healthy diet. Where is the proof that mothers are incapable of providing their babies with enough vitamin K? The only thing we know is that babies in the western world are often deficient in vitamin K if they don’t receive the shot, there’s no evidence that I’m aware of that indicates that vitamin K is not properly absorbed during pregnancy or breastfeeding, this seems to be a big assumption on the part of the medical field because they lack nutritional education and fail to understand the importance of a woman’s diet during pregnancy. Frankly I just don’t see how a vitamin K deficiency would be advantageous to the survival of our species if it can produce such a dire outcome, these theories about why babies are deficient seem to be trying to over-complicate this issue while ignoring the more obvious truth: following the standard american diet instead of the plant-based diet that is more natural to humans can create birth and newborn complications, and women need better nutritional guidance during pregnancy to avoid bad outcomes. Sure you can just give your baby the injection and not worry about eating enough vegetables, but this is far bigger than simply vitamin K, the low-nutrient western diet also creates gestational diabetes, preeclampsia, preterm labor, stillbirth, babies that are too large to fit through the birth canal (which is designed for babies that are 5-8 lbs), c-sections that put the mother and baby’s life at risk, the list goes on and on. It’s frankly a travesty that women are not being provided the information they need to have healthy, enjoyable pregnancies and keep their babies safe. I had two amazing pregnancies and births on a plant-based diet, with no complications and minimal pain, yet I watch the women around me needlessly suffer and be forced to endure pregnancy and birth complications, agonizing labors, and some even lose their babies or end up with long term injuries from the birthing process. This day in age with the nutritional information we have, the medical industry can and should do better by these women.

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