What's the Deal with Vitamin K Shots for Newborns?

On today’s episode, Drs. Sarah and Alicia get down to brass-tacks on one topic you may not know is a routine part of newborn care - the Vitamin K shot. What is Vitamin K and why do newborn babies need it? Drs. Sarah and Alicia address this and so much more in this quick yet informative episode, including dispelling common myths that you’ll want to know more about.

If you’d like to learn more about this and many other essential parts of routine pregnancy, postpartum and newborn care, be sure to check out our low-cost Pregnancy to Parenthood Online Prenatal Masterclass, taking you from anxious and overwhelmed to confident during your childbirth experience!

What is Vitamin K and what does it do in the body?

Vitamin K is a fat-soluble vitamin crucial for blood clotting that plays a vital role in our health. But our bodies don't naturally produce Vitamin K! We obtain it from two primary sources: Vitamin K1 from leafy green vegetables such as spinach, kale, broccoli, and avocado, and Vitamin K2 from bacteria residing in our intestinal tracts. Without sufficient Vitamin K, our blood's ability to clot diminishes, leading to potential bleeding issues.

How common is Vitamin K deficiency bleeding?

Vitamin K deficiency bleeding, or VKDB, can occur when infants lack an adequate amount of Vitamin K. This is particularly prevalent in exclusively breastfed babies, as breast milk doesn't provide enough Vitamin K compared to formula. VKDB can manifest as early, classical, and late. Early VKDB is commonly associated with medications taken during pregnancy, while classical VKDB occurs within the first week of life and is more common but usually mild.

Late VKDB happens after the first week of life, usually during weeks 3-8, but can occur anytime in the first 6 months. The bleeding usually happens in the brain, skin, and gastrointestinal tract. Bleeding in the brain is often the first sign of late VKDB. Late VKDB happens in exclusively breastfed infants who did not receive a Vitamin K shot. Some infants may also be at higher risk if they have undetected gallbladder disease, cystic fibrosis, chronic diarrhea, and antibiotic use. 

How dangerous is late VKDB?

When infants do not receive any Vitamin K at birth, statistics from Europe show that 4.4 to 7.2 infants out of 100,000 will develop late VKDB. Although late VKDB is rare, the consequences can be catastrophic. More than half of infants who develop late VKDB will have bleeding in the brain. The death rate for late VKDB is approximately 20%. Of the surviving infants, about 40% had long-term brain damage.

So what is the treatment for Vitamin K deficiency bleeding?

The primary treatment for VKDB is Vitamin K supplementation! There are a few ways to administer the Vitamin K, with a shot at birth being the most effective for several reasons. The next most effective route is giving your newborn at least three doses of Vitamin K from birth to 4 weeks of age. Oral treatment is dependent on multiple doses - including sleepy parents remember to administer them - and doesn’t offer the same level of protection as the shot, given in the muscle, which ensures a slow release of Vitamin K over the subsequent weeks, maintaining adequate levels.

Why is it more common in solely breastfed babies?

Infants naturally have very limited Vitamin K at birth, with levels reaching their lowest at 2-3 days of life. Breast milk also contains minimal Vitamin K, so solely breastfed babies run a higher risk of contracting VKDB, even though it is rare. Formula is fortified with Vitamin K and babies who are formula fed receive nearly 100 times more Vitamin K than babies who are breastfed.

If babies are born this way, aren’t low vitamin K levels natural?

While babies are born with low Vitamin K levels, the potential consequences of not addressing this deficiency can be catastrophic. Vitamin K treatment is a modern practice akin to many others that have decreased newborn and morbidity and mortality. Serious side-effects are minor and extremely rare. Any injection can lead to site irritation, redness and a bit of pain, which can be minimized by nursing the baby during and after the shot. There are also many myths about the effects of Vitamin K shots and other treatments circulating the internet, and we encourage you to verify the validity of the source, and talk to your care provider about your concerns.