Vitamin K deficiency in newborns is rare, and concerns about the risks of the vitamin K shot given to babies at birth lead an increasing number of parents to decline it. Doing so could put babies at risk of late-onset Vitamin K Deficiency Bleeding that has a high fatality rate, the Centers for Disease Control and Prevention warn.
Why Vitamin K?
There is increasing evidence to suggest that vitamin K — which is actually a group of fat-soluble vitamins — plays an important role in bone health. The reason it is given to newborn babies is that it is also essential for the clotting of the blood. In rare instances, babies are born with a vitamin K deficiency that causes blood-clotting issues.
Vitamin K Deficiency Bleeding (VKDB) causes spontaneous bruising or bleeding under the newborn's skin and can also lead to nosebleeds, bleeding from the rectum, or bleeding from the baby's umbilical cord stump.
Late-onset VKDB is extremely rare. Even when you include the cases that do happen closer to birth, VKDB only happens to one in every 10,000 newborns. Yet, VKDB is really not something you want your baby to end up with; half of late-onset cases lead to brain hemorrhage, and a fifth are fatal.
Thankfully, there is an easy way to prevent Vitamin Deficiency Bleeding — a shot given to newborns soon after birth. There are also oral options for both breastfed and formula-fed babies, but they need to be taken in several doses at predetermined intervals.
That is why most hospitals and homebirth midwives prefer to use the vitamin K injection, which effectively covers a baby's vitamin K needs in one dose.
The low risk of VKDB combined with perceived side effects that might come with the shot (and, I think, the fact that many parents don't like to see their babies in pain for something they think is not going to be necessary) means that some parents decline the vitamin K shot for their babies.
CDC Warns That Declining The Vitamin K Shot Puts Your Baby At Risk
"Not giving vitamin K at birth is an emerging trend that can have devastating outcomes for infants and their families," the director of the Centers for Disease Control and Prevention Dr Tom Frieden recently warned. His statement wasn't preemptive.
Vitamin K Deficiency Bleeding is a relatively rare event, but four infants were diagnosed with the late-onset variety between February and September 2013.
All four babies survived, and we'll talk about how they're doing now in a while. First, we should note that the parents of these four had declined the vitamin K shot. Why? The CDC reports that reasons to decline the shot included "concern about an increased risk for leukemia when vitamin K is administered, an impression that the injection was unnecessary, and a desire to minimize the newborn's exposure to 'toxins'."
A report goes on to explain that the fear of an "increased risk for leukemia in those receiving the vitamin K injection was initially generated by a 1992 report associating vitamin K injection and childhood cancer", but that "the finding of an association with either leukemia specifically or general childhood cancer has not been replicated in other studies." Concerns persist despite evidence to the contrary, in other words.
One baby recovered completely, while two are being monitored by neurologists and one has an apparent gross motor deficit. The CDC points out that the parents were not aware of the possibility of late-onset VKDB in most cases, and that they had either no or incomplete information about the risks of vitamin K deficiency when they declined the shot for their babies.
The four recent cases of late-onset VKBD led researchers to begin studying additional risk factors that could place babies who didn't receive the vitamin K shot at birth in danger. In the meantime, Dr Frieden says that "ensuring that every newborn receives a vitamin K injection at birth is critical to protect infants."