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Evidence for the Vitamin K Shot in Newborns – Exclusive Q&A with Rebecca Dekker on her New Research

 Evidence Based Birth , a popular blog written by occasional Science & Sensibility contributor Rebecca Dekker, PhD, RN, APRN, has just published a new article, “Evidence for the Vitamin K Shot in Newborns that examines Vitamin K deficiency bleeding (VKDB)- a rare but serious consequence of insufficient Vitamin K in a newborn or infant that can be prevented by administering an injection of Vitamin K at birth.  I had the opportunity to ask Rebecca some questions about her research into the evidence and some of her conclusions after writing her review. – Sharon Muza, Science & Sensibility Community Manager.

Note:  Evidence Based Birth website may be temporarily unavailable due to high volume loads on their server.  Please be patient with the site, I know the EBB team is working on it.

Sharon Muza: Why was the topic of Vitamin K an important one for you to cover and why now?

Rebecca Dekker: Well, I try to pick my articles based on what my audience wants me to cover. I heard over and over again that people were confused and concerned about Vitamin K. A lot of parents told me they weren’t sure if they should consent to the injection or not. There was just so much confusion, and even I didn’t understand what the Vitamin K shot was all about. I didn’t know what I was going to do at the birth of my own child last December. It seemed like there was a need for an evidence-based blog article to clear up all the confusion once and for all.

So as usual, I dove in head first into the research, with no up-front biases one way or the other. I just wanted to get to the bottom of this mess!

SM: Were you surprised by what the current research showed about the rates of VKDB, and the apparent significant protection offered by the Vitamin K shot?

RD: I knew that Vitamin K deficiency bleeding (VKDB) was rare, but I didn’t realize—until I started reading the research—how effective the shot is at basically eliminating this life-threatening problem.

I was surprised by how low the rates of VKDB are in European studies, and by how VKDB is more common in Asian populations. I was also surprised by the fact that we don’t track VKDB in the U.S. and we have no idea how many infants in the U.S. would develop VKDB if we stopped giving the shot.

The number of infants in Tennessee last year who developed VKDB is very concerning to me. They had 5 cases of life-threatening VKDB in Nashville during an 8 month period—7 if you count the infants who were found to have severe Vitamin K deficiencies but didn’t bleed. None of these infants received Vitamin K, mostly because their parents thought it was unnecessary and weren’t accurately informed about the risks of declining the shot.

So the Tennessee situation makes me worry that maybe there is something about our diets in America, or our genetics, that makes us at higher risk for VKDB if we decline the Vitamin K shot for our newborns. But we don’t know our underlying risk, because we don’t track these numbers on a nationwide scale.

SM: What was the most surprising finding to you in writing this article?

RD: That the research on Vitamin K for newborns goes back as far as the 1930’s and 1940’s… that we have literally eight or nine decades of research backing up the use of Vitamin K for newborns. I was under the impression that we were using the shot without any supporting evidence. That turned out not to be the case.

I even forked out the money to buy the landmark 1944 study in which a Swedish researcher gave Vitamin K to more than 13,000 newborns. He observed a drastic decrease in deaths from bleeding during the first week of life. I am usually able to read all of my articles through my various subscriptions, but this article was so old the only way I could read it was to buy it. It was pretty eye-opening. There was some really good research going on back then on Vitamin K. About 15 years later, the American Academy of Pediatrics finally recommended giving Vitamin K at birth. We know that it takes about 15 years for research to make its way into practice. It looks like the same was true back then.

But there is this misconception that “Vitamin K doesn’t have any evidence supporting its use,” and I found that belief is totally untrue. There is a lot of evidence out there. People have just forgotten about it or not realized it was there.

SM: What was the most interesting finding to you in writing this article?

RD: That the two main risk factors for late Vitamin K deficiency bleeding (the most dangerous kind of VKDB that usually involves brain bleeding) are exclusive breastfeeding and not giving the Vitamin K shot.

Parents who have been declining the shot are the ones who are probably exclusively breastfeeding. So their infants are at highest risk for VKDB.

SM: What do you think is the biggest misconception around the Vitamin K shot?

RD: How do I choose which one? There are so many misconceptions and myths. I’ve heard them all. The scary thing is, I’ve heard these misconceptions from doulas and childbirth educators—the very people that parents are often getting their information from. I’ve heard: “You don’t need Vitamin K if you aren’t going to circumcise.” “Getting the shot isn’t necessary.” “Getting the shot causes childhood cancer.” “Getting the shot is unnatural and it’s full of toxins that will harm your baby.” “You don’t need the shot as long as you have delayed cord clamping.” “You don’t need the shot if you had a gentle birth.”

Informed consent and refusal isn’t truly informed if you’re giving parents inaccurate information.

SM: What do you think are the sources of information that families are using to make the Vitamin K decision and where are they getting this information from? Do you think families trust the evidence around this?

RD: This is what I did—I googled “Vitamin K for newborns” and read some of the blog articles that pop up on the front page of results. It is truly alarming the things that parents are reading. “Vitamin K leads to a 1 in 500 chance of leukemia.” “Vitamin K is full of toxins.” Most of the articles on the front page of results are written by people who have no healthcare or research background and did not do any reference checking to see if what they were saying was accurate. It’s appalling to me that some bloggers are putting such bad information out there.

If parents don’t trust the evidence, it may be because they have read so many of these bad articles that it’s hard to overcome the bias against Vitamin K. All I can say is, given the number of bad articles on the internet about Vitamin K, I can totally understand the confusion people have.

I mean, even I was confused before I started diving into the research! I truly went into this experience with no pre-existing biases. I just wanted to figure out the truth. If even I—the founder of Evidence Based Birth—didn’t know all the facts about Vitamin K, then I think that’s a pretty good sign that most other people don’t know the facts, either!

To help remedy the amount of misinformation out there, I’d like for the new Evidence Based Birth article to make it towards the top of the Google results so that parents can read evidence-based information on Vitamin K and check out the references for themselves.

SM: In your article, you state “The official cause of classical VKDB is listed as “unknown,” but breastfeeding and poor feeding (<100 mL milk/day) are major risk factors.” – Why, if breastmilk offers little to no protection against VKBD, is “poor feeding” seen as a risk factor?  What should it matter?

RD: Poor feeding is a risk factor for classical VKDB, which happens in the first week of life. There are limited amounts of Vitamin K in breastmilk overall, but there is more Vitamin K in colostrum than in mature milk. So infants who don’t receive enough milk in those first few days may be at higher risk. This connection was first observed by Dr. Townsend in Boston in the 1890’s. He figured out that he could help some infants with early bleeding by getting them to a wet nurse. These infants weren’t getting enough milk from their biological mothers, for whatever reasons.

SM: Are families in the USA receiving proper informed consent around the issue of Vitamin K and the risks and benefits of the different options available to their children at birth (injection, oral,  or declination of both?)

RD: I’m not sure, but my gut reaction is that I don’t think parents are giving informed consent. In my case, when my first child received the shot, I wasn’t even told that she got it! They just did it in the nursery when they separated me from my daughter after birth. It would have been nice to receive some education on it and be given the chance to consent. Maybe if healthcare providers had been properly consenting parents all along, we wouldn’t have so much misinformation out there! By taking parents out of the equation and doing the shot in the nursery without their knowledge, that certainly doesn’t help educate the public!

I don’t think we are doing a very good job with the parents who decline the shot, either. If you read the part of my article where I wrote about the epidemic in Nashville, all of the parents refused the shot, but none of the parents gave informed refusal. All of them had been given inaccurate information about the shot, so they couldn’t make a truly informed decision. Can you imagine what it must be like for the people who gave them the inaccurate information? That would be so terrible to know that your misinformation may have led to the parents making the choice that they did. 

SM: What should the information look like during the consent process so that families can make informed decisions about having their newborns receive Vitamin K in injection or oral form.

RD: I think the CDC has a really great handout that can be used for informed consent. If parents want more detailed information and references, or if they have concerns that the CDC handout doesn’t answer, then the Evidence Based Birth blog article covers most of the research out there. 

Also, here is a link to a peer-reviewed manuscript that is free full-text, and although it is written at a higher level, it does a good job addressing the myths about the Vitamin K shot.

SM: Are you aware of any adverse effects from either the injection or the oral administration of Vitamin K, other than bruising, pain and bleeding at the injection site if an injection pathway is chosen?

RD: Not if given via the intramuscular method. Some bloggers out there look at the medication information sheet and immediately start pointing out some scary sounding side effects. It’s important to realize that those side effects refer to intravenous administration. Giving a medication intravenously (IV) is a whole different ballgame than giving an intramuscular shot (IM). In general, medications have the potential to be a lot more dangerous if they are given IV—because when medications are given IV they go straight to the heart and all throughout the circulation in potent quantities. For newborns, the Vitamin K is given IM, not IV, which is a much safer method of giving medications in general.

SM: In a childbirth education class, with limited time and a lot of material to cover, what message do you think educators should be sharing about the Vitamin K options.

RD: If I had to sum it up in a minute or less, I would share that babies are born with limited amounts of Vitamin K, and Vitamin K is necessary for clotting. Although bleeding from not having enough Vitamin K is rare, when it happens it can be deadly and strike without warning, and half of all cases involve bleeding in the baby’s brain.

Breastfed babies are at higher risk for Vitamin K bleeding because there are very low levels of Vitamin K in breastmilk. Giving a breastfed infant a Vitamin K shot virtually eliminates the chance of life-threatening Vitamin K deficiency bleeding. The only known adverse effects of the shot are pain, bleeding, and bruising at the site of the injection.

Right now there is no FDA-approved version of oral Vitamin K, although you can buy a non-regulated Vitamin K supplement online. A regimen of three doses of oral Vitamin K1 at birth, 1 week, and 1 month reduces the risk of bleeding. Although oral Vitamin K1 is better than nothing, it is not 100% effective. It is important for parents to administer all 3 doses in order for this regimen to help lower the risk of late Vitamin K deficiency bleeding.

If parents want to use the oral method, or decline the Vitamin K altogether, I would encourage them to do their research and talk with their healthcare provider so that they truly understand the risks of declining the injection. I would tell them to take caution when reading materials online because there is a lot of misinformation out there and you don’t want them making important healthcare decisions based on faulty information.

 SM: How should a childbirth educator (or other professional who works with birthing women) respond when asked  by parents “Why does breastmilk, the perfect food for babies, not offer the protection that babies need? It doesn’t make sense?”

RD: Breastmilk is the perfect food for babies! But for some reason—we don’t know why—Vitamin K doesn’t do a very good job of going from the mom to the baby through breastmilk. Our diets today are probably low in Vitamin K (green leafy vegetables), which doesn’t help matters, either.

It’s possible that maybe there is some reason we don’t know of that could explain why Vitamin K doesn’t cross the placenta or get into breastmilk very well. Maybe the same mechanism that keeps Vitamin K out of breastmilk is protecting our babies from some other environmental toxin. Who knows?

If it helps, look at it this way—don’t blame it on the breastmilk! Blame it on the Vitamin K! That pesky little molecule doesn’t do a good job of getting from one place to the other. So we have to give our infants a little boost at the beginning of life to help them out until they start eating Vitamin K on their own at around 6 months.

SM: If formula feeding is protective, because of the addition of Vitamin K in the formula, why wouldn’t oral dosing of Vitamin K be effective for the exclusively breastfed infant  – is it just a compliance issue?

RD: Part of the failure of oral Vitamin K is compliance—not all parents will give the full regimen of oral doses, no matter how well-intentioned they are. But research from Germany shows that half of the cases of late VKDB occur in infants who completed all 3 doses. It’s thought that maybe some infants don’t absorb the Vitamin K as well orally. Vitamin K is a fat-soluble vitamin, and it needs to be eaten with fatty foods or fatty acids in order for it to be absorbed. So maybe some of those infants had the Vitamin K on an empty stomach. Or maybe they spit it up!

SM: Do you expect a strong reaction from any particular segment of professionals or consumers about your findings?

RD: No more so than when I published the Group B Strep article!

I anticipate that some people may think that the shot is too painful for newborns, and they may theorize that this pain will cause life-long psychological distress. Unfortunately there really isn’t any evidence to back that claim up, and so I can’t really address this theory. But I have spoken with parents and nurses, and they say that having the baby breastfeed while the shot is administered can drastically reduce the pain of the shot.

I would encourage parents who are worried about pain to weigh these two things: the chance of your infant experiencing temporary pain with an injection, versus the possibility of a brain bleed if you don’t get the shot.

 SM: Any last thoughts that you  would like to share with Science & Sensibility readers on this topic?

RD: You can be a natural-minded parent… interested in natural birth and naturally healthy living, and still consent to your newborn having a shot with a Vitamin K to prevent bleeding. These things are not mutually exclusive. One hundred years ago, infants with Vitamin K deficiency bleeding would have died with no known cause. But today, we have the chance to prevent these deaths and brain injuries using a very simple remedy. The discovery of Vitamin K and its ability to prevent deadly bleeds is a pretty amazing gift. I am thankful to all of the researchers and scientists who used their talents and gifts and got us to this point, where we now have the power to prevent these tragedies 100% of the time.

I want to thank Rebecca Dekker for taking the time to answer my questions  I always look forward to Rebecca’s new articles, and appreciate the effort she puts into preparing them,  Have you had a chance to read Rebecca Dekker’s new post on the Evidence for Vitamin K Shots in Newborns?  Will you be changing what you say to your clients or patients based on what you read or based on this interview with Rebecca?  What are your thoughts on this information?  Are you surprised by anything you learned?  I am very interested in your thoughts – please share in our comments section. – SM

Babies, Childbirth Education, Evidence Based Medicine, informed Consent, New Research, Newborns, Research, Vaccinations , , , , , , , ,

  1. March 18th, 2014 at 10:07 | #1

    Great blog today, thank you. As a childbirth educator brings a lot of things to mind for me. 1) The amount of inaccurate information available to parents and attempting to overcome this. 2) How serious the ramifications can be passing on incorrect information to parents. 3) The importance of helping parents asses risk for themselves. 4) The sometimes contradictory feeling I get when explaining to parents that on one hand our bodies and babies know best (birth, breastfeeding, etc…) and on the other hand that some interventions can ben necessary and save lives. Lots to think about today!

  2. avatar
    Billee Wolff
    March 18th, 2014 at 11:01 | #2

    Thank you for this article, it really clears up so much misinformation I have read and believed.

  3. March 18th, 2014 at 11:36 | #3

    Thanks for this information. I refused vitamin K with my last two babies because I assumed that with gentle births there would be no need for it. Apparently I was wrong. But with my last baby, I developed blood clots post partum. Is vitamin K still a good idea for infants whose mothers have known clotting issues?

  4. March 18th, 2014 at 11:47 | #4

    Rebecca ~ Thank you for countering the myths surrounding the Vit. K shot. I appreciate your realistic perspective. I find that any dogmatic way of parenting (e.g. “natural”) doesn’t leave the parent room to be flexible… Though I suppose that’s the definition of dogmatic! I encourage my parents not to be dogmatic with regards to their pregnancies, childbirth or parenting. So, again, thank you. As always, I will share your article on my social media outlets.

  5. March 18th, 2014 at 11:47 | #5

    Thank you, Rebecca Dekker, once again! Whether we (speaking for birth professionals) already have an opinion or not, I think we should all know this information to be able to pass onto clients/students who are asking us what we think or know about the possible risks of getting or refusing the vitamin K shot following birth. This was a lot of work, I know it! Thank you again for clearing the myths surrounding this after-birth intervention and bringing light to fact that parents are so often bombarded with misinformation on the net, even perpetuated sometimes by doulas and childbirth educators. Well worth the $5 to purchase the pdf as a handout for clients and classes. And I love your 1 minute summary above! :)

  6. March 18th, 2014 at 12:40 | #6

    Hi Cara and Deena, thank you for your comments!! Cara… I totally concur. Definitely food for thought. I feel that way about my blog articles all the time, which is why I have such high standards for what I will publish, and why I send it to experts in the field for review. I really don’t want to put inaccurate information out there. And Deena– that is a really good point. I think flexibility is important. The most outspoken opponents of Vitamin K are often the most dogmatic and leave little room for flexibility.

  7. March 18th, 2014 at 13:04 | #7

    Thank you for all the research you did and for sharing this with all of us in the childbirth field. As a birth doula and childbirth educator who teaches evidence based practices, I can now share these finding to help couples make the best and safest decisions for their babies.

  8. avatar
    lex
    March 18th, 2014 at 13:59 | #8

    Hi,
    Glad to hear its not all negative towards things that help our babies live.
    I’ve just read it on facebook and someone has left a comment there saying about women having vit k in their diets etc…
    doesn’t matter for some women like me, i depend on medical stuff, i have epilepsy and take drugs which require me to have doses of vit k and obv best for baby too because of the effect the drugs have.
    People need educating, its half the problem these days people make ”trend” choices and not informed and educated choices.

  9. avatar
    Kathy Harvey
    March 18th, 2014 at 15:17 | #9

    Very interesting Rebecca and thank yo for your time and preparation. Very worthwhile investing a few dollars. How do you see a babies biological blueprint as fundamentally faulty when there must be reasons why nature provides relatively low levels of vit k in early days? Your page 10 no. 3 seems incomplete as there is discussion around these “low levels” at birth being why foetal intracranial haemorrhage is very rare? More research please?

  10. avatar
    Infinite Sovereign
    March 18th, 2014 at 15:40 | #10

    On Merck’s package insert for AquaMEPYTON it states that “typically” severe reactions occur after IV use, but it does not say that they happen exclusively as a result of IV adminstration. What is the risk of anaphylaxis from intramuscular injection as compared to the risk of death from VKPD? It should also be noted that Hospira’s version of the vit k shot contains aluminum, which concerns me greatly. It is hard to make a risk/benefit evaluation without knowing this information.

  11. avatar
    Sheila
    March 18th, 2014 at 18:15 | #11

    Vit. K is is synthesized by intestinal bacteria in a normal healthy adult. Infants are born with an essentially sterile GI tract and it takes weeks for them to establish enough intestinal bacteria to synthesize vitamin k. For this reason, adults in the US are typically NOT deficient in vitamin K unless he/she has taken antibiotics that have killed their normal intestinal bacteria or have a medical condition. Babies only need 1 shot of vit k at birth to tide them over for a couple weeks when their gut can begin to synthesize it on its own. ~RN and breastfeeding Mom of 4 babies that got vitamin k shots.

  12. March 18th, 2014 at 18:34 | #12

    Great Article and information, as usual. With regards to the question of “why doesn’t breastmilk have enough vitamin K” or maybe “what did people do before the invention of vitamin K supplementation”, vitamin K is produced by our gut bacteria and absorbed through the intestines, as well as being present in green leafy vegetables. When a baby is newly born, their guts are sterile and so it takes about 1 week for the baby to acquire the gut flora to start making vitamin K on its own. So I wonder (and this wasn’t mentioned in the article), cord clamping was practiced before 1930′s and so if the baby wasn’t receiving all of its blood (and clotting factors from mum)would this have contributed to the need for vitamin K in the first place (even now, early cord clamping is routine for many births). Also, our diets, medications and environmental exposure to all sorts of things can cause long-standing changes to our gut flora which have been known to alter health -imagine the impact on the newborn’s gut flora and health. Add to this, the antibiotics, medications and interventions used during labor and the high rates of C-sections directly affect the flora (or lack of flora) that a baby acquires at birth. Perhaps its a combination of all these things that now requires us to supplement the baby with vitamin K.

  13. March 18th, 2014 at 18:39 | #13

    Thank you for this great blog. Once again, Rebecca has done the hard work for ALL of us by sifting through the mountains of material and research out there, finally making sense of it all.
    It was really heartening to read her recommendations for CBE’s like myself. I am currently giving exactly the advice she recommended to my clients.
    What I did find very interesting though was a) the fact that oral Vitamin K is NOT as effective as the shot and b) that exclusively breastfed babies who do not have the shot are at the highest risk.
    Great information which I will now be sharing on a regular basis with all my clients!

  14. avatar
    Sara G
    March 18th, 2014 at 19:38 | #14

    Thank you so much for your time and energy on this topic! I’m about to complete my informed consent forms with our midwife and I’m so grateful to have this article to bolster my decision. What a talented lady you are!

  15. March 18th, 2014 at 21:33 | #15

    The writings and research of UK midwife Sara Wickham is my fav source of information to give to the women I journey with and this is from here latest blog and is a response that resonates with me when I read this post; “Wouldn’t it be great if we could take the next step and expand the discussion and our vocabulary further to indicate that many of those who are seen by some as declining intervention are actually actively seeking individualised care which might well include deciding to have those very same interventions, but on a deployed-when-needed rather than routine basis?”

  16. March 18th, 2014 at 21:44 | #16

    I feel Sara Wickham’s 2013 summary http://sarawickham.com/wp-content/uploads/2013/11/em-vitamin-k.pdf is not dismissive of parents concerns!!

  17. March 19th, 2014 at 04:33 | #17

    Hi! Thanks for this informative article & all your research!~

  18. avatar
    Johanna
    March 19th, 2014 at 05:59 | #18

    In Germany, nobody uses IM shots but oral doses. The infant death rate is not higher than in other countries. Also, there is another possible way for oral intake, which is a daily dose of Vitamin-K as used in the Netherlands.

  19. avatar
    Bekah
    March 19th, 2014 at 06:00 | #19

    I would still refuse the shot for future babies like I did for my two sons. At the end of the day, babies do have sterile guts and the shot is made of synthetic vitamin k and yes, some other nasty ingredients. I don’t ever purposely give my kids synthetic anything, much less right after they’ve been born.
    I received antibiotics with my first because I didn’t do my research, and then again with my second because I had a c section, but I drink green smoothies every morning, in addition to eating salad most every day, and I take probiotics everyday. I feel I did make an informed decision both times. Until more research can be done on the American population, comparing babies in the US, and US babies to other countries, and the shot is devoid of any gross ingredients and synthetic vitamins, I would not change my mind in refusing.

  20. avatar
    Mommo
    March 19th, 2014 at 08:10 | #20

    I have the same questions as EeVon but also a few others that this interview didn’t clarify. The sort they give the babies here (Konakion( contains sojalecitin (the manufacturer says they canä’t gaurantee it is GMO-free soy they say, which I take as that it probably is since most soy is GMO) and also a couple of other ingredients that aren’t so funny.
    Do we know how that effects us on long terms? Probably not I guess since GMO hasn’t been used for decades…

    I also wonder a lot about wether there may be some meaning behind this arrangement, maybe the thinner blood for ex lets the cord cells around more easily which might be necessary?

  21. avatar
    Mommo
    March 19th, 2014 at 09:24 | #21

    I wonder one thing more, the shot has the potential to last for 2-3 weeks only I have been informed by my midwives, but the most dangerous forms of VKBD is the late VKBD which occurs later. How is that? I have also read in other places that K1-vitamin leaves the nody pretty fast, so how does the early shot protect against late VKBD?

  22. March 19th, 2014 at 13:22 | #22

    Thank you so much! I look forward to reading the full article. Under the care of midwives and consulting with them, I opted for the oral vitamin K, which we gave as 1 drop per day for the first month. I did this with both of my sons. If I’d read this, though, I may have opted for the shot.

  23. avatar
    Gmom
    March 19th, 2014 at 14:17 | #23

    It’s obvious that many of the commentors have not read the actual article that this interview is discussing. Go read the article, all of your objections are raised there and thoroughly explained.

  24. avatar
    Merle
    March 19th, 2014 at 19:35 | #24

    First off I love the work you’re doing for us Rebecca. I’m 6.5 months along, FTM, who unfortunately just came across your site yesterday! I was researching the Glucose Test, which I intend to refuse.

    My issue with the Vitamin K shot is that I can NOT, for the life of me, understand WHY they need to include so many harmful, unnecessary ingredients in the shot? Why can’t a baby have every opportunity to start their life with a clean, toxin-free, healthy body?

    It’s so frustrating that we have to fight for our health! I’m disheartened. I try to do my eon research to make the best decisions, but wouldn’t it be great if the medical community would advocate for us and work as hard as we do to find the best answers for our long-term health?

    Anyway, I’d love to find an alternative to the shot. Perhaps an oral dose of K is what I need to research.

    PLEASE keep researching and doing what you do!

    P.S. As someone with MTHFR, I had to take baby aspirin for the first trimester. Two things I’d love for you to research: 1. I was told by my RE only to take it for the first trimester. My perinatologist said I should keep taking it and she wished every single one of her patients would take it. So…what do I do? (I took it through first trimester and then stopped) 2. I went everywhere and could not find a single “clean” baby aspirin! Seriously. They make it for babies and include aspartame, shellac (!!), artificial dyes and saccharine. They’re inactive, so why, pray tell, are they necessary?

  25. avatar
    Megan
    March 19th, 2014 at 20:36 | #25

    Babies if born via the birth canal are seeded from the moment of birth with mothers bacteria. It does not take ‘weeks and weeks’ unless there are multiple interruptions to the natural birth process ie; cesarean, separating baby from mother after birth. If take immediately to be ‘cleaned’ can be seeded with the ‘un healthy’ bacteria of the hospital environment – this is why the location of birth, and being placed immediately on mother is critical in those first moments and days after birth. @Sheila

  26. avatar
    Lisa
    March 19th, 2014 at 22:14 | #26

    I have several problems with the original article.

    Two big examples include the comment “Although this amount may seem high to some, it is thought that the Vitamin K1 injection is temporarily stored in the leg muscle and gradually released into the baby’s system over the next several months.” “Thought” is not exactly scientific. Either they know or they don’t know and if they don’t know, they should be finding out.

    The other big issues, is if something is a universal phenomena, it clearly exists for a reason. If all babies are born with a lower level of Vitamin K and breast milk has lower levels of it, that is for a reason. Evolution doesn’t universally screw up something important to the continuation of the species. Before universally recommending something, it would be a very good idea to know why it exists and conduct research comparing other outcomes for those who have the treatment and those who don’t. As near as I can tell (please correct me if I’m wrong) there has never been a study that followed a group with Vitamin K injection and a group without for even a couple of months, much less a year a or more to compare and attempt to figure out why vitamin K levels are “low”.

    Then there’s the issue that just because something is safe to ingest doesn’t make it safe to inject. The body deals with ingested substances differently than injected substances.

    I don’t find this persuasive at all and think far more research needs to be done.

  27. avatar
    Adrienne
    March 19th, 2014 at 22:48 | #27

    Re: “evolution/nature/God doesn’t screw up”: tell that to the numerous Rh negative women who had chronic miscarriages due to Rh sensitivity prior to the routine administration of RhoGAM/WinRho.

  28. March 19th, 2014 at 23:33 | #28

    That was misleading. A – all babies are born low in vitamin K which increases on day 6-7 (hence reason for circumsicion on day 8 & never on day 1 as is common), B – vitamin k1 supplement is not a good option only vitamin K2, C – We do know what causes low vitamin K in the mom; ie. insufficient intake of probiotics, sunshine or vitamin D, calcium/magnesium and exercise to help all of it properly process. When all necessary nutrients are present, our gut flora produces vitamin K. However, today with 95% of our foods being toxic GMOs that destroys the integrity of all of our organs from properly functioning, and 50% of US population does not regularly exercise, we have a problem.

  29. avatar
    Emily
    March 20th, 2014 at 05:57 | #29

    When our second daughter was born at a birth center there was a Vitamin K shortage in our area and they couldn’t get any. Our pediatrician was “horrified” that the birth center would go forward with a birth without having Vitamin K shots, but when we asked how we could get it – could we go to the hospital and get it with a prescription? Could they do it at their office? – she said it was too late and it wouldn’t help then (our daughter was probably 3 days old at that visit).

  30. avatar
    CatieM
    March 20th, 2014 at 06:22 | #30

    Re: Mother Nature doesn’t screw up:

    Really? Then why do I need glasses? Eyes are perfectly designed for seeing, right? Oh wait, our eyes evolved for seeing underwater, not on dry land. Also, Mother Nature/God never intended for every baby to live but that’s not an acceptable outcome in our culture.

    Also, I hear the concern about starting off life toxin free and, at the same time, there are toxins everywhere, including the air we breathe but their not at levels that are harmful. And you can get a preservative free version of the shot. But to say you don’t want to expose your baby to the toxins…I would ask if you have carpet, or drive a car, or go outside on smoggy days?

    (And I know tone doesn’t come across well in writing…I’m not being snarky, genuinely trying to encourage more discussion.)

  31. avatar
    CatieM
    March 20th, 2014 at 06:23 | #31

    Ack! Sorry for the their/they’re typo! Commenting from my phone.

  32. avatar
    Ralph Kimball
    March 20th, 2014 at 06:53 | #32

    My only real concern about giving this potentially life saving treatment is whether the vitamin K is natural or at least bio identical and not a manufactured pharmaceutical variety that could have some negative side effects. Just one more question to ask when gathering quality info.

  33. March 20th, 2014 at 11:28 | #33

    @Denise Hynd
    I hear you Denise – I find Sarah’s work on this topic more palatable also. I have huge respect for Rebecca’s work and I gather from her email that she will be editing the article slightly.

  34. avatar
    Stephanie
    March 20th, 2014 at 12:03 | #34

    Thank you for this and the article. I was always on the bandwagon of the Vitamin K being unnecessary….but this has certainly made me rethink that stance.
    Now, if only they would take all the crap and poisons OUT of the shot, I’d be very happy!
    Stephanie

  35. avatar
    Sharon Hodges-Rust
    March 20th, 2014 at 12:44 | #35

    I had done very similar research for my own understanding of the vitamin K issue. In the UK when they state a rate of vitamin K deficiency bleeds from not getting vitamin K supplementation – the calculations were done out of total population – instead of figuring the rate out of the infants that do not get vitamin K either thru oversight or refusals- so the incidence is actually a much higher rate in infants that do not get any supplemental vitamin K.

  36. avatar
    Leeanne
    March 20th, 2014 at 19:45 | #36

    I would like to see conclusive evidence. There have been no comparative studies to include caesarean, epidural, painkillers vs normal vaginal delivery with no drugs. I can see that Vitamin K maybe required for some babies, but not all.

  37. avatar
    Sharon Hodges-Rust
    March 20th, 2014 at 20:20 | #37

    to address the flora issue- The article addressed that only 10% of vit K comes from flora. Breastfed infants get nearly none from flora because the predominate flora is bifidus and that eats up vitamin K but does not produce it at all. Additionally vitamin K has been assessed in babies the majority of vitamin K in an infant’s body is vitamin K1 so- straight from plants and oils that mom eats right into milk and the second type is MK4 ( which is a subtype of vitamin K2 that is converted by human tissues not bacteria source- it is rare to even find a trace of bacteria sourced vitamin K in infant blood samples) – the Japanese studies found some mk7 in trace amounts in some infants-

  38. March 21st, 2014 at 09:55 | #38

    Hi Rebecca thank you for this informative article that invites all of us natural birth and parenting advocates to review unfounded assumptions regarding vitamin K. I find the details you offer about modes of administration (orally, intramuscular and intravenous) most helpful for parents to make informed decisions.

  39. avatar
    b
    March 23rd, 2014 at 14:01 | #39

    Great article. A question on formula Vitamin K – obviously, those babies are receiving a relatively large oral dose every day. Was VKDB the reasoning behind its inclusion in formula? Or is there more Vitamin K available in the cow milk used to make the formula compared to human milk?

  40. avatar
    Carol Roberts
    March 24th, 2014 at 15:35 | #40

    thank you for this excellent and potentially life saving article.

  41. avatar
    Avery
    March 27th, 2014 at 17:59 | #41

    Just wanted to say that this was a great post. When I looked into the Vitamin K shot as a questioning pregnant woman this was the exact conclusion I came to. As you say, giving the vitamin K shot does not have to be mutually exclusive with ‘natural’ birthing practices. As a woman who had a home water birth and delayed cord clamping I couldn’t agree more.

  42. avatar
    Merle
    March 27th, 2014 at 18:30 | #42

    @CatieM
    Not for nothing, but just bc we are exposed to toxins in our environment, is that reason enough to shove more toxins unnecessarily into our babies? Shouldn’t we control what we can to make up for what we can’t?

  43. avatar
    Elaine
    April 4th, 2014 at 01:14 | #43

    @EeVon
    Did you read her article in full? She explains delayed cord clamping wouldn’t help. Also, babies were dying of this issue in the olden days also; people just didn’t know how to prevent it.

  44. avatar
    Heidi
    April 7th, 2014 at 08:20 | #44

    I’ll second Jessica’s question. What about when the mother has increased clotting factors that could be inherited by her infant? I have Factor V Leiden Thrombophilia that makes me more likely to develop blood clots (though I haven’t had any as of yet). This is inheritable, so my baby could have this also. This is what makes me leery of giving my baby the Vitamin K shot.

  45. avatar
    Sunday
    April 21st, 2014 at 22:28 | #45

    It’s good that things like vitamin K injections are being discussed, some new mums don’t even know that this is one of the things routinely given to newborns or why! While it is true that babies are born low in vitamin K, it is also true that colostrum is extremely high in vitamin K, which could be seen as a design by nature to encourage babies to want to breastfeed. Another point worth considering is that babies that are prone to heavy bleeding are those that have been subjected to a ‘rough’ birth, such as the use of forceps in delivery which can cause severe bruising. These things are also worth considering when undertaking this type of research.

  46. avatar
    Satya
    October 20th, 2014 at 21:06 | #46

    This link contains the package warnings, precautions and ingredients which directly contradict some of her statements in the above “interview.” Clearly this should not be given to newborn infants haphazardly! Please do your own research. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e8808230-2c44-44c6-8cab-8f29b6b34051
    ” WARNING — INTRAVENOUS AND INTRAMUSCULAR USE

    Severe reactions, including fatalities, have occurred during and immediately after INTRAVENOUS injection of phytonadione, even when precautions have been taken to dilute the phytonadione and to avoid rapid infusion. Severe reactions, including fatalities, have also been reported following INTRAMUSCULAR administration. Typically these severe reactions have resembled hypersensitivity or anaphylaxis, including shock and cardiac and/or respiratory arrest. Some patients have exhibited these severe reactions on receiving phytonadione for the first time. Therefore the INTRAVENOUS and INTRAMUSCULAR routes should be restricted to those situations where the subcutaneous route is not feasible and the serious risk involved is considered justified.”

    “WARNINGS

    Benzyl alcohol as a preservative in Bacteriostatic Sodium Chloride Injection has been associated with toxicity in newborns. Data are unavailable on the toxicity of other preservatives in this age group. There is no evidence to suggest that the small amount of benzyl alcohol contained in Vitamin K1 Injection (Phytonadione Injectable Emulsion, USP), when used as recommended, is associated with toxicity.

    An immediate coagulant effect should not be expected after administration of phytonadione. It takes a minimum of 1 to 2 hours for measurable improvement in the prothrombin time. Whole blood or component therapy may also be necessary if bleeding is severe.

    Phytonadione will not counteract the anticoagulant action of heparin.

    When vitamin K1 is used to correct excessive anticoagulant-induced hypoprothrombinemia, anticoagulant therapy still being indicated, the patient is again faced with the clotting hazards existing prior to starting the anticoagulant therapy. Phytonadione is not a clotting agent, but overzealous therapy with vitamin K1 may restore conditions which originally permitted thromboembolic phenomena. Dosage should be kept as low as possible, and prothrombin time should be checked regularly as clinical conditions indicate.

    Repeated large doses of vitamin K are not warranted in liver disease if the response to initial use of the vitamin is unsatisfactory. Failure to respond to vitamin K may indicate that the condition being treated is inherently unresponsive to vitamin K.

    Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants.

    WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they required large amounts of calcium and phosphate solutions, which contain aluminum.

    Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.”

  47. avatar
    sim
    November 20th, 2014 at 10:01 | #47

    @CatieM
    do you know which manufacturer makes the preservative free vitamin k shot?
    thanks so much

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