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New moms: don’t skip the newborn vitamin K shot!

As of this summer I have been out of residency and working as a board-certified pediatrician for ten years. Practicing in a clinic is very different than spending most of my day in the hospital. Hospitalized children, in general, are often very ill. Their care is focused often on managing complex medical problems such as cancer, endocrine disorders, and those resulting from trauma. Medications and their side effects are a daily struggle for the doctors making those medical decisions. It is understood that everything has a risk and a benefit, and the latter must outweigh the former whenever possible.

The risk/benefit ratio of treatment is something doctors think about often and is why physicians get frustrated when parents are unwilling to vaccinate, for example. For us, the risk of the disease far outweighs the risk of the vaccines. The most recent example of this is the alarming trend of parents refusing the newborn vitamin K shot. Instead, some websites advocate that expecting moms eat a lot of “leafy greens” before giving birth while giving dire warnings that the vitamin K shot is actually a “synthetic” vitamin and potentially toxic and may cause cancer (there’s no evidence to back this up).

It’s important to understand that vitamin K is not a vaccine. It does not stimulate the body to produce antibodies against a particular disease. Rather it is a vitamin that is deficient in the newborn period and yet required for normal clotting of blood. Babies without sufficient vitamin K are at risk for something called “vitamin K deficiency bleeding.” It is given in the first day of life as a shot (oral vitamin K is far, far less effective and not recommended).

According to the Centers for Disease Prevention and Control, newborns who do not receive vitamin K shortly after birth are at 81 times higher risk for vitamin K deficiency bleeding than newborns who receive the shot. As a result, the American Academy of Pediatrics has been recommending vitamin K be given to each and every newborn since 1961! The bleeding is not something like what you’d see from a cut or scratch. It’s internal bleeding into organs such as the intestine and brain. Babies with vitamin K deficiency bleeding are at risk for permanent injury, including brain damage, and one in five babies with vitamin K deficiency bleeding dies.

Understandably, parents want to minimize pain and discomfort to their babies. A shot in a newborn can cause stress for both family and baby. They also want to minimize the amount of health risks they assume on behalf of their child. Doctors want to minimize risk: risk of bleeding, risk of blood transfusion, risk of surgical procedures and their resultant pain and risk of death. The decision to give vitamin K needs to be understood in the context of the risks of not giving the shot. It is important when weighing risks against benefits that parents are informed with correct, scientifically based information that is free of conspiracy theory. Once a parent has a clear understanding of the vitamin and vitamin K deficiency bleeding, the choice should be an easy one.

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