Your Newborn and Vitamin K: Making Informed Decisions
Show Notes:
[1:30] Our Review of the Week, MECovell123, said: "I am a pelvic floor PT and I first started listening to this podcast to learn more information about pregnancy and birth for my clients. I continued to listen throughout my own pregnancy and was overwhelmed at the amount of helpful information that helped me prepare mentally and physically for my own delivery. I loved listening to all the positive birth stories and found the information in the class very helpful. I am now a proud mama of a 2 week old little girl and enjoying all the information in the postpartum course! Thank you, Stephanie, for all that you do!"
[2:43] Today's topic is about Vitamin K. Stephanie emphasizes the importance of gathering information to make informed decisions, especially regarding newborn care. There is uncertainty many parents feel about certain medical interventions immediately after birth. While not advocating for or against these interventions, Stephanie aims to provide deeper insight, particularly into vitamin K, to help parents make informed choices.
[4:03] What does Vitamin K do? Vitamin K is a fat-soluble vitamin essential for blood clotting. It is especially important for newborns, particularly if they undergo procedures like circumcision, which carry a risk of excessive bleeding. While Vitamin K can be administered after bleeding begins and typically stops it within 20–30 minutes, healthcare providers prefer to give it preventatively. Stephanie also touches on different administration methods, including injections and oral doses, highlighting the importance of understanding its role in newborn care.
[5:11] Why do babies need Vitamin K? What are your options for getting Vitamin K?
Newborns are born with low levels of vitamin K, which is essential for blood clotting. While the exact reason for these low levels is unknown, insufficient vitamin K can put babies at risk for Vitamin K Deficiency Bleeding (VKDB), a rare but serious condition. There are two types of VKDB: idiopathic, which commonly affects exclusively breastfed infants, and secondary, linked to underlying health issues.
Breast milk contains minimal vitamin K, whereas formula is fortified with it. Some research suggests maternal diet and supplementation may improve vitamin K levels in breast milk, but not enough to significantly impact the baby. Foods rich in vitamin K, like liver, may help, but most studies have focused on plant-based sources.
Vitamin K can be given to newborns via injection or oral administration. The injection is standard in the U.S., though some parents prefer oral doses, which require multiple administrations. Other countries, such as Germany, offer oral vitamin K more widely due to stronger postpartum care systems. Some parents question the injection’s preservatives and ingredients, though a preservative-free option exists.
[19:52] Stephanie discusses the controversy surrounding the Vitamin K injection for newborns, referencing an old study that suggested a possible link to leukemia, though later research has not supported this claim. She emphasizes the proven benefits of the injection in preventing Vitamin K Deficiency Bleeding (VKDB) and acknowledge that while unknown risks could exist, the benefits outweigh them in saving lives.
Stephanie also highlights the importance of informed decision-making, respecting parental choice, and the potential issue of removing the oral vitamin K option. Some researchers advocate against offering the oral option due to concerns about parents not completing all doses, but Stephanie believes that limiting choices can place parents in a difficult position.
There are three types of VKDB:
- Early onset (within 24 hours): Often linked to maternal medications that interfere with vitamin K.
- Classical onset (2–7 days): Occurs when newborns have naturally low vitamin K levels.
- Late onset (weeks 3–7, up to 6 months): Rare but serious, potentially leading to brain damage.
Treatment with a Vitamin K injection can stop bleeding within 20–30 minutes, but if bleeding occurs in the brain, it may be too late to prevent lifelong damage. This risk underscores why a "wait and see" approach is not recommended.
[24:09] Stephanie discusses statistics on Vitamin K deficiency bleeding (VKDB) and the impact of the vitamin K shot. Without supplementation, 250–1500 out of 100,000 infants experience classical VKDB, and 4.4–7.2 per 100,000 develop late VKDB. With the vitamin K injection, late VKDB drops to 0–0.4 per 100,000, making it highly recommended.
Stephanie outlines vitamin K supplementation options:
- Injection – Often preservative-free, given intramuscularly for slow release.
- Dietary adjustments – Requires careful monitoring, including animal liver consumption.
- Maternal supplementation – Taking vitamin K directly and testing breast milk levels.
- Oral option – Not licensed in the U.S., but available in some areas, requiring multiple doses.
While VKDB is rare, the consequences can be severe, including brain bleeding. The shot is particularly important for infants undergoing procedures like circumcision.
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