- Since 1961, the American Academy of Pediatrics (AAP) has recommended that all newborns receive a vitamin K1 injection to prevent vitamin K deficiency bleeding (VKDB), which can be life-threatening
- Parental refusal of the vitamin K1 injection for their newborn is on the rise, and one study found a correlation between vitamin K1 shot refusal and subsequent vaccine avoidance
- Children who did not receive the vitamin K shot at birth were also 14.6 times more likely to be unvaccinated at the age of 15 months. The findings were said to offer a means to identify “high-risk” parents that will be prone to not vaccinating their children
- Parents have had their newborn babies taken from them simply because they declined the vitamin K injection. Several Illinois families have filed a class-action lawsuit against local hospitals, the AAP, the DCFS and several pediatricians
- The vitamin K1 injection presents unnecessary and avoidable risks. A safe and effective noninvasive way to avoid VKDB is to administer multiple doses of oral vitamin K1
Since 1961, the American Academy of Pediatrics (AAP) has recommended that all newborns receive a vitamin K1 injection to prevent uncontrolled bleeding caused by vitamin K deficiency.1,2
Vitamin K1 is required for proper blood clotting, and newborns tend to have low levels due to the fact that vitamin K doesn’t cross the placenta very well. Deficiency can result in sudden internal bleeding — typically in the brain or intestines. This is referred to as “vitamin K deficiency bleeding” or VKDB, and can be life-threatening.
Research published in 20143,4 in the journal Pediatrics found the number of parents declining the vitamin K shot for their newborn babies was on the rise, increasing from 0.21% in 2006 to 0.39% in 2012.5
The data were based on infants born in Alberta, Canada. In the U.S., data6 presented at the 2014 CSTE conference reported the refusal rate at two Nashville, Tennessee, hospitals ranged from 2.3% to 3.7% in 2013.
A second 2014 study7 also concluded vitamin K refusal was on the rise, and with it, an increase in late onset vitamin K deficiency bleeding in infants. Of seven infants with confirmed vitamin K deficiency, five developed vitamin K deficiency bleeding.
A 2017 poll8 found the most common reasons given by parents for refusing the vitamin K shot were “perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives.”
Vitamin K Refusal Linked to Vaccine Avoidance
As reported by Scientific American,9 the 2014 Pediatrics paper10 found that children who did not receive the vitamin K shot at birth were also 14.6 times more likely to be unvaccinated at the age of 15 months. According to the authors:11
“This is the first population-based study to characterize parents who are likely to decline vitamin K for their infants and whose children are likely to be unimmunized. These findings enable earlier identification of high-risk parents and provide an opportunity to enact strategies to increase uptake of vitamin K and childhood immunizations.”
Senior author Shannon MacDonald told Scientific American:12
“Our finding of a link between vitamin K refusal and vaccine refusal was very concerning. We had expected a correlation between the two but had not expected the association to be so high.”
The correlation between vitamin K shot refusal and vaccine avoidance is turning out to have severe ramifications for many parents. In short, by saying no to the vitamin K shot, some hospitals are automatically labeling you a negligent parent and a dreaded anti-vaxxer in the making, so to speak.
Babies Taken From Parents Who Refused Vitamin K Shot
A number of stories have emerged detailing how parents have had their newborn babies taken from them by simply because they declined the vitamin K injection. In a September 2019 article,13 The Daily Citizen describes the harrowing ordeal of Angela and Brian Bougher:
“The Christian couple believes that ‘God’s creation isn’t automatically deficient or flawed at birth’ and the shot is unnecessary. The Boughers have a right to their beliefs, and if they were fully informed of the risks then they should be able to decline. The state of Illinois didn’t see it that way.
Instead, in the moments after birth, a nurse told the Boughers that their newborn daughter was being taken away and they were being investigated for ‘medical neglect.’ It took 12 hours to get their daughter back.
It’s debatable whether the logic of Boughers’ decision is sound — however, medical professionals should know that the first moments of life are crucial to both mother and child. To remove a child for such a reason is a severe overreach of the state’s responsibility to protect children from neglectful parents.
The family’s pain did not stop there. Later the Illinois Department of Children and Family Services (DCFS) had law enforcement officers make an unannounced visit the Boughers’ home to investigate and determine if any of their other four children were being ‘neglected.'”
The Boughers and several other Illinois families who experienced harassment and investigation by the DCFS over refusal of the vitamin K shot have filed a class action lawsuit against local hospitals (Silver Cross Hospital, Advocate Christ Medical Center and the University of Chicago Medical Center), the AAP, the DCFS and several pediatricians. As reported by CBS September 24, 2019:14
“They want a compensation and a court-enforced guarantee that the Illinois Department of Children and Family Services won’t be called if parents refuse to give their babies a Vitamin K shot.”
Is the Vitamin K Shot Needed?
In 2010, I interviewed Cees Vermeer, Ph.D., an associate professor of biochemistry at the University of Maastricht in the Netherlands,15 and one of the world’s leading specialist in vitamin K.16 I’ve included it above for your convenience.
According to Vermeer, while vitamin K1 is necessary for newborns, the shot is not. There are far safer and noninvasive ways to normalize your baby’s vitamin K1 level. He points out several areas of risk associated with the vitamin K injection:
•The amount of vitamin K injected into newborns (0.5 to 1 milligram17) is far greater than needed
•The injection may contain benzyl alcohol,18 a preservative that may be toxic for the baby’s delicate immune system.
Preservative-free shots may contain a combination of polysorbate 8019 and propylene glycol20 instead,21 but these ingredients also have a questionable safety profile. For polysorbate 80, hypersensitivity and possible death are among the known risks22
•An injection creates an additional opportunity for infection in an environment that contains some of the most dangerous germs, at a time when your baby’s immune system is still immature
Perhaps most importantly, though, inflicting pain immediately after birth causes psycho-emotional damage and trauma to a newborn, which is both inappropriate and unnecessary.
In his 1999 paper, “Babies Don’t Feel Pain: A Century of Denial in Medicine,” David B. Chamberlain, Ph.D., a psychologist and co-founder of the Association of Pre-and Perinatal Psychology and Health, wrote:23
“The earlier an infant is subjected to pain, the greater the potential for harm … We must alert the medical community to the psychological hazards of early pain and call for the removal of all man-made pain surrounding birth.”
A 2004 study24 found that very early pain or stress experiences have long-lasting adverse consequences for newborns, including changes in the central nervous system and changes in responsiveness of the neuroendocrine and immune systems at maturity. Similarly, a 2008 study25 concluded:
“Healthy newborns routinely experience acute pain during blood sampling for metabolic screening, injection of vitamin K or hepatitis vaccine, or circumcision.
Acute pain caused by skin-breaking procedures can lead to physiologic instability and behavioral distress, and it has downstream effects on subsequent pain processing, development and stress responsivity. Because of these detrimental effects, reduction and prevention of pain are worthy clinical goals that are also expected by most parents.”
Oral Vitamin K Is a Safe and Effective Alternative
The good news is there’s a completely noninvasive and pain free way to ensure your baby gets the vitamin K1 it needs: oral vitamin K drops, which are readily available for hospitals to purchase26 if they do not routinely stock it.
Oral vitamin K1 is absorbed less efficiently than vitamin K1 that is injected. However, this can easily be compensated for by adjusting the dose. And, since vitamin K1 itself is nontoxic, there is no danger of a bad reaction.
One reason oral vitamin K is not routinely used is because it requires multiple doses, and it’s feared new parents will forget to comply with the dosing. There are many variations in recommendations for the oral dosing. Among them:
|Six-month weekly regimen — One 2-mg oral dose at birth, followed by a once-weekly dose of 1 mg for the first six months of life, provided they’re breastfed at least half of the time. This regimen was found to be as effective as the vitamin K shot, Evidence Based Birth reports.27|
|Three-month weekly regimen — 2 mg at birth, followed by once weekly dose of 1 mg for the first three months was found to be “an efficient prophylaxis against VKBD.”28|
|Three-month daily or weekly regimen — 1 mg dose at birth followed by 25 micrograms per day for 13 weeks, or 2 mg at birth followed by 1 mg per week for three months was found to provide the lowest risk of VKDB.29|
|Three-dose regimen — 1 mg by mouth at birth, 1 mg at 1 week of age, and a third 1 mg dose at 4 to 6 months of age.30|
|Three-dose regimen — 2 mg four hours after birth, 2 mg on day four, and a third 2-mg dose in the fourth week was found to “adequately” protect infants from VKDB.31 (Omitting the third dose was shown to provide inadequate protection).|
|Single dose — A single oral dose of 1 mg may protect against early VKDB in exclusively breastfed babies but not late VKDB.32|
As noted by Vermeer, you can also increase your infant’s vitamin K level naturally if you are breastfeeding by increasing your own vitamin K level. The milk of lactating women has been tested, and most is low in vitamin K because the women themselves are vitamin K deficient.
If you take a vitamin K1 supplement, your milk also becomes richer in vitamin K, as you would expect. However, prudence is required — you need to make sure your vitamin K level is truly optimized, and for most women, the vitamin K absorbed from foods won’t be enough, so supplementation might be needed.
Discuss Wishes With Your Doctor Before Your Baby Is Born
Ultimately, the choice about whether or not to consent for your baby to be given a vitamin K shot is yours. For some, eliminating a source of avoidable pain right after birth is worth the extra work required to make sure your baby’s vitamin K level is optimized.
If you choose to not expose your child to a vitamin K shot and would prefer to have it given orally, you will have to make it very clear not only to your obstetrician but also the nursing staff, as they would be the ones who actually administer the shot.
The time to do this is well before your baby is born, to avoid getting into a nasty argument right after delivery. That way, you can make sure the hospital has oral drops on hand on the day of delivery, and for you to take home with you to continue the dosing.
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