Our resident GP answers the question, ‘Why Vitamin K for newborns?’
In the haze following the delivery of your baby, one of the really important things done (with your consent – usually discussed prior to the birth of your baby) is a vitamin K injection. The reason for this is to protect the newborn baby from a condition called “Haemorrhagic disease of the newborn (HDN)” or “Vitamin K Deficiency Bleeding (VKDB)”.
Vitamin K helps with blood clotting. Babies are not born with adequate levels, nor do they get enough with breastfeeding. Because of this, they are at higher risk of bleeding because their blood can’t clot as well. By about six months, they will have built up their own supply. Vitamin K given at birth boosts their stores until this time.
Prior to vitamin K being routinely given to newborns, the incidence of HDN/VKDB was approximately 5 to 20 cases out of 100 000 births. The incidence is now less than one baby per 100 000 births.
Vitamin K has been given for over 30 years in Australia and no significant problems have been recorded. In 2000, over 95% of babies received it at birth. While there have been some claims of it being linked to increased rates of childhood cancer, the NHMRC (National Health and Medical Research Council) have investigated and the evidence does not support this claim.
Vitamin K for newborns – injection or oral doses?
It is normally given as an intramuscular injection into your baby’s leg. This is the best way to administer vitamin K. Some people prefer not to have the injection and there is an option to have oral vitamin K. HOWEVER this is not the preferred route for a couple of reasons:
- It requires you remembering that a second and third dose (if breastfed) is required.
- It is not absorbed as well and doesn’t last as long.
- If there is any vomiting within about an hour, another dose will be required.
It is the parents’ choice whether or not to have Vitamin K; however, it is strongly recommended. It is safe, easy to administer and the potential consequences of not having a Vitamin K injection (bleeding, for example in the brain) – although uncommon – can be catastrophic.
Babies at highest risk of bleeding include:
- Premature babies
- Sick newborns
- Babies having surgery (e.g. circumcision)
- Babies whose mother is on certain medications (e.g. to treat seizures, blood thinners, certain antibiotics, TB medication)
- Babies with liver disease
- Babies who have gut disease that means they don’t absorb vitamins as well (e.g. coeliac disease, cystic fibrosis).
- Breastfed babies (formula contains some vitamin K)
Bleeding due to vitamin K deficiency can occur early on, or even months later. It ranges from bruising or bleeding from the umbilical cord/nose/puncture sites, through to bleeding in the gut or bleeding in the brain, which can cause a type of stroke or death. There are often no warning signs before a life-threatening bleed starts. The “Late” form of the disease (from day eight through to six months) involves bleeding on the brain in 30-50% of cases. It is mainly seen in breastfed babies and is almost entirely preventable by giving Vitamin K at birth.