Pediatrician talks about Vitamin K shots

Deficiency of Vitamin K is common in the newborn, and therefore is given shortly after birth. The purpose of this injection is to prevent Vitamin K deficiency bleeding (VKDB), previously known as hemorrhagic disease of the newborn. We asked Le Bonheur Pediatrician Elisha McCoy, MD, to weigh in on the topic of Vitamin K shots and why they’re important.

What is Vitamin K?

Vitamin K is a fat-soluble vitamin that is required by humans for normal clotting of the blood. If your blood can not clot appropriately, it can lead to uncontrolled bleeding. Vitamin K is primarily acquired through dietary sources, such as green leafy vegetables, banana, kiwi and avocado, to name a few.

How is the vitamin administered?

Typically, a newborn will receive Vitamin K as an intramuscular injection within the first six hours after birth.In 1961, the American Academy of Pediatrics published its recommendation for all babies to receive intramuscular Vitamin K, and they subsequently reaffirmed this recommendation in 2009. Since that time, there have been parents who refuse the injection for their children. In a report from the CDC in 2013, there were four confirmed cases of infants with Vitamin K deficient bleeding, and each of whose parents had refused the Vitamin K prophylaxis. There are countries that give an oral formulation of Vitamin K; however, there is no clear data on appropriate dosing, and it has been shown to be less effective than the intramuscular injection.

What are symptoms of Vitamin K deficiency bleeding (VKDB)?

Symptoms can present from the first few days of life up until about 12 weeks of age. Presenting signs and symptoms can include bleeding from the mouth, nose, umbilical stump or circumcision site. It is also possible that the bleeding can occur in the gastrointestinal tract or the brain. These are less visible and can be life-threatening if they occur.

Risk factors for Vitamin K deficient bleeding include:

  • premature infants
  • infants who have problems with intestinal absorption
  • breastfed infants (although this is still highly recommended by pediatricians)

Are there any risks associated with Vitamin K shots?

The risks of Vitamin K injection are similar to other intramuscular injections that the infant will receive. There will be some pain during the injection and possibly a small bruise, but the injection only takes a few seconds. In the early 1990s, a couple of studies attempted to show an association between intramuscular Vitamin K administration in newborns and an increased risk of childhood cancers, specifically leukemia. Since that time, additional studies have been performed and found no association between intramuscular Vitamin K and the incidence of childhood cancers. The benefits of a newborn receiving Vitamin K outweighs any potential risks associated.

Risk factors for vitamin K deficient bleeding include: premature infants, infants who have problems with intestinal absorption, and breastfed infants (although this is still highly recommended by pediatricians). Ultimately, the recommendation is intramuscular vitamin K given as a 0.5-1mg dose (based on weight) given shortly after birth for prevention of vitamin K deficiency bleeding. For further questions or concerns, you should speak to your child’s pediatrician.

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