Vitamin K injections: what you need to know

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A five-week-old baby whose parents declined a routine vitamin K injection after his birth suffered a brain haemorrhage and remains in a Brisbane hospital, The Daily Telegraph reported last week. 

The tragic case has highlighted a concerning trend: that of more and more parents refusing the life-saving injection after their babies' birth. So what's behind the increase?

A 2014 Canadian study revealed that parents who refused vitamin K after their baby's birth had a number of specific characteristics: they were more likely to have had a home birth, for their baby to have been delivered by a midwife, and to have subsequently refused to vaccinate their children against other illnesses. In fact, kids whose parents had refused vitamin K were more than 14 times as likely not to have been vaccinated by 15 months than were those who had received the needle.

More recently, a 2017 study found that of the parents who declined the vitamin K injection, 53 per cent believed that it was unnecessary, while 36 per cent indicated "a desire for a natural birthing process." 

Published in Science-based Medicine, pediatrician Clay noted that "there's a lot of overlap with that anti-vaccine mentality".

"Though not as widespread as anti-vaccine propaganda, and certainly lacking that particular entity's infrastructure and celebrity support, there is an online presence of bogus anti-vitamin K information to be found," he wrote.

With that in mind, here are the facts and what parents need to know about vitamin K.

Why do babies receive vitamin K?

All newborn babies have a relative vitamin K deficiency at birth. This can cause unexpected bleeding known as vitamin K deficiency bleeding (VKDB).

VKDB can be early (first day of life), classic (one to seven days after birth) or late (eight days to six months after birth). The bleeding can result in brain damage and can also be fatal. About half of babies who develop VKDB bleed into their brains.

Vitamin K helps blood to clot.

According to the Centre for Disease Control (CDC), the relative risk for developing late VKDB has been estimated at 81 times greater among infants who do not receive vitamin K than in infants who do receive it.

How is it administered?

Parents can elect for their baby to receive vitamin K one of two ways: an injection, or to receive the vitamin via three oral doses. In the latter, the first dose is administered at birth, the second at around three to five days old, and the third at four weeks (for breastfed babies only). Why? Human breast milk contains relatively low concentrations of vitamin K1, whereas infant formula is - by law - supplemented with additional vitamin K1.

The easiest and most reliable way is via injection.

Who should receive it?

In Australia it is recommended that all newborn infants receive vitamin K. Most newborn babies, since around 1980, have received the injection.

Small or very premature babies may require smaller doses.

​Is it a vaccine?

No, it isn't a vaccine - it's a vitamin delivered orally or via an injection.

Does my baby have to receive vitamin K?

No, it's your choice. However, it is strongly recommended that babies receive vitamin K to prevent VKDB. 

For more information, consult the National Health and Medical Research Council guidelines here.