Why Should My Baby Have Vitamin K?

Author: Hayley McGrath, Midwife

One of the first things as a new parent you need to decide is whether to have Vitamin K administered to your baby. Vitamin K cannot be given to your baby without your permission, so its beneficial to know some information about it in advance, so you can make an informed choice.

What is Vitamin K?

Vitamin K is an important group of chemicals which play an essential role in helping our blood to clot properly, so that we don’t bleed too easily.

Why is it recommended for my baby?

Newborn babies have low levels of vitamin K in their blood compared to older children and adults. Because of these low levels of vitamin K, babies are at risk of having complications from excessive bleeding know as Vitamin K Deficiency Bleeding (VKDB) previously know as Haemorrhagic Disease of the Newborn (HDN)

The Department of health recommends that all newborn babies are given a supplement of Vitamin K shortly after birth.

More information on VKDB

· Early onset- can occur within 24 hours after birth

· Classical onset – can occur within the first week after birth

· Late onset- can occur from the first week and for up to 6-8 months after birth

If your baby develops VKDB in the first few months, they may have obvious bleeding:

· from their umbilical stump

· in their urine

· from their bottom

· from their skin and mucous membranes, for example, the nose and gums

· appearing as bruises on the skin

· there is also a risk of internal bleeding, for example, inside the head

This must be looked at urgently, so do speak to your doctor, midwife or health visitor.

How common is VKDB?

This is an extremely rare condition that effects approximately 1 in 10,000 babies. Although it is rare, it can be serious, which is why all parents in the UK are offered vitamin K to their babies shortly after birth.

The impact of VKDB can be mild, or in rare cases (seven in 100 babies with VKDB) can lead to death. Approximately 30 out of 100 of babies with VKDB are left with a mental impairment, because of bleeding to the brain.

Are some babies more at risk than others?

Yes, some babies are more at risk of VKDB than others especially if:

· they were born prematurely (before 37 weeks)

· they were delivered by forceps, ventouse (suction cap) or caesarean section, where bruising may occur

· they had breathing difficulties at birth

· you are on certain drugs during your pregnancy, such as anticonvulsants (medication for epilepsy)

· your baby is circumcised

Even if your baby is not at a higher risk of developing VKDB, they could still develop a vitamin K deficiency. About one third of babies with VKDB do not have any of the risk factors listed above.

How is the vitamin K given?

The recommended method of giving your baby vitamin K is an injection soon after the birth – usually once time has been taken to get to know your baby, initiated skin to skin and breastfeeding. It is usually incorporated within the initial baby check. The injection is given by a midwife into the muscle of your baby’s thigh. It is a single injection – no further doses are required. A paediatric needle is used to administer it, which is smaller than an adult needle.

Alternatively, if you decide that you don’t want your baby to have the injection, then you can opt to have vitamin K orally- where the vitamin K is put into the baby’s mouth, a total of 3 doses are recommended:

· 1st dose - After birth, ideally after a breastfeed

· 2nd dose – 5-7 days, usually given by your midwife

· 3rd dose- 4-6 weeks, given by a midwife, parent, doctor, or health visitor. Who gives the dose may vary depending on your care providers. The 3rd dose does not need to be given if you are formula feeding, as vitamin K is added to formula milk.

You can of course decide to decline vitamin K administration completely. This increases the risk of the baby getting VKDB from one in 1,000 up to 100 in 1,000. Recognising signs of VKDB is useful to know if you do make this decision.

Are there any drawbacks to vitamin K supplements?

In the early 1990s it was suggested that vitamin K injections might increase the risk of leukaemia (a type of cancer of the blood) in children. However, a review of data from the UK Children’s Cancer Study Group in 2003 found no link that vitamin K administration increases the risk of children developing leukaemia or any other cancer.

Things to consider:

· Discuss further with your midwife if you need to – makes sure your wishes are documented on you birth plan or preferences

· Discuss with your birth partner, just in case your baby needs to go to special care baby unit after birth

· Remember, vitamin K cannot be given without your permission, so you will be asked for your consent prior to administration

· Whether you choose to give or not to give vitamin K to your baby, you should report any concerns you have with your baby to a midwife, doctor or health visitor.

· Although vitamin K is added to formula milk, breastfeeding is still recommended for your baby – some studies have shown that colostrum is slightly higher in vitamin K content