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Vitamin k for newborns pros and cons


Seven things every parent needs to know about vitamin K

Good information about vitamin K is key for every parent.

In most countries, one of the first decisions that parents need to make for their baby is whether or not they want their baby to have vitamin K. If they do, it’s usually given within the first hour of birth.

It’s your decision whether or not your baby has vitamin K. It’s also up to you to decide which kind of vitamin K (oral or injection) you want your baby to have. So you’ll want to weigh up the pros and cons, as with every decision you’ll make for your child.

I have been researching vitamin K for more than twenty years, and I have written several books and information leaflets on this subject. Here’s the most recent. I have written this summary of information about vitamin K that you might want to consider when making your decision. It’s based on the information in my book, and you might also want to visit my vitamin K information hub, which brings together all of my information about vitamin K.

1. Vitamin K is offered in order to prevent a rare but serious blood clotting problem.

Vitamin K is needed in the human body for several key processes. One of the most important is that it helps blood to clot. This is why it is offered to newborn babies. Without it, a small number of babies will develop a rare but serious blood clotting problem. We used to call this problem haemorrhagic disease of the newborn (HDN). It is now more commonly known as vitamin K deficiency bleeding (VKDB).

 

2. The likelihood of the problem is low, but it can be serious.

Exact figures vary, but the chance of a baby experiencing VKDB if they don’t have vitamin K is about 1 in 11,000. Most babies who have VKDB will recover, especially if they receive treatment quickly. This is why it is important to be vigilant if you decide to decline vitamin K. A small number of the babies who experience VKDB will experience long-term damage and, sometimes, a baby will die. The actual chance of death from VKDB is very low, but if we give vitamin K to all babies, it’s even less likely.

 

3. Vitamin K can be given by mouth or by injection.

Vitamin K can be given by injection, or your baby can have oral drops. The drops may be given in several doses over the first few weeks of your baby’s life. Oral drops are not as effective as the injection, but some parents prefer to give vitamin K that way. The timing and amount of vitamin K that is given orally can vary between areas of the world. Vitamin K is also added to formula milk.

 

4. Vitamin K is very effective, especially when given by injection.

We do not have a randomised controlled trial into vitamin K. However, other studies, audits and long experience suggest that vitamin K is very effective at preventing VKDB when given by injection. Oral vitamin K is less effective than vitamin K given by injection. But oral vitamin K is more effective than no vitamin K. We don’t have good data on exactly how effective oral vitamin K is.

 

5. Vitamin K is very safe, but there are a few downsides.

Compared to some drugs, vitamin K is considered very safe. The injection of vitamin K will occasionally result in infection (at the injection site), bruising or bleeding (as with any injection). It can cause pain to the baby when it is being given. There have been cases of the wrong drug being injected, but these are rare. Some people are concerned about other possible downsides to vitamin K, because it hasn’t been well researched. We have given vitamin K to millions of babies for many years because we know that it prevents almost all cases of VKDB. But we don’t know why babies have a relatively low level of vitamin K (compared to adults). It may be that this is beneficial to them in some way. No research has been done into this, and not enough research has been carried out into possible side effects. The fact that so much is unknown makes the decision difficult for some parents.

 

6. There are alternatives; it’s not always ‘all or nothing’.

What is Vitamin K? Why is it offered to all newborn babies? Does my baby need it? This book guides the reader on a journey through the information, debate and research on this topic.

As with many birth and parenting decisions, it’s not always an ‘all or nothing’ decision. For instance:

You may decide to have oral vitamin K rather than the injection. In this situation, be aware that Vitamin K is fat soluble. So in order to be properly absorbed by the baby’s body, it should be given with or just after a feed. Also be aware that it tastes bitter. Many babies will try to spit it out again and you might want to have your finger ready to scoot it back in!

You may decide to wait and see and make a decision according to your situation. There are a few key vitamin K information issues to consider. If your baby is breastfed and is slow to feed or has feeding problems, the chance of VKDB is higher and you may want to reconsider. If you or your baby have antibiotics, this can increase the chance of VKDB. Again, you may want to take that into account. Likewise if your baby has a procedure such as a tongue tie division or circumcision.

It is good to look into all aspects of this decision to make sure that you are fully informed.

 

7. It’s up to you

As I said at the beginning of this blog post, this is your decision. You have the right to have good information and make the decision that is right for you and your baby. I hear from midwives and others in some areas of the world (notably the USA) that parents are sometimes told that it is illegal to decline vitamin K. This may not be true, so please check what your rights are. It is also the case that, unfortunately, some parents are put under pressure to accept vitamin K. In some situations, senior professionals are brought in to try to persuade parents to accept it.

If you are thinking of declining vitamin K, I really would recommend that you look further into this area. Here’s a link to my book if you’d like to get more depth. We have an entire information hub on this topic, with links to several more articles and blog posts. And if you are thinking of declining vitamin K, please take a look at this information in particular.

 

If you’d like to know more about vitamin K, you might enjoy my book on this topic.
And if you’re a midwife or other birth worker and you’d like to learn more about topics such as vitamin K and discuss how to best share information with parents-to-be with colleagues from around the world, join one of our online courses!

 

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Key facts

  • Vitamin K helps your baby’s blood to clot.
  • Babies need more vitamin K than they get from their mother during pregnancy or from breast milk.
  • Parents of all newborns are offered a vitamin K injection for their baby soon after birth.
  • This helps prevent babies from becoming vitamin K deficient.
  • Without the injection, they are at risk of developing a condition called Vitamin K Deficiency Bleeding (known as VKDB).

What is vitamin K?

Vitamin K is an essential vitamin, and has an important role in maintaining good health by helping blood to clot. Vitamin K helps prevent serious bleeding.

Why is vitamin K important for my baby?

Vitamin K helps your baby’s blood clot and prevents serious bleeding. Babies do not get enough vitamin K naturally from their mother during pregnancy. Breast milk also does not provide babies with enough levels of vitamin K. This can result in vitamin K deficiency in newborns.

If your baby has vitamin K deficiency, they are at risk of developing a disease called Vitamin K Deficiency Bleeding, or VKDB. While VKDB is rare, it can be very serious as it can cause babies to bleed excessively and may cause them to bleed into their brain. This condition may result in brain damage and even death.

How is vitamin K given?

Vitamin K is usually given as a single injection in your baby’s leg muscle shortly after birth. If you prefer that your baby does not get an injection, they can have liquid vitamin K drops into their mouth. It is important to note that oral vitamin K drops are not absorbed as well by the body than injected vitamin K, so 3 doses of oral vitamin K are needed. The first dose is given at birth, the second at 3 to 5 days of age and the third when they are 4 weeks old.

Vitamin K injections are preferred over the oral drops for all babies. Some babies aren’t able to have oral vitamin K, such as if the mother was taking certain medications while pregnant, or if your baby is premature, unwell, taking antibiotics or has diarrhoea.

Can all babies have vitamin K?

Yes, all babies can have vitamin K. If your baby is premature or very small, they might need a smaller dose of vitamin K. You can discuss this with your doctor.

How much does vitamin K cost?

Vitamin K injections or drops are free. The cost is covered by the government for all babies born in Australia.

Does vitamin K have any side effects? What should I look out for?

Vitamin K in newborns is not associated with any side effects, and has been given to Australian babies for more than 30 years. Studies have investigated whether there is an association between injected vitamin K and childhood cancers. Doctors and scientists have concluded that vitamin K injections are safe and beneficial for babies, and that there is no link between vitamin K and childhood cancer.

If your baby has not had a vitamin K injection or the full 3-dose course of vitamin K oral drops it is important that you look out for:

  • unexplained bleeding or bruising
  • showing signs of jaundice after they are 3 weeks old

If they show any of these symptoms, see your doctor or midwife immediately.

If your baby has liver problems, they may be at a higher risk of bleeding, even if they have had their recommended dose of vitamin K.

Does my baby need to have vitamin K?

It is your choice whether to give your baby vitamin K or not. However, giving vitamin K to your newborn is an easy way to prevent a very serious disease. Health authorities in Australia and throughout the world recommend giving vitamin K to all newborn babies — even babies who were born prematurely or are sick.

How do I get vitamin K for my baby?

During your pregnancy your doctor or midwife will talk to you about vitamin K, including the pros and cons of giving your baby vitamin K by injection or by mouth. Your doctor or midwife will then note this on your file. Your baby will receive vitamin K soon after birth by a doctor or a midwife, based on your decision.

If you have chosen to give your baby vitamin K by mouth then your baby will need to receive 2 more doses after the dose they receive at birth. The second dose can be given in hospital at the same time as your baby has their newborn screening test, or by your local doctor or healthcare worker. It is important to remember to arrange your baby’s third dose when they are 4 weeks old. This important final dose can also be given by your doctor or health care worker.

If you are having a home birth, be sure to discuss giving your baby vitamin K with your midwife. Homebirth midwives are required to have all essential equipment available for a planned home birth, including vitamin K injections.

Sources:
Australian Government, National Health and Medical Research Council (Vitamin K for Newborn Babies), South Australian Neonatal Medication Guidelines (Vitamin K), NSW Health (Having a baby - Labour and birth), SA Health (Planned Birth at Home in SA. 2018 Clinical Directive), The Royal Women Hospital Australia (Tests and Medicines for Newborn Babies)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2022


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Need more information?

Vitamin K for newborns | NHMRC

Vitamin K helps blood to clot and is essential in preventing serious bleeding in infants. Vitamin K deficiency bleeding can be prevented by the administration of vitamin K soon after birth. By the age of approximately six months, infants have built up their own supply of vitamin K.