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Vitamin K for Newborns

by Lauren Feder, M.D.

What are my options regarding a vitamin K shot? I don't feel comfortable giving my newborn an injection at such an early age.

Newborns are routinely given vitamin K at the time of birth. Babies normally have low levels of vitamin K until they are able to manufacture it in their systems. Vitamin K is one of the blood clotting factors which is produced by normal intestinal bacteria. On rare occasions, this transitory condition can lead to bleeding in approximately 1/10,000 babies. For preventive measures, newborns have been receiving Vitamin K routinely since the 1960s. Traditionally vitamin K has been given as a shot. However, studies show that vitamin K given orally is just as effective in healthy infants.

Infants who are born prematurely, delivered with complications such as forceps, or those who have liver conditions are at higher risk from bleeding. Also babies whose mothers took epilepsy medication during pregnancy. Vitamin K deficiency can result in early bleeding in the first week of life (0.4%-1.7% of newborns) or 2-12 weeks of age in almost exclusively breast fed infants.(reports vary from 4.4 to 10.5 in every 100,000 births) This is due to the fact that mother's milk is low in vitamin K (baby formula contains vitamin K). However, substances in breast milk help baby build up enough normal digestive bacteria which are needed to produce vitamin K. Formula fed babies take longer to build up the necessary bacteria because of its processed nature.

In the early 1990s several medical papers were published that investigated a link between the vitamin K injection and childhood leukemia. It has been suggested that vitamin K or one of the constituents, may increase the risk of childhood cancer. As a result of this finding, many studies have been done. Most studies have not shown a significant association between vitamin K injections and cancer. However, one study concluded that they have not been able to exclude the possibility that vitamin K increases the risk of childhood cancer by up to 10%. Several case studies have found asignificant increase in the incidence of acute lymphoblastic leukemia within one to six years after birth.

Some mothers supplement their diet with foods high in vitamin K prior to childbirth and in the postpartum period, although there is no research to support this. Spinach, broccoli, brussel sprouts, cauliflower, and watercress contain large amounts of vitamin K. Most of my patients breastfeed their babies exclusively. Many prefer oral vitamin K rather than the injection. Since oral vitamin K has benefits without any obvious side effects this would be the treatment of choice. Although most pediatricians administer one dose of oral vitamin K, some clinicians advocate giving breastfed infants three doses of oral vitamin K during the following intervals: first week, between week 2 to 3 and at 28 days.

Summary of Vitamin K

Newborns have low levels of vitamin K, which can lead to bleeding on rare occasions.
Routine use of Vitamin K, either by injection or oral is recommended by most doctors.
Controversial link between vitamin K injection and childhood leukemia.
Vitamin K given orally is just as effective in healthy infants.

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