Between February and September 2013, health officials in Tennessee noted a bizarre phenomenon: In that relatively short time period, four infants between ages 6 and 15 weeks were diagnosed with vitamin K deficient bleeding, or VKDB, a rare bleeding disorder caused by insufficient amounts of vitamin K, which is essential to proper blood clotting.
The disorder can lead to significant, potentially devastating internal bleeding, including in the brain, as sadly happened with three of the infants. The fourth infant had gastrointestinal bleeding.
Why would four previously healthy newborns suddenly develop a rare and serious bleeding disorder? As it turned out, the babies had something very important in common:Their parents had purposefully refused the vitamin K shot that is recommended for all newborn infants prior to discharge from the hospital.The shot is recommended—and has been standard practice since 1961—because, while adults and older children absorb sufficient levels of vitamin K from their food, newborns receive only a very small amount in utero. Infants need this shot to ensure that their blood will be able to clot; without it, they are at an increased risk of bleeding.
One out of five infants who develop VKDB will die from it, according to the CDC. Unfortunately, the decision to refuse the vitamin K shot is becoming more common, and this means more infants are at risk of developing this serious condition.
Myths about the vitamin K shot
Why are some parents refusing the vitamin K shot for their infants? Well, like parents who refuse to vaccinate their children against measles and other infectious diseases, parents who refuse the vitamin K shot are usually basing their decision on misinformation. Often this information is spread via the Internet and propounded by the same small factions of people that urge parents to avoid or delay childhood vaccines. The rumors surrounding the vitamin K shot, like anti-vaccine rumors, are not based in science or medicine but are the result of fear-mongering.
For instance, one myth is that a preservative in the vitamin K shot can cause childhood leukemia. Scientific studies, however, disprove this theory and the American Academy of Pediatrics, after reviewing various studies on this issue, has concluded that there is “no association between the intramuscular administration of vitamin K and childhood leukemia or other cancers.”And, contrary to some reports online, there are no “toxic” or otherwise unsafe ingredients in the routine vitamin K shot.
Another myth is that the vitamin K injection is unnecessary.Some parents believe that an infant will be sufficiently protected if the mother eats plenty of vitamin K prior to delivery and continues to do so while exclusively breastfeeding. The fact is, a mother simply cannot pass sufficient levels of vitamin K to her infant through breastfeeding, even if she eats kale (one of the richest food sources of the vitamin) until she turns a deep leafy green. And while vitamin K does pass through the placenta to the infant, again the amount passed is insufficient to protect the baby.
Other parents believe that they can protect their infant by giving an oral vitamin K drop, and there are some unscrupulous people who sell these drops online. But the drops are a poor substitute for the intramuscular vitamin K injection, for several reasons. Unlike with the injection, there is no standard regimen or formula for oral vitamin K, so parents using it can’t be assured that their child will be protected adequately, if at all. In addition,the absorption of vitamin K is much less reliable from an oral liquid than from the injection; that is, just because the baby swallows it doesn’t guarantee they’re getting the full amount of the vitamin. And moreover, whereas the injection is a one-time, single dose, oral vitamin K must be administered repeatedly over a course of weeks.
Putting discomfort in perspective
One legitimate worry some parents have is that the injection of Vitamin K will be painful for their infant. Many providers will allow the injection to occur while the baby is nursing or being held, which can help ease concerns about the child’s comfort. And the fact is, the pain of a tiny needle stick is nothing compared with the potentially devastating effects of a brain bleed.Three of the four Tennessee babies with VKDB are being followed by neurologists for long-term complications. One baby has an apparent gross motor deficit, according to a report from the CDC, which assisted the Tennessee Department of Health in investigating the VKDB cases.
Bottom line: The vitamin K shot is safe, effective, and necessary—no less essential than a car seat and diapers. Parents of newborns shouldn’t leave the hospital without it.