Care in the first hours includes: . . .

* administering vitamin K to the baby if country policy prescribes it, either by injection or orally. However, the evidence for routine administration of vitamin K to all newborns to prevent the relatively rare haemorrhagic disease of the newborn is still lacking.

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Another Long Vitamin K Treatise

‘Fact’ 1: All babies are born with low levels of vitamin K.

‘Low’ in relation to whom? If all babies have low levels, then who has the ‘normal’ levels against which this is measured? Well, believe it or not, only adults are perceived by the medical profession to have normal levels of vitamin K. Yet there is a big gap between noticing that babies have relatively lower levels than adults and deeming this a pathological condition which needs routine treatment.

Babies also have large heads relative to adults, but this is not perceived as pathological. This is deemed a good thing, because the human brain needs to be large at birth. Why is the fact that relative vitamin K levels differ between newborn and adult perceived as pathological?

Philosophically, the question is raised that, if all babies have what is perceived as a ‘low’ level of vitamin K, then in reality this must be the ‘normal level’ of vitamin K for babies to have. Even if proponents of vitamin K think that this is ‘too low’ a level for some reason, they should say this, rather than telling women their baby is deficient in an essential substance. Otherwise, this just reinforces the idea that women are relatively inefficient at making babies and need to be supplemented by the skills and technology of hospitals and doctors.
‘Fact’ 2: Babies need vitamin K to prevent late-onset haemorrhagic disease, which can cause serious complications.

There is no doubt that some babies suffer from late-onset haemorrhagic disease (HDN), and there is also no doubt that this can be dangerous for some babies. But does this mean that all babies should be given vitamin K? The risk of a baby who is not given vitamin K developing HDN is between 1 in 10,000 and 1 in 25,000 (Von Kries and Hanawa 1993). We also know that the babies most at risk from HDN are those who have traumatic births (clinically, this might include babies who are delivered by forceps, ventouse or emergency caesarean section, or babies who show bruising).

Babies who are born physiologically, or without undue trauma, are at the very lowest risk of developing HDN. Of course, there are never any guarantees either way; there is still a risk that a baby who is born physiologically will develop HDN, just as there is a risk that a baby given vitamin K may still develop HDN, or suffer from other side effects.

For example, the risk of healthy babies developing cancer as a result of being given vitamin K may be higher than the risk of developing HDN without (Parker et al 1998, Passmore et al 1998). Anecdotal evidence suggests that babies given vitamin K may be more at risk from jaundice, which may lead to the need for interventions. Unfortunately, we need much more research evidence in order to assess these relative risks and offer women statistics concerning every aspect of this decision (Slattery 1994, Wickham 2000).

Von Kries (1998) points out that some of the babies who are diagnosed as having HDN caused by vitamin K deficiency actually have HDN caused by underlying cholestatic disease (where there is a stoppage or suppression of bile flow). Even if giving vitamin K to these babies could prevent the development of HDN, we should not be saying that they have HDN because they were not given vitamin K.

This just confuses and confounds the issue and is a bit like saying that someone who was hit on the head by a block of wood has a headache because they weren’t given an aspirin. The idea of giving vitamin K to all babies may then be akin to the suggestion that we should all take an aspirin before going outside just in case we are hit on the head by a block of wood.

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What are the risks/benefits to letting your baby have a shot of vitamin K after birth?

Today there are many reasons to de-dramatize the topic and to reassure at the same time the parents who are inclined to refuse the shot and also those who prefer to do it.

To the parents who refuse the injection, we can say that they don’t take a great risk, since the chances of their breastfed baby having a hemorrhagic disease related to vitamin K deficiency is in the region of one in 15,000. It is even probable that the risks are still lower if the birth and the initiation of lactation were undisturbed. My view is that vitamin K deficiency of breastfed babies is probably no more physiological

I would do more research and weigh the pros and the cons of having this shot for yourself, but that is the gist of why it is given.