This is something that you may not know about - Vitamin K and newborn babies. It’s offered to all babies here in the UK and many places around the world. It’s a decision you’ll need to make soon after your baby is born - so a good idea to have done your research in pregnancy, so you can decide if vitamin K is right for your baby or not.

Some here’s the basics:

Vitamin K is offered to all newborn babies just after birth (it’s usually offered within the first hour - it’s one of the first decisions you’ll have to make, after delayed or optimal cord clamping).

So why does it get offered? Well it’s to prevent them getting a rare, but potentially fatal, blood clotting problem. We call this disorder ‘vitamin K deficiency bleeding’ or VKDB.

Vitamin K deficiency bleeding occurs in around 1 in 11,000 babies (source: Dr Sara Wickham). We have given vitamin K to millions of babies for many years because we know that it prevents almost all cases of VKDB.

What choices do I have? It’s up to you as parents to decide whether your baby has vitamin K given to them or not, and if they do how it’s administered (there are two options available - details on those below).

So this article is all about getting a bit more informed before you decide what's right for you as parents, and but it into your birth preferences / birth plan - so very important.

WHY DO we offer vitamin K ?

Vitamin K is offered to your baby as newborn babies natural level are low straight after birth, that we do know. Vitamin K helps blood to clot.

There are unfortunately many things that we don't know about vitamin K - including why babies are born with low vitamin K levels, and actually if being born with 'low' vitamin K actually is beneficial to them in some way. We need more research to find this out, sadly we don’t have the evidence we need.

So Vitamin K is offered as a prophylactic medicine - to prevent something happening (VKDB), which in itself is rare.

We know that without administering vitamin K to newborns, a small number of babies will develop a rare but serious blood clotting problem - vitamin K deficiency bleeding (VKDB). This used to be called haemorrhagic disease of the newborn (HDN)

Most babies who have VKDB will recover, especially if they receive treatment quickly. A small number of the babies who experience VKDB will experience long-term damage and, sometimes, a baby will die. But it is a potentially fatal condition. The actual chance of death from VKDB is very low, but if we administer vitamin K to all babies, it’s even less likely.

WHATS the evidence on vitamin K?

We do not unfortunately have a randomised controlled trial into vitamin K.

But this is the best we do do know:

~ Other studies (not randomised control trials), audits and long experience suggest that vitamin K is very effective at preventing VKDB when given by injection.

~ Oral drops of vitamin K are less effective than vitamin K given by injection.

~ Oral vitamin K is more effective than no vitamin K.

~ We do not have good data on exactly how effective oral vitamin K is.

are there any risks to giving vitamin k?

Compared to some drugs, vitamin K is considered very safe. But as with all drugs, of course there are potential risks you need to know about.

~ Vitamin K injection will occasionally result in infection at the injection site, also there can be bruising or bleeding just like any injection

~ the injection can cause pain to the baby when it is being given.

~ there have been (rare) cases of the wrong drug being injected

~ as the research into vitamin K is lacking, some people are concerned about other possible downsides to vitamin K and other possible side effects which we don’t yet fully understand

It can of course be hard to make a decision when so much is unknown. But you can only make decisions with the information you have at the time.

what increaces the chances of VKDB?

~ If your baby is breastfed and is slow to feed or has feeding problems, the chance of VKDB is higher.

~ If you or your baby have antibiotics, this can increase the chance of VKDB.

~ if your baby has a procedure such as a tongue tie division (frenotomy) or circumcision when bleeding will occur.

So you may opt to change your mind and take the offer of vitamin K, and you can do this even if you declined straight after birth.

WHAT choices do I have?

It’s your choice if your baby has vitamin K at all.

If you decide you’d like your baby to have vitamin K then it can be administered in two ways - but oral drops or an injection. Even if your hospital/birth centre/midwife has a ‘usual’ way they administer it BOTH options should be available to you.

If you choose to have the oral drops, they are usually given in several doses over the first few weeks of your baby’s life. One dose initially after birth, and then the other dose(s) following, usually by your GP here in the UK. The little research we have shows that the drops are not as effective as the injection, although we don’t have good quality evidence on this currently

Also to note that as Vitamin K is fat soluble for it to be properly absorbed by your baby’s body it should be given with or just after a feed. The oral drops taste bitter and often babies can try to spit it out - be ready to get it back into their mouth

If you decline vitamin K then it can be a good idea to read this article by Dr Sara Wickham to help minimise the risk to your baby

Once you decide it’s a good idea to write down your preference in your birth preferences / birth plan. Although of course you can change your mind in the moment if you want to.

MORE InFORMATION on vitamin k

It’s important to have all the information you need to make the right decisions for you and your family. Your oracle for up to date research on Vitamin K and newborn babies is the very excellent Dr Sara Wickham - you can read more about vitamin K here And she has also written a book Vitamin K and The Newborn too, which is really in depth.

I hope that’s helpful. Because my work really is to support pregnancy folk in having a more confident and less anxious pregnancy. For more support, practical techniques, ands of evidence-based information and up to date research do join one of my Hypnobirthing & Antenatal Courses

Susan x

K is for Vitamin K