In the United States, the practice of newborn vitamin k injections has become almost universal. However, this routine newborn procedure is controversial in other nations. It originated during the hospital age of routine separation of mothers from their babies, before rooming-in was an accepted practice.
The rationale for newborn vitamin K injection at birth is that newborns are born with a "deficiency" of vitamin K. This perceived deficiency is based upon a comparison of newborn levels to normal adult values. Low levels of vitamin k can lead to decreased clotting ability of the blood, that can leave the newborn more susceptible to hemorrhage. The risk is quite small, only about 1 in 200, but it does exist. The following factors increase risk of hemorrhage in newborns:
While newborn vitamin K injection may sound like an acceptable intervention, there are several points to ponder, foremost of which is that all infants are born with a low level of vitamin k. Thus, it raises the question of whether the low newborn concentration of vitamin k should in fact be termed a deficiency. Additional concerns include:
1. Minimize interventions and the use of pain medications to reduce the risk of intercranial bleeding.
Interventions such as epidural anethesia, iv narcotics, internal fetal monitoring, induction, and operative delivery including forceps and vacuum extraction (ventouse) put the baby at greater risk of developing bruising and intercranial hemorrhage during or shortly after birth. Planning a low intervention birth limits risks to the baby and mother by reducing risks associated with these interventions.
1. Consider requesting an oral dose rather than an injection.
This eliminates the overdose and lessens the risk of hemorrhage and jaundice, as well as the pain of the injection and exposure to harmful preservatives. Also, the Vit K is absorbed through the gut, as it was intended to be. While this may seem like an easy solution, be sure to discuss this option first with your care provider. Since hospitals are accustomed to standard operating procedure, it can be difficult for them to correctly determine the oral dosage for your infant.
Some hospital pharmacies may not stock oral Vitamin K. In this situation, you may wish to refuse the injection and administer the oral dose yourself. Oral vitamin K can be purchased online here and this is an oral dosing protocol you may wish to follow.
2. Nurse immediately after the birth with no supplementation given.
3. During the last few weeks of pregnancy, load your diet with foods rich in Vit K.
While this hasn't been shown to improve newborn vitamin K levels, it has been shown to increase the amount of Vit K in breastmilk.
By following these simple solutions, you can receive the benefits of an accurate newborn vitamin K dose while avoiding all the negatives of an injection.
Page Last Modified by Catherine Beier, MS, CBE
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