Vitamin K at Birth- Why You Should Do This
For over 50 years, here in the US we have been giving newborns a shot of Vitamin K right at birth. I’ve been a busy pediatrician for over 25 years and have never seen a case of vitamin K deficiency bleeding (VKDB), so how do I justify promoting giving this shot?
First, realize this is just a vitamin and should thus be harmless and might be helpful. I’ve always thought that the reason I haven’t seen any problems is that 99% of my patients get the vitamin K shot at birth. I have a few who choose to do oral supplementation, but it is likely not as effective and in the US we don’t have any oral preparations of vitamin K for newborns.
A Tennessee hospital’s discharge data from 2007 to 2012 showed that there were about half a million live births in the state with no cases of VKDB. There were 4 cases of VKDB in Nashville, Tennessee, in 2013 which spurred the interest in studying this further. None of these 4 got the vitamin K shot. Three were born in hospitals and one in a birthing center. All were healthy and then developed dramatic bleeding between 6 and 15 weeks age. Three had diffuse intra-cranial hemorrhages and the fourth had gastrointestinal bleeding. All four survived, but only one recovered fully.
To my way of thinking, a harmless shot of vitamin K can prevent brain damage. It seems a worthwhile step to take. Without vitamin K prophylaxis, about 1% of infants develop early (first 24 hours) or classic (first week of life) VKDB. Late VKDB usually happens in less than 1 in 10,000 but is estimated to be 81 times more common in those who do not get the vitamin K shot at birth. The data of this study doesn’t follow the statistics, but it still makes me nervous for those who choose to skip this simple vitamin shot.
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