Vitamin K injection

[Ame80]

Hi I've been for my 34 weeks midwife appointment so been through the Labour information pack. I'm just wondering what people thoughts on the Vitamin K injection at birth is?
Will you be opting for your baby to have it or not?
Thanks Aimee x

There's a tiny risk of infection (and even tinier risk of bleeding and muscle trauma) with any injection given to anybody. Some people may wish for their baby to not have an injection.

Like I said I would (and have) give my baby vitamin k but would prefer it orally.

I'm not saying there is anything wrong with vitamin k, just that parents should be aware of what it is, how it can be given and why it's recommended.

I think there's evidence that oral doses aren't as effective. In addition to that apparently they taste horrible.

It tastes really horrible and it is oil, so it coats the inside of the mouth.

My baby had tongue tie that needed cutting shortly after birth. The practitioner told us they wouldn't have cut it if baby hadn't had vitamin k at birth.

We went for drops then forgot to give them. So the injection!

@Alyosha My DC seemed to enjoy them He was pulled off midway through his first feed, drops dumped into mouth and back on to continue feeding. Seemed to quite enjoy the second dose too.

However he also enjoyed his rotavirus drops and was looking for more, so not the best taste I guess.

There is very little evidence surrounding it. All we know is that babies are born with low levels of vitamin k and there is virtually none in breast milk. Which to me suggests that physiologically there must be a reason for this?!

By 'reason' it sounds like you mean good reason? But that's not necessarily the case. We've not finished evolving yet. The reason might simply be that it's not something that kills enough of us off to make a difference, rather than because there's any inherent benefit in the low level itself. Whereas we do know for sure that administration of vitamin K can prevent an (admittedly tiny) number of deaths.

(Apologies if this isn't what you meant).

It's a good point about breastmilk though. OP are you thinking of breastfeeding? Because there's more Vitamin K in formula than breastmilk, though not enough to replicate the amount given in the injection.

These threads make me despair and wish there was an obligation for all adults to be scientifically literate and have critical thinking skills.

to respond to some points:

It basically says unless you had a traumatic / assisted birth, the risk of haemorrhage disease is tiny.
This is completely wrong. The possible incidence of the disease is fortunately low, but the consequence of it does occur is absolutely catastrophic - death or extremely serious injury of your newborn baby. Risk involves both incidence AND consequence.

What idiot pretending to be a medical professional said to weigh it up against side effects? As if these were any way equivalent?? Any evidence of the rates of infection from a sterile injection? Any evidence to suggest this is in any way comparable to the risk of painful death of your newborn, bleeding to death uncontrollably?

And as for whoever said it is natural to be born with low vitamin K, therefore it must be good. Please remember that what is deeply unnatural is our 21st century expectation for every mother and every baby to survive the birth and newborn period. Nature certainly never allowed this to happen. It is only because we do things like vitamin k, anti-d shots, etc. Natural is babies dying in their droves during and shortly after birth. Why on earth would we want "natural"?

OP. Please don't be fooled by these anti-vaccine false equivalences. "There are two sides to every story etc". Vitamin k is lifesaving. Every baby when born has at least one open wound at the umbilical cord, so it's false to say low-intervention birth = no risk. The side effects are minimal and extremely rare. The consequence of not getting it does not bear thinking about. The drops even when administered correctly (which they often are not) do not have as strong a protective effect. The injection is a safe, effective way to protect your baby's life.

Massive post partum haemorrhage is natural, obstructed labour is natural.
I suppose we could just go back to having no interventions for those.

We could stop checking blood groups and giving antiD to rhesus negative mothers carrying positive fetuses. That would be natural too.

Ahh my post has been completely misinterpreted, I think I worded it wrong. What I meant by it was that when explaining why it's recommended for babies to have it it needs to be explained why they need it as they have very little levels of it at birth. And in breastmilk.

My mum developed sepsis (thankfully it was diagnosed very early on and she recovered very well) and that was from an infection in an injection site. Like I said it is extremely rare but that would be why I would give my baby the oral dose (and did give my daughter the oral dose).

I did not mean to imply that babies shouldnt have vitamin k, just that for full information parents should know why we recommend it as HCPs. I have re read my original post though and understand i didn't word it very well, apologies.

That's all very well and good but the risks of the Vit K injection (potential sepsis infection?!!) are much lower than many things...like breastfeeding (breastfed infants are orders of magnitude more likely to be readmitted to hospital), formula feeding (slightly higher risk of infection), practically any other decision a parent might take, it's just a really odd thing in the realms of maternity decision making to focus on.

Aloysha, I fully agree with you apart from saying it is odd. It is not odd, it is a very deliberate anti-vaccine / anti-medicine / conspiracy theory strategy to muddy the waters and create doubt and fear. The poster has strongly implied she is a healthcare professional (presumably a midwife since she is so full of woo), then raises serious side effects that are so rare as to possibly never have existed beyond theoretical - any evidence at all of a single septic infection traced to vitamin k in a newborn? I have searched and not found any.

It's insidious and dangerous, but it is so common online that sadly I no longer find it odd.

Op I hope you get the injection for your baby. Please speak to your doctor with any questions.

Babies don't receive a lot of vitamin K across the placenta and it is not well expressed in breastmilk - regardless of the mother's diet or vitamin K levels. Formula fed babies receive some oral vitamin K fortification but this is still much less protective than the IM injection.

Vitamin K is a resource that the body (the liver) can store and uses to make clotting factors when necessary. So a single high dose around birth gives the baby enough stores to continue producing clotting factors as needed. Any "excess" of vitamin K will remain in storage - it doesn't cause excessive clotting as some people might imagine it does.

Around 1:10,000 "normal" babies not given supplemental vitamin K will die or be irreversibly disabled by vitamin K deficiency bleeding, which can start spontaneously and unpredictably at days, weeks or even months of age - and many more will have less serious bleeding (that is still very worrying for parents and may need blood transfusion and high doses of vitamin k).

Whilst having a certain type of delivery can increase the chances of early bleeding, the mode of delivery is irrelevant to late onset deficiency bleeding. We are not able to predict which babies will be affected (short of regularly checking all babies clotting function which would be more invasive than vitamin k injection).

It is really difficult in the circumstances of a baby's serious injury or death to come to terms with the baby and family's suffering being completely preventable in most cases. There are almost no cases of haemorrhagic disease of the newborn in babies protected with IM vitamin K. Oral vitamin K is better than nothing, but there is incomplete data on how well absorbed it is (many babies drool or vomit the stuff it seems!) and many busy parents will struggle to complete the full oral schedule. Babies treated with the oral vitamin K are still around 10x more likely to have deficiency bleeding than those treated with the IM injection.

Downsides - while some babies don't seem to mind the injection, most will cry for a short while in my experience. Most babies also cry just as vigorously after they are born, after they vomit, when their nappies are changed... Of course we cannot know what babies subjective experiences are but I do not personally believe the injection is more traumatic than many of the "natural" uncomfortable indignities that newborn babies go through.

Many parents were understandably concerned about a possible link with leukaemia and the IM injection. There has since been further research into this area with no clear evidence of a relationship. If I had to choose between leukaemia and haemorrhagic Vitamin K deficiency bleeding for my child (what an awful thought!) I would choose leukaemia. Children generally survive leukaemia. The risk of leukaemia for me would have to be at least equal to that of death by haemorrhage for Vitamin K not to be worth it. As it, I think that any hypothetical risk of leukaemia is certainly much lower than that of deficiency bleeding.

I am a (pregnant!) junior paediatrician and I spend a lot of time chatting to parents about Vitamin K when they refuse it on the postnatal ward. I hope that I have never bullied a parent and I don't talk about the horror stories (new parents are frightened enough!) but I have seen 1 case of a previously healthy baby die of preventable Vitamin K deficiency bleeding and it is not a devastation I can forget. I would certainly give the IM vitamin K injection to my baby. I don't think most midwives encourage parents enough to have the IM injection or emphasise it is more effective than the oral drops.

It can be difficult to make the decision straight after giving birth! If you have given nothing or given some oral drops but "change your mind" and want the IM injection it's not too late whether the baby is hours or days or weeks old. Insist! Though it will probably be much more difficult to arrange the injection the more time passes.

Ps we give the IM injection to tiny 23 weekers with translucent skin and virtually no immune system. Just as soon as we can after they're born. In fact almost every baby admitted to a neonatal unit will be given IM vitamin K. In my experience I have never known of a single case of significant skin damage or infection. Though it must be possible, I would imagine it is rarer than vitamin K deficiency bleeding, and certainly more treatable and with less severe consequences.