Does Your Baby Really Need the Vitamin K Shot?
Megan Crawford
I have seen so much on social media lately about the Vitamin K for newborns. Some parents have been told it’s absolutely necessary. Others worry about sticking their brand-new baby with a needle, wonder what ingredients are actually in the injection, or ask whether oral vitamin K works just as well. And there is a LOT of conflicting information out there. So let’s clear some of the fog and look at what the evidence actually says.
The short answer: The American Academy of Pediatrics recommends that newborns receive an intramuscular vitamin K injection shortly after birth to prevent vitamin K deficiency bleeding (VKDB), a rare but potentially life-threatening bleeding disorder. The injection is more effective at preventing late VKDB than oral vitamin K.
(Learning about newborn procedures is only one part of preparing for birth. Our childbirth education classes help parents understand common newborn procedures, birth interventions, and their options before labor begins, as well as how to communicate to their medical team firmly yet politely to have their wishes respected. If you’re still deciding where to learn about these topics, I also broke down some differences between hospital and independent birth classes.)
What is in the Vitamin K shot for newborns?
So, the active ingredient of the Vitamin K shot is…brace yourself…vitamin k. The medical name for it is Phytonadione, but we call it Vitamin K1. This is a plant based form of Vitamin K that is fat soluble and can be found in leafy greens. It helps the body build blood-clotting factors.
There are a few inactive ingredients, too. Water, so that the solution can be a liquid. Dextrose (sugar), so that the isotopes are stable and balanced (this is the same sugar we eat every day). An emulsifier (fat soluble things don’t mix with water without one) and some preservatives to stop bacteria growing in the shot itself (though there are preservative free options). Sometimes there is an ingredient added to make sure that the injection is not too acidic (vinegar).
Why do we give the Vitamin K shot?
It has to do with blood clotting. Without sufficient blood clotting, babies can have devastating, sometimes fatal, bleeds.
Your baby is born with all of the clotting factors needed, right? So why do they need Vitamin K?
Vitamin K is the key to unlocking all of those clotting factors.
It’s having all of the information at your fingertips via the internet, but you still need the WiFi password.
It’s the grocery store having all the food you could ever need available to you, but you still need money to buy it.
Your baby has all of the clotting factors they need at birth, but they still need the Vitamin K to make them work.
Why aren’t they born with enough Vitamin K? You ate a ton of leafy greens during pregnancy, right? Unfortunately, Vitamin K doesn’t cross the placenta very well. We get Vitamin K from the beneficial bacteria in our gut, which is almost completely absent in newborns. Will they make their own Vitamin K? Yes, eventually. Around the six month mark.
Oral Vitamin K vs. the Vitamin K Shot - Isn’t the oral version just as good?
It’s viable. But you have to have a very strict regimen over a long period of time, and the chances of messing it up are higher. It doesn’t absorb in the body as well, either. It is less effective against the most serious type of bleeding - VKDB - which can cause brain bleeds and death. Oral Vitamin K must be given perfectly multiple times over months. The shot is a one time thing that works until Baby’s microbiome is mature enough.
Don’t get me wrong, the oral version is better than nothing! If you are dead set against the shot, please do the oral version. But if you are thinking the oral version is just as good, the research says otherwise.
Is it true that the Vitamin K shot has a black box warning?
Yep, but not for babies. The black box warning on the Vitamin K shot is for adults receiving a high dose, usually to reverse the effects of blood thinners. This is not anywhere close to what your newborn will receive. There has never been a documented case of a baby dying from the Vitamin K shot given at birth.
Can’t we just do delayed cord clamping?
I mean, you can. Certainly. And you should, if you want to. But it won’t affect your baby’s Vitamin K. Like I said, it does not pass well through the placenta. So your baby can keep receiving cord blood until it runs out, but it still won’t have enough Vitamin K in it.
But I’m exclusively breastfeeding. So my baby gets Vitamin K from me.
For sure. But breastmilk contains a very very low amount of Vitamin K. Not enough to keep baby safe from bleeds. As a matter of fact, the second biggest risk for Vitamin K deficiency bleeding is breastfeeding (the first being not receiving the shot). Formula fed babies fare better in this arena, since formula is fortified with vitamins, including K. This doesn’t mean formula fed babies don’t need the shot! Review the part about oral Vitamin K.
What are the risks of skipping the Vitamin K shot for newborns?
One of the things we discuss with birth clients is how to ask questions about routine newborn procedures before the baby arrives.
The AAP says babies who do not receive vitamin K are substantially more likely to suffer severe bleeding, with brain bleeding being a major concern; it notes that about one in five infants with a serious VKDB bleeding event may die. Babies who’s bleeds aren’t fatal may still have long lasting consequences like cognitive impairment, motor disabilities, and developmental delays.
In the US, when they started giving Vitamin K shots at birth, newborn brain bleeds disappeared. As a matter of fact, there was a time that refusing the shot could get CPS called on you for withholding a lifesaving prevention.
What are the risks of getting the shot?
Pretty much the same risks as any other shot - bruising, pain, redness or swelling where the injection goes, skin irritation. That’s about it. There was a single study in 1990 that suggested a link between the shot and childhood cancer, but decades of follow up research has debunked this claim. Claims of toxic additives and heavy metals are false. Serious allergic reactions are extremely rare - there’s only one on record ever.
Frequently Asked Questions about the Vitamin K shot for newborns
Is the Vitamin K shot a vaccine?
No. Vitamin K is a vitamin, not a vaccine.
When is the Vitamin K shot given?
In the US, the standard is within six hours of birth.
Is this just an American thing? Is it political?
The American Academy of Pediatrics (AAP) recommends giving vitamin K to newborns within six hours after birth. The Royal College of Paediatrcs and Child Health strongly recommends vitamin K prophylaxis for all newborn babies “shortly after birth”. The Royal Australasian College of Physicians (RACP) – Paediatrics & Child Health Division strongly supports the guidelines of the NHMRC and the RANZCOG that all newborn infants should receive vitamin K prophylaxis shortly after birth to prevent Vitamin K Deficiency Bleeding. The Canadian Paediatric Society (CPS) recommends that all newborns receive a single intramuscular vitamin K injection within the first six hours of life. The European Academy of Paediatrics (EAP) strongly recommends vitamin k prophylaxis for all newborn infants. The International Pediatric Association (IPA) aligns with global health authorities like the World Health Organization (WHO) and the American Academy of Pediatrics in recommending a routine intramuscular vitamin K injection for all newborns.
I have more questions. Where can I find more information?
CDC - Frequently Asked Questions About Vitamin K Deficiency Bleeding
Also look to the NIH, ACOG, and other reputable resources. Social media doesn’t count!
This article is intended for educational purposes and is not medical advice. Talk with your baby's pediatrician, midwife, or other qualified healthcare provider about vitamin K and newborn care decisions.
