Vitamin K Supplementation for Newborns

What is vitamin K?

Vitamin K has many roles but, most importantly, it is vital for blood clotting. Babies are born with low vitamin K, which is beneficial to minimize clotting before and during birth. Even with the expected low levels, healthy babies can still clot and are not at risk for excessive bleeding under normal circumstances. Without any supplementation, a baby will have adequate levels of vitamin by three months. According to the American Academy of Pediatrics, 4-7 in 100,000 newborns have a condition called vitamin K Deficiency Bleeding (VKDB). VKDB is an abnormal condition in which a newborn is deficient in vitamin K to the point that they are unable to prevent excessive bleeding. Even without injury, a baby with VKDB could bleed to the point of death. Bleeding may be internal, hard to detect, and even healthy babies born without VKDB may develop VKDB before three months of age.

Although the chances of your baby having VKDB are very low, the consequences of it going undetected can be devastating. Diagnosing VKDB before an incident of bleeding is very unlikely, therefore administering vitamin K to the newborn can eliminate VKDB. The babies of mothers who have or have a family history of cystic fibrosis, celiac disease or other intestinal malabsorption disorder, liver or bile disease, use recreational drugs, on antibiotics or Coumadin are at higher risk for VKDB. Breastfeeding alone does not provide enough vitamin K to protect against VKDB.

Vitamin K via injection:

The medical standard, most effective, and reliable method of preventing VKDB is administering a mixture of vitamin K concentrate in an alcohol-based solution by intramuscular injection (a shot) within the first two hours of birth. This injection would need to be administered at least 24 hours prior to any surgical procedure. Most pediatricians strongly suggest/require vitamin K, so you should speak to your baby's pediatrician for their medical expertise in this matter.

Risks of not administering vitamin K include but are not limited to: possible tissue damage; organ failure; death due to hemorrhage.

Risks of administering intramuscular vitamin K include but are not limited to: possible pain at injection site; small chance of infection at the injection site; hypersensitivity (rare). There is no known risks of overdose and no verifiable evidence to suggest that Vitamin K increases risks for cancer.

Alternative methods of Vitamin K:

Alternative methods require diligence to be effective. Combining these methods increases the likelihood of preventing VKDB (i.e. supplementing vitamin K for both the mother and baby)

Oral supplementation for newborn: 3 doses of 2 mg vitamin K by mouth; first dose at birth, second dose between 3-7 days. and last dose between weeks 5-6. The actual amount of vitamin K swallowed (and not spit up) can vary, therefore it is highly recommended that this method be performed in conjunction with other methods. Some providers do not provide oral Vitamin K, therefore, if this is your preference, please discuss with your doctor or pediatrician to obtain Vitamin K prior to birth.

Dietary intake for mother: If mother is breastfeeding it is recommended she ingest at least 2 mg of vitamin K daily until the baby is three months old. Foods with high Vitamin K: herbs, dark leafy greens, spring onions, brussels sprouts, broccoli, asparagus, cabbage, cucumber and prunes. The average diet only contains 50 micrograms of Vitamin K, so it is suggested to keep track of dietary intake of vitamin K for this method to be effective. Absorption of vitamin K can vary greatly from person to person and by method of preparation (ex; steamed vegetables versus sautéed.)

Oral supplementation for mother: supplement with at least 5 mg of vitamin K daily until the baby is three months old.

Formula: If breastfeeding is not an option, formula feeding exclusively with vitamin K fortified formula will provide adequate vitamin K to prevent VKDB. This is not recommended over breastfeeding, because breastmilk has many more benefits for your baby than formula.

Clarissa Gonzales

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