A 2-week-old term baby born after a healthy pregnancy and uncomplicated delivery should have been sleeping in the comfort of her home. Instead, her high-pitched cries filled the intensive care unit.
Instead of wearing cute hats, her small head was covered in wires to capture seizures. She had IVs placed into her tiny hands to give medications and a yellow feeding tube in her nose because she could not make coordinated mouth movements to feed.
As she screamed inconsolably in pain from brain swelling due to a brain bleed caused by vitamin K deficiency, all I could think was, “This was preventable.”
A single vitamin K shot could have saved her from this agony.
While learning about vitamin K deficiency bleeding in medical school, I never imagined I would be caring for babies with this complication because it is easily preventable. So, it was a rude awakening for me as a pediatrician to face such high rates of parental refusal for the vitamin K shot fueled by misinformation.
I have heard various misguided reasons for refusal, including that vitamin K is a vaccine; it causes cancer; and only babies with difficult births need it.
Firstly, the vitamin K shot is not a vaccine. It is a supplement in the form of a shot instead of a Flintstone gummy. Vitamin K is a fat-soluble vitamin and a vital ingredient for our bodies to make clotting proteins without which our risk for bleeding increases exponentially.
Our two main sources of vitamin K are our diet and the bacteria in our gut. Babies have immature gut bacteria, and they cannot get vitamin K from their diets until around 6 months of age, when they can start eating solids. So, all babies have vitamin K deficiency. Unfortunately, Vitamin K does not pass well through the placenta, and breast milk is a poor source of it despite moms eating foods and supplements rich in vitamin K. Oral vitamin K for newborns is also not a good option since it must be given daily for three months without skipping doses. Moreover, there is no FDA approved oral vitamin K for babies in the United States. Consequently, without the vitamin K shot, all babies, not just ones with difficult births, are in grave danger of having spontaneous bleeds with outcomes similar to hemorrhagic strokes, for the first 6 months of life.
Parents’ concern regarding pain from the shot is understandable. However, it is short lived compared to pain from other procedures such as circumcisions which requires a local anesthetic. Moreover, pain at the injection site from the shot can be a valuable side effect because it makes babies cry which helps them clear fluid from their lungs after birth.
Additionally, the black box warning for severe allergic reactions is usually associated with vitamin K given rapidly through an IV and is very rare with the intramuscular injection.
Furthermore, multiple studies show no link between the vitamin K shot and childhood cancers. The current formulation and dose does not cause jaundice, either research shows.
Another common reason parents cite is waiting for the body’s natural vitamin K surge on day 8 of life. Historically, circumcisions were done around this time, which highlights the importance of vitamin K in preventing bleeding. However, without supplementation this natural surge is not enough to prevent bleeding since there are different stages of vitamin K deficiency bleeding that can happen spontaneously at any time before and after day 8. So, it is not advisable to solely rely on this and forgo the shot.
Childhood mortality was high at 30-40% at the turn of the century, but advances in medicine and public health like the vitamin K shot have significantly lowered that rate. So, whenever I hear a baby did not get vitamin K, my heart drops because I think about the little girl whose life was forever changed due to a preventable condition — and I worry about the babies who could be next.
I empathize with parents who are bombarded with a firehose of information making it difficult to know what to believe.
To those parents-to-be, we as doctors are on your team and want the best for your child. I implore you to talk about vitamin K with your OBGYN, pediatrician and midwife before your child’s birth and make medically sound decisions.
If your initial choice was to forgo the shot, I urge you to be open-minded and willing to change your perspectives and support others in your life to do the same. Choose to give the vitamin K shot, because we owe it to our children to give them their best shot at life.
(Sarmishta Kannan) Dr. Sarmishta Kannan, M.D., is pediatrician in Salt Lake City.
Dr. Sarmishta Kannan, M.D., is pediatrician in Salt Lake City with an interest in pediatric emergency medicine, public health, advocacy and medical education.
The Salt Lake Tribune is committed to creating a space where Utahns can share ideas, perspectives and solutions that move our state forward. We rely on your insight to do this. Find out how to share your opinion here, and email us at voices@sltrib.com.