why do they give babies vitamin k
When your baby was born, if they were born in a hospital, they wereásubjected to what we euphemistically call Ánewborn procedures. Á Theyáwere weighed. Theyáwere measured. They took theiráfingertip pulse and checked theiráheartbeat. Then erythromycin ointment was squirted into theiráeyes to deter infection. Theyáwere given theiráfirst hepatitis B shot. And finally, theyáwere given a shot of vitamin K. recommended by the American Academy of Pediatrics in 1961. This was after a definitiveástudy showed, that infants given 0. 5 mg of vitamin K Á either orally or by injection Á had 5 times less risk of suffering bleeding during the first week of life. Out of 100,000 newborns, researchers estimated, the introduction of prophylactic vitamin K would save the lives of 160 infants. ThatÁs a heck of a lot of lives saved with one vitamin dose. But why vitamin K? tells us that vitamin K is necessary for clotting, and is actually named after the German word k. The blood-clotting factors necessary are there at birth, but without sufficient vitamin K, they canÁt be activated. As levels drop lower and lower, the blood loses the ability to clot entirely, and people can start to bleed spontaneously. Babies are born with very low stores of vitamin K because it doesnÁt cross the placenta well, and thereÁs very little available in. In fact, humans donÁt store it all too well in general. Therefore, the medical community agrees that
newborns have low stores of vitamin K. They need it from another source Á the shot, without which babies are 81 times more likely to develop severe bleeding, says the CDC. Giving vitamin K to all newborns prevents this from happening.
ItÁs usually given as an injection; however, it can also be administered as a three-series dose in the first month of life. BritainÁs notes that the shot likely confers greater protection; the dose is stored in the muscle and keeps levels higher for longer. Parents also often forget to give the subsequent two oral doses, so the baby isnÁt given full protection. And science backs it up: says that when three oral doses of vitamin K are given, 1. 4 to 6. 4 infants out of 100,000 will develop late vitamin K deficiency bleeding (VKDB). With the shot, only 0 to 0. 62 infants out of 100,000 will suffer from VKDB. Late VKDB is the most dangerous kind. deliniates three different presentations of VKDB. The first, early onset VKDB, happens in the first 24 hours and usually only occurs when the mother is taking medication that interferes with vitamin K (certain blood thinners or seizure meds). Classical VKDB happens from day 2Á7, usually 2Á3. Vitamin K stores are lowest at this point, and nursing and poor feeding are seen as risk factors for this presentation. Late stage VKDB usually occurs during weeks 3Á8 Á though it can happen as late as 24 weeks. Unfortunately, bleeding in the brain is usually this presentationÁs first sign. It happens to babies who are exclusively breastfed and did not get a vitamin K shot. How dangerous is late VKDB? Very, shows. More than half of infants who develop it will have bleeding on the brain, and 20% will not survive. 40% of infants with VKDB may suffer long term brain damage. ItÁs almost impossible to tell if a baby is having a brain bleed, and parents can remain oblivious for a long time before realizing something is wrong, during which the bleeding can do catastrophic damage.
In late 2013 and early 2014, seven infants between the ages of 7 and 20 weeks were diagnosed with VKDB in Nashville alone. Each childÁs parents had refused the vitamin K shot. Though all the children survived, itÁs not known to what extent they will suffer intellectual disabilities, according to. Their treatment? A vitamin K shot. claims the shot is dangerous for several reasons. It causes pain right after birth, inflicting Ápsycho-emotional damage and trauma toá a newborn. Á He also says itÁs crammed full á of dangerous preservatives, and the dosage of vitamin K is much higher than needed. , on the other hand, assures parents that the shot is safe. The amount of preservatives in it is very, very small, and well tolerated even by preterm infants. Moreover, the amount of the vitamin is only high when compared to the daily dosage of vitamin K. Because babies have no reserve of the vitamin, itÁs stored in the liver, where itÁs released and used for clotting over a period of several months. My family refused many of the standard newborn procedures. None of my babies had eye drops. None of my babies were given a hepatitis B shot. But every single one of my children was given a shot of vitamin K. When I read about the risks, I decided it just wasnÁt worth it. I didnÁt want my kids to suffer from brain bleeds, or worse, die from them. The shot was worth it to us. And itÁs been worth it to parents since the AAP recommendation in 1961. á Vitamin K deficiency bleeding recently made the news whená á All parents had declined vitamin K, and their infants were reported to be developing normally until sudden bleeding occurred between 6 and 15 weeks. á During my first year as a pediatric resident, I had the opportunity to work in the. á It was fun and incredibly fulfilling to be the first medical provider for brand new babies and their parents.
It was also an excellent time to review many of the current practices surrounding newborn care, including the routine vitamin K shot. I was asked to review what we know about vitamin K shots versus oral vitamin K and to share what I learned. Why does my baby require vitamin K? All babies are born with low levels of vitamin K, an important factor in helping a babyÁs blood clot. We give all healthy newborns a vitamin K shot shortly after delivery to prevent a type of bleedingá called Vitamin K deficiency bleeding (VKDB), formally known as hemorrhagic disease of the newborn. VKDB can range from bruising of the skin to bleeding inside the babyÁs brain,á and can occur from birth to months later. Fortunately, thereÁs a simple and effective solution that has been recommended by the American Academy of Pediatrics since 1961 Á a vitamin K shot at birth. A shot versus oral medication? In multiple scientific studies, the vitamin K shot has proved effective in preventing both early and late forms of bleeding. We administer vitamin K via injection because we donÁt know enough about oral vitamin K to recommend its routine use. Several countries have studied oral use, and early evidence shows a one-time oral dose to be less effective than the shot in preventing bleeding.
That said, there are several ongoing international scientific studies evaluating the effectiveness of various oral vitamin K treatmentsá given over several weeks. Many of these studies show that oral vitamin K may protect against Vitamin K deficiency bleeding, but not as effectively as giving the shot. Additionally, the vitamin K oral formulations in the international studies are different than oral formulations available in the United States. Therefore, it is difficult to say if the United States would have similar results. Unregulated vitamin K supplements not recommendedÁÅ We do not recommend giving your baby vitamin K from a source not approved by the FDA. The FDA does not regulate vitamin supplements purchased over the counter and there is no way to tell if the dose is too little or too much. In summary, we recommend the vitamin K shot to prevent Vitamin K deficiency bleeding, because we know it is effective. Right now, even with international studiesá on oral vitamin K,á we just donÁt know enough to recommend its use. We encourageá moms-to-be to talk to their provider and their babyÁs provider before delivery about vitamin K. They can provide more resources. This post originally was written by Dr. Carrie Phillipi and updated by Dr. Allison Empey. Allison Empey, M. D. Associate Professor of Pediatrics,á OHSU Doernbecher ChildrenÁs Hospital Director, OHSU Mother-Baby Unit á To learn more about Vitamin K á Pediatrics, American Academy of Pediatrics. á National Center for Biotechnology Information, National Institutes of Health. á Cochrane Database of Systematic Reviews. Á,Á Centers for Disease Control and Prevention.
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