7 Vitamin K Myths Busted

7 Vitamin K Myths Busted

Social media has allowed the sharing of misinformation about many things, especially medically related things. When the specifics of something are unknown to a person, pretty much anything that’s said can sound reasonable, so people believe what they hear. This happens with many things, such as vaccine risks, chelation, and vitamin K. I want to tackle 7 Vitamin K Myths.

Refusing Vitamin K

I am especially frustrated when parents refuse to give their newborns vitamin K after birth. Since 1961, the American Academy of Pediatrics has recommended giving every newborn a single shot of vitamin K given at birth. This is a life saving treatment to prevent bleeding.

Life.

Saving.

Life saving.

Vitamin K works to help our blood clot. Insufficient levels can lead to bleeding in the brain or other vital organs. Vitamin K deficiency bleeding or VKDB, can occur any time in the first 6 months of life. There are three types of VKDB, based on the age of the baby when the bleeding problems start: early, classical and late. Unfortunately there are usually no warning signs that a baby will have significant bleeding, so when the bleeding happens, it’s too late to do anything about it. Why parents don’t want to give this preventative life saving treatment is usually based on incorrect information.

This is a matter of a fairly low risk of bleeding if you don’t give vitamin K: 250-1700 per 100,000 within the first week, and 4-7 per 100,000 between 2 and 12 weeks. You might notice that the number is variable – it’s hard to study since the large majority of babies have gotten vitamin K over the years and the risk is low even without vitamin K. However, when there is bleeding it has significant consequences: lifelong disability or death. And we also know that there’s very low risk from the vitamin K and it works very well to prevent bleeding. So why take the chance of not giving it?

Conspiracy Theories, Misunderstandings, and Science

This is not a governmental conspiracy to somehow kill children. It’s a world wide attempt to help children survive and thrive.

The World Health Organization (WHO) guidelines:

All newborns should be given 1 mg of vitamin K intramuscularly [IM] after birth [after the first hour during which the infant should be in skin-to-skin contact with the mother and breastfeeding should be initiated]. (Strong recommendation, moderate quality evidence)

Science is hard to understand

Most people look at scientific information and can’t make heads or tails of what it means.

Photo Source: Hemorrhagic Disease of the Newborn

That coupled with the fact that things we read that make us react emotionally (such as fear that something will harm our child) makes us remember and associate with the information that created the emotion, whether it is right or wrong. This can lead parents to make dangerous decisions for their children while trying to do the right thing.

Myth Busting

I’m going to attempt to de-bunk the most common concerns I’ve heard because the best way to combat misinformation is to help explain the facts as we know them.

1. If every baby’s born with too little vitamin K, that’s the way we’re supposed to be.

Babies are born with very little vitamin K in their body. If they don’t get it with a shot, they need to either eat it or make it. Breast milk has very little vitamin K and babies won’t be eating leafy greens for quite awhile. Formula does have it, but it takes several days for vitamin K to rise to protective levels with formula and the highest risk of bleeding is during that first week of life. (Of course if you’re using this argument because you want babies to be all natural, you probably won’t be giving formula at this point.)

Bacteria help us make vitamin K, but babies aren’t colonized at birth with these gut bacteria.

Just because they’re born that way doesn’t mean they’re supposed to stay that way. Inside the mother the baby is in a very different situation. They don’t breathe air. A fetus doesn’t eat. They don’t have gut bacteria. Their heart has a bypass tract to avoid pumping blood to the lungs. This all works well in utero, but must change once they leave the womb. Change takes time, and during this time they are at risk. Why not minimize the risk if we know a safe way to do it?

2. The package insert has a big warning at the top that it can kill.

There are many reasons why we should not use the package insert of a medicine or vaccine to make healthcare decisions. These have been discussed before so I won’t go into all the details but please see these great blogs on how to read and use package inserts:

It is true that there is a black box warning on the top of the vitamin K package insert. This has scared some parents from wanting to get the vitamin K shot for their newborn.

Screen Shot from Package Insert 

Reactions to IV (intravenous) vitamin K are much more common than IM (intramuscular) injections. The difference is anything given by IV goes directly into the bloodstream and back to the heart. But we don’t give vitamin K by IV to newborns.

IM injections go into the muscle, allowing very slow absorption of the medicine. This not only decreases reactions to the injected vitamin, but also helps the level of vitamin K stay elevated for a prolonged time after a single injection.

I only found one report of a newborn with a significant reaction to vitamin K. The authors of the paper did note that IM vitamin K has been given for many years to babies all over the world without significant reactions and could not explain why the one infant had such a significant reaction.

Since we must always look at risk vs benefit, the very, very low risk of a serious reaction from receiving vitamin K IM is preferable to the benefit of the prevention of VKDB.

Another great resource on this topic is Dr. Vincent Iannelli’s That Black Box Warning on Vitamin K Shots. He doesn’t want you to skip the Vitamin K shot either.

3. Vitamin K causes cancer.

Many years ago there was a small study that suggested vitamin K led to childhood cancers. This issue has been extensively studied since then and no link has been found.

Vitamin K does not cause cancer.

Rates of cancer have not increased in the years since vitamin K has been given to the large majority of newborns worldwide. This is reported in the Vitamin K Ad Hoc Task Force of the American Academy of Pediatrics report Controversies Concerning Vitamin K and the Newborn.

4. Bleeding from vitamin K deficiency is rare or mild.

In the US bleeding from vitamin K deficiency is rare because most babies get the vitamin K shot soon after birth. In countries where vitamin K is not used routinely, bleeding is not rare at all. Some communities of the US where vitamin K is being refused by parents are seeing an increase in newborn bleeding.

Early VKDB occurs within 24 hours of birth and is almost exclusively seen in infants of mothers taking drugs which inhibit vitamin K. These drugs include anticonvulsants, anti-tuberculosis drugs, some antibiotics (cephalosporins) and blood thinners to prevent clots. Early VKDB is typically severe bleeding in the brain or gut.

Classic VKDB typically occurs during the first week of life. The incidence of classic VKDB ranges from 0.25-1.7 cases per 100 births.

Late onset VKDB occurs between 2 and 12 weeks usually, but is possible up to 6 months after birth. Late VKDB has fallen from 4.4-7.2 cases per 100,000 births to 1.4-6.4 cases per 100,000 births in reports from Asia and Europe after routine prophylaxis was started.

One out of five babies with VKDB dies.

Of the infants who have late VKDB, about half have bleeding into their brains, which can lead to permanent brain damage if they survive. Others bleed in their stomach or intestines, or other vital organs. Many need blood transfusions or surgeries to help correct the problems from the bleeding.

5. It’s just as good to use oral vitamin K.

Early onset VKDB is prevented well with the oral vitamin K in countries that have oral vitamin K available, but late onset VKDB is an issue.

Children with liver or gall bladder problems will not absorb oral vitamin K well. These problems might be undiagnosed early in life, putting these kids at risk for VKDB if they are on an oral vitamin K regimen.

Getting the oral form isn’t easy

There is no liquid form of vitamin K that is proven to be effective for babies in the US.

That is a huge issue.

Some families will order vitamin K online, but it’s not guaranteed to be safe or even what it claims to be. This is an unregulated industry. It is possible to use the vitamin K solution that is typically given intramuscularly by mouth, but this requires a prescription and the taste is questionable, so baby might not take the full dose.

It would be an off-label use so physicians might not feel comfortable writing a prescription. The other issue that might worry physicians is with compliance in remembering to give the oral vitamin K as directed, since most studies include babies with late onset bleeding who had missed doses.

Vitamin K in food

Most of us get vitamin K from gut bacteria and eating leafy green vegetables.

Newborns don’t have the gut bacteria established yet so they won’t make any vitamin K themselves. They may get vitamin K through their diet, but breastmilk is very low in vitamin K. Unless baby is getting formula, they will not get enough vitamin K without a supplement.

It is possible for mothers who breastfeed to increase their vitamin K intake to increase the amount in breast milk, but not to sufficient levels to protect the baby without additional vitamin K.

What do other countries do?

Many countries that have used an oral vitamin K protocol, such as Denmark and Holland, have changed to an intramuscular regimen because the oral vitamin K that was previously used became no longer available.

There are various oral vitamin K dosing strategies that can be reviewed in the linked abstract.

  •  Australia and Germany: 3 oral doses of 1 mg vitamin K are less effective than a single IM vitamin K dose. (In 1994 Australia changed to a single IM dose and their rate went to zero after the change.)
  • Netherlands: A 1mg oral dose after birth followed by a daily oral dose of 25 mcg vitamin K1 may be as effective as parenteral vitamin K prophylaxis.
  • Sweden: (a later study) 2 mg of mixed micellar VK given orally at birth, 4 days, and 1 month has a failure rate of one case of early and four cases of late VKDB out of 458,184 babies. Of the failures, 4 had an undiagnosed liver issue, one baby’s parents forgot the last dose.
Oral Vitamin K vs injectable (IM) Vitamin K

When vitamin K is given IM, the chance of late VKDB is near zero.

Oral vitamin K simply doesn’t prevent both early and late bleeding as well. This is especially true if there is an unknown malabsorption disorder, regardless of which dosing regimen is used.

6. My baby’s birth was not traumatic, so he doesn’t need the vitamin K.

Birth trauma can certainly lead to bleeding, but the absence of trauma does not exclude it.

Late vitamin K deficient bleeding (VKDB) cannot be explained by any birth traumas since they can occur months later.

7. We’re delaying cord clamping to help prevent anemia and bleeding. Isn’t that enough?

Delayed cord clamping can have benefits, but decreasing the risk of bleeding is not one of them.

There is very little vitamin K in the placenta or newborn. Delaying the cord clamping cannot allow more vitamin K into the baby.

Still not convinced?

Read stories about babies whose parents chose to not give vitamin K:

For More Information:

Evidence on: The Vitamin K Shot in Newborns (Evidenced Based Birth)

Author: DrStuppy

I am a pediatrician and mother of two teens. I have a passion for sharing health related information.

6 thoughts on “7 Vitamin K Myths Busted”

  1. The black box warning is for BOTH IV and IM administration of Vitamin K. So both have had severe reactions and fatalities, enough to warrant the black box warning,. It makes sense for parents to be concerned about this.

    1. I understand that the black box warning is scary, but the risk to a newborn who doesn’t get the vitamin K is much higher than the risk of the vitamin K injection itself – too many babies suffer significant bleeding without vitamin K and the large number of infants who receive IM vitamin K do well. There are no written criteria or guidelines as to which events cause the FDA to initiate a boxed warning. They are there to be sure physicians take into account risks and benefits. There has only been one reported of a serious allergic reaction to intramuscular vitamin K in a newborn. Newborns have a lesser chance of anaphylaxis than older children and adults. I do not know why the FDA made the warning without mention of lower risk in newborns, but it clearly says on the same insert that the intramuscular route of administration is recommended for all newborns. It can be life saving to give it.

  2. A baby doesnt start making vit k for 8 days. Ever thought that the body knows best and it’s for a reason?

    Babies don’t need any vitamin k . They don’t make it for 8 days for a good reason . Interesting points made about Vitamin K at birth by a brilliant pediatrician who remains anonymous:

    “You know what “synthetic vitamin K” enthusiasts don’t understand? The thought that babies (and all animals for that matter) have lower levels of vitamin K at birth for a beneficial, protective, reason. I’m just going to throw these “common sense-based” thoughts out there but let’s consider them:

    and BTW this goes for the Drops as well as the Shot

    First, in order to absorb vitamin K we have to have a functioning biliary and pancreas system. Your infant’s digestive system isn’t fully developed at birth which is why we give babies breast milk (and delay solids) until they are at least 6-months-old, and why breast milk only contains a small amount of highly absorbable vitamin K. Too much vitamin K could tax the liver and cause brain damage (among other things). As baby ages and the digestive tract, mucosal lining, gut flora, and enzyme functions develop, baby can process more vitamin K. Low levels of vitamin K at birth just…makes…sense. ???

    Secondly, cord blood contains stem cells, which protect a baby against bleeding and perform all sorts of needed repairs inside an infant’s body. Here’s the kicker, in order for a baby to get this protective boost of stem cells, cord-cutting needs to be delayed and the blood needs to remain thin so stem cells can easily travel and perform their functions. Imagine that, baby has his/her own protective mechanism to prevent bleeding and repair organs…that wasn’t discovered until after we started routinely giving infants vitamin K injections.

    Third, a newborn might have low levels of vitamin K because it’s intestines are not yet colonized with bacteria needed to synthesize it and the “vitamin K cycle” isn’t fully functional in newborns. It makes sense then to bypass the gut and inject vitamin K right into the muscle right? Except baby’s kidneys aren’t fully functional either.

    Fourth, babies are born with low levels of vitamin K compared to adults, but this level is still sufficient to prevent problems; vitamin K prophylaxis isn’t necessarily needed.

    Finally, several clinical observations support the hypothesis that children have natural protective mechanisms that justify their low vitamin K levels at birth . I don’t know about you, but we should probably figure out why that is before we “inject now and worry about it later.”

    Do you know why vitamin K is pushed on parents and their children? Because pharmaceutical companies don’t like to lose money, doctors don’t like to be questioned, the American Academy of Pediatrics dare not change its recommendations.”

    “Since 1985, the medical profession has known that oral vitamin K raises blood levels 300 – 9,000 times higher. The injectable vitamin K, results in vitamin K levels 9,000 times thicker than adults blood.

    Baby’s blood thickened with vitamin K, causes a situation where stem cells have to move through sludge, not nicely greased blood vessels full of blood which can allow stem cells easy acess to anywhere. Maybe one day it will dawn on the medical profession that not only are cord blood stem cells important and useful to the newborn baby, but that stem cells need to thin blood for a reason.”

    “Any fetus which gets being wrung out like a wet towel while travelling down a narrow drain pipe, can incur damage in any part of the body, including in the brain, and needs an in-built fix-it. And stem cells cross the brain blood barrier. In fact, stem cells can go … anywhere!!! Amazing don’t you think. God’s design has solutions for situational problems. Three solutions, actually. The second is the fact that naturally, in the first few days, a baby’s blood clotting factors are lower than normal.

    But … pediatricians consider this a … “defect” … so want to give vitamin K which results in blood nearly 100 times thicker than an adult’s. This vitamin K injection, so they say … (like they say immediate cord clamping is safe, and normal, and delayed cord clamping is an unproven intervention) … is because the baby wasn’t designed right, and if you don’t give a vitamin K injection, the baby “could bleed to death”.

    It’s not for nothing that the vitamin K syringe, sits right alongside that cord clamp and the scissors!

    But there is an unanswered question:

    “Why are blood clotting factors in babies low in the first few days after birth? Why has a baby got much thinner blood as a result?”

    Might a logical hypothesis be, that thinner blood allows freer and quicker access of cord blood stem cells to any part of the body damaged during birth? After all, why should stem cells have to fight through a baby’s blood which is now 100 times thicker than any adult’s, courtesy of another needle?”

    1. I find it to be a big red flag if a “brilliant” pediatrician wishes to remain anonymous. If they really stand behind what they are saying, they should give a name.

      It does not cause the damage you suggest if a newborn gets a dose of IM Vitamin K. Since the large majority of newborns in the US (and other countries) get it, you would expect to hear frequent reports of problems if it did. We don’t.

      I don’t understand your argument that newborns don’t need vitamin K. Without it they are at risk of bleeding to death. That is a real risk. Not every baby has this happen, but if it does, the baby suffers. The parents who thought they were doing the best they could for their infant by not giving the lifesaving Vitamin K suffer when they realize they could have prevented hemorrhagic disease of the newborn.

      As for pharmaceutical companies making money as the reason for pushing Vitamin K: no. It is cost saving compared to treating hemorrhagic disease of the newborn (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857497/).

      I don’t know why you think a baby’s blood is thicker than an adults after getting Vitamin K. Again, think of the vast number of babies who get this life saving injection. They’re protected. The babies who don’t get it risk death.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.