What Is Vitamin K and Why Is it Recommended for Newborns?

What does vitamin K do in the body?

Vitamin K helps our liver produce essential clotting factors for our blood - we need it to prevent bleeding. It's recommended by the Department of Health for all babies as it virtually eliminates the risk of vitamin K deficiency bleeding (VKDB) - more on that below!

Why are babies born with low vitamin K levels?

We don’t actually know why babies are born with lower levels of Vitamin K or if there is some physiological advantage to this or not.

What is vitamin K deficiency bleeding (VKDB)?

Vitamin K deficiency bleeding (VKDB) is a rare condition that causes a baby to have internal bleeding, which can in very rare cases, lead to brain damage or even be fatal. The good news is that if treated quickly, most babies will recover from VKDB. The treatment for VKDB is vitamin K.

Is the Vitamin K Injection Safe for My Baby?

What ingredients are in the vitamin K injection?

The active ingredient is vitamin K1 (phytomenadione). Other ingredients are: glycocholic acid, sodium hydroxide, lecithin, hydrochloric acid and water for injection. Some ingredients can be derived from animal products and if this is important to you, you’ll need to weigh up the risks and benefits of your baby having or not having vitamin K. A full manufacturer's leaflet can be found here.

Are there any side effects?

As with all injections, there is a small chance of infection, bleeding and swelling at the injection site and some babies may have a bruise. Allergic reactions are very rare but possible.

Does the injection cause pain or distress?

Giving vitamin K via injection involves a needle. In our experience most babies will cry when they have the injection and we can assume it does cause them some pain, in the same way injections cause adults pain. It’s helpful to administer it when your baby is having a close cuddle with a parent, so that they can be soothed straight away. Feeding your baby whilst they have the injection may also help to soothe them.

Vitamin K Injection vs. Oral - What's the Difference?

How does the injection work?

The vitamin K injection is usually given soon after birth within the first few hours of life. It’s an intramuscular injection, meaning it is injected into the muscle and it goes into one of your baby’s thighs. The injection is a one-off dose of 1mg.

How do oral Vitamin K drops work?

Oral vitamin K is given via an oral syringe into your baby’s mouth. 3 doses are required: within the first few hours after birth, on day 7 and on day 28 after birth. Each dose is 2mg.

Which option is more effective?

The injection is more effective than the oral drops, which is why the injection is one-off and the oral dose is 3 doses. With oral vitamin K there are a few factors that can impact its effectiveness: absorption (vitamin K is fat soluble - so ideally should be given after a feed to boost its absorption), babies are prone to vomiting (so there is uncertainty about how much vitamin K the baby actually gets with the oral dose) and subsequent doses can be missed or forgotten. Oral vitamin K is however still effective, and certainly more effective than no vitamin K.

When you book care with us, we go through all your options and can signpost you to extra resources so that you can make the decision that feels right for you and your baby.

Why do some parents choose oral vitamin K?

Some parents understandably don’t like the idea of putting their baby through any pain or distress if they don’t have to. You have the right to choose if and how your baby receives vitamin K. If you choose the oral vitamin K, depending on where you live, community midwives will give this to your baby at the right times or you may have to get a prescription and give the vitamin K yourself. If our clients choose to have oral vitamin K we will provide all the required doses - it’s all included as part of our care packages.

What Happens If My Baby Doesn't Get Vitamin K?

How common is Vitamin K deficiency bleeding?

VKDB is rare. The chance is thought to be about 1:11000 babies - although this figure changes slightly depending on the source.

What are the signs of VKDB in newborns?

• Minor bleeding from the skin, nose or mouth or umbilical cord.
• Jaundice that is present at 2 weeks of age with a baby that’s not gaining weight, possibly with pale stools and dark urine.
• Any unexplained bleeding or bruising in the first 6 months of life.

If you notice any of these signs in your baby, they require an a prompt review by a doctor. It's particularly important to be vigilant of these symptoms if you have decided to not give your baby Vitamin K.

Are some babies at higher risk?

Some babies have a higher chance of developing VKDB. These include:

• Babies who are born to women or birthing people taking certain medications (such as anticonvulsants)
• Premature babies (born before 37 weeks)
• Babies born with the help of forceps or ventouse
• Babies with liver disorders
• Babies who are not feeding well
• Exclusively breastfed babies have a higher chance of developing VKDB compared to formula-fed babies as vitamin K levels are low in breastmilk, but vitamin K is added to formula milk. This is not a reason to not breastfeed, as there are so many health benefits for babies and women with breastfeeding - but it is worth thinking about if you’re unsure about whether to give your baby vitamin K or not.

It is also worth knowing that VKDB can occur without any of the above risk factors being present.

Frequently Asked Questions About Vitamin K for Babies

Can I decline the vitamin K injection?

You can decline the vitamin K injection and your decision should be respected. A healthcare professional might want to understand your rationale - and this is part of their duty of care to you and your baby - but should never be told you have to speak to a doctor or a more senior midwife if you decline as this can amount to coercion and it is something we sadly still see in clinical settings.

When is the Vitamin K injection given?

Soon after birth, usually within the first few hours of life.

Does my baby need Vitamin K if I had a straightforward birth?

Vitamin K is recommended for all babies - regardless of how they were born. VKDB can occur in the absence of any risk factors.

Is Vitamin K the same as a vaccine?

Vitamin K is not a vaccine.

What if I missed the Vitamin K dose?

You can still have vitamin K as an injection if for some reason your baby wasn’t given at birth. If an oral dose of vitamin K is missed it should be given as soon as possible (but don't give a double dose!) - this might mean you need to chase your GP or community midwife if you weren’t given a prescription to take home.

Sara Wickham has a book and other excellent resources on her website all about vitamin K, this article is a good place to start if you're looking for further information to help you decide.

If you'd like to discuss your options further, we offer one-off birth planning appointments where we can discuss vitamin K and everything else related to your birth! Book an appointment here.