In our BabyNatal classes we go through the choices that new parents can make straight after the birth of their babies. One of the very early decisions that parents are asked to make is whether they would like their baby to have a supplement of vitamin K.
So we put together this blog post to answer some of the key questions you might have about this.
- Why is my baby offered vitamin K soon after birth?
When babies are born, they have low levels of vitamin K because only small amounts of vitamin K in mum’s body pass through the placenta. In the vast majority of healthy newborn babies, the amount of vitamin K they have in their body is enough to prevent any problems. However, some babies are born with an insufficient amount of vitamin K. Because it’s impossible to accurately predict which babies will be born with a vitamin K deficiency, a vitamin K supplement is currently offered to all babies born in the UK.
- Why is vitamin K so important?
Vitamin K helps the blood to clot and therefore helps to prevent excessive bleeding. Giving newborn babies a vitamin K supplement shortly after birth can help prevent a type of bleeding called Vitamin K Deficiency Bleeding. This is very rare, but when it happens, it can have serious consequences for the baby and their family. If the bleeding occurs, it could affect the intestine or the brain, and brain damage or even death could ensue as a result.
- Are all babies at risk?
It is not really possible to say for sure which babies will be born with insufficient levels of vitamin K, but it has been found that some babies are more at risk than others. Babies who have an increased risk of vitamin K deficiency bleeding are babies:
- Who were born before 37 weeks of pregnancy;
- Who were born through the use of forceps, ventouse or c-section which caused bruising;
- Who, at birth, have trouble breathing and suffered a shortage in their oxygen supply;
- Who have liver disease;
- Who were born from mums who are taking anti-convulsants, anti-coagulants, or drugs to treat tuberculosis.
Babies who fall into all these categories combined, account for approximately one third of all babies born in the UK.
- As a preventative measure, can vitamin K given to mum during pregnancy instead?
It is not recommended to give expectant mums vitamin K supplements. Although this may not be harmful to the baby’s development, it may cause extended jaundice and not prove as effective in the prevention of vitamin K deficiency bleeding.
- Is it mandatory for my baby to have vitamin K at birth?
A vitamin K supplement is offered to all babies born in the UK. It is however your choice as to whether you want your baby to have it or not. Once your baby is born, should you conclude that they do not fall into any of the above risk categories, it’d be entirely up to you whether you choose to give them a vitamin K supplement. We recommend, however, that you make this decision whilst being fully informed and aware of any risks as well as the benefits. If you are unsure about any of this information, your midwife or GP should be able to answer any questions you might have about this during your routine antenatal appointments.
- How is vitamin K given to my baby?
If you decide to give your baby a vitamin K supplement after birth, you currently have two choices as to how this is done.
- As an injection: the injection will most probably be given to your baby in one of their thighs, as it’s important that the vitamin K is injected into a muscle. The injection will be offered and given soon after birth. Once the baby has been given the injection, they will have a sufficient amount of vitamin K in their body to prevent excessive bleeding, should any bleeding occur.
- As drops: oral doses of vitamin K can be given to a baby as an alternative to the injection. Drops of vitamin K are given at three separate times during the first month of the baby’s life. Once all doses have been taken, the baby is protected, should any bleeding occur, but this protection isn’t achieved until all doses have been given. There is also a higher chance that parents might inadvertently miss an appointment and forget to give the baby their due dosage on time.
- If the injection works straight away, why would I choose oral drops for my baby?
There are a few reasons for this:
- Some parents don’t like the idea of their baby receiving an injection so soon after birth and prefer a gentler approach for their babies.
- You may have considered all the risks, and knowing that your baby does NOT fall into any of the risk categories, you may decide that you are satisfied with the oral doses instead.
- You may be worried that mistakes are made by your health professional when giving the injection, and that the wrong dosage or medication might be given.
- You may be worried about any potential side-effects of injecting your baby with chemicals (all injection contain chemicals that allow for the medication to be effective).
- You may be satisfied that your baby has been fed a sufficient amount of colostrum, which is higher in vitamin K than the breast milk that is produced approximately 4/5 days after birth.
- Or you may be satisfied that because your baby is formula-fed (and vitamin K is added to formula milk) they should have received a sufficient amount of vitamin K through feeding.
- I’ve carefully considered all my options and made a decision. What do I do now?
Once you are satisfied with all the information provided by your midwife or your GP about vitamin K, and made a decision for your baby, we recommend that you discuss this with your birth partner(s) so that they are also in agreement or aware of your decision. To help your midwife know what your wishes are we also recommend that your write this down in your notes, together with your other birth preferences. Remember that even though your decision may have been written down, you can always change your mind and give your health provider a different set of instructions, should you find, for example, that your baby now falls in one of the risk categories above.
- What are the symptoms of vitamin K deficiency bleeding?
There are no warning signs of vitamin K deficiency bleeding. However, it has been found that babies who didn’t receive a vitamin K supplement after birth, may experience any of these signs:
- A bulging fontanel;
- Diffused bruising;
- Feeding intolerance and irritability;
- Bleeding from the nose;
- Jaundice and pallor – including jaundice that lasts 2/3 weeks, pale stools and dark urine, which may be signs of liver disease. As previously said, liver disease can put a baby at a higher risk of vitamin K deficiency bleeding.
If you notice any unusual or excessive bleeding (for example from the umbilical cord stump or following the heel prick test on day 5) or any bruising in your baby, we suggest that you seek immediate medical attention.
Should you have any further questions on vitamin K before the birth of your baby, the midwife or GP who is in charge of your routine antenatal care should be able to provide you with any information you might need on this.
And now over to you – did you find this useful? Have you already had your baby? And if so, do you have any additional information to share with expectant parents?