One of the most common questions I get is about newborn Vitamin K. Vitamin K Deficiency Bleeding, or VKDB, occurs when a baby cannot stop an internal bleed because they lack the Vitamin K needed to form clots. Most commonly, this internal bleeding would be found in the baby’s brain (this instance may increase with assisted deliveries) or in the intestines. 

The level of Vitamin K that a newborn has naturally rises on day 8. Vitamin K is more readily available once a baby starts eating solid food, as we get this nutrient from whole foods in our diet. Vitamin K does not pass from the mother to the baby through breast milk. 

VKDB is extremely rare, but it can be life-threatening.

VKDB is divided into three categories as defined by: 

• Early – the first 24 hours after baby is born
• Classic – day 1 through day 7 of life
• Late – day 8 of life through six months old

Early and classic VKDB occurs 1 in 250 (0.4%) to 1 in 60 (1.6%) of babies, and late VKDB 1 in 14,000 (0.007%). Risk factors for VKDB include moms who use seizure medication during pregnancy, and babies with liver or gallbladder diseases. 

In the United States, a Vitamin K shot is recommended for all babies, regardless of risk status. Like everything, there are pros and cons to choosing the shot for your child. When the shot is given to a baby, the risk of VKDB is almost zero. Families who skip the shot are typically concerned with common injection site side effects such as pain, swelling, bruising, and redness for their newborn; the ingredients of the shot; or the Black Box warning (the highest warning level issued by the FDA) from the manufacturer.

Alternatively, you may choose oral Vitamin K or forgo treatment altogether. Oral Vitamin K is the standard procedure for most European countries. A meta-analysis in 2021 showed oral Vitamin K was just as effective at preventing classic and late VKDB as the shot (PMC8424792). The downside of this option is that you are responsible for purchasing the supplement and administering it to your baby (read: you have to remember to do it). In order for it to be effective, a baby will need at least three doses in early infancy. This is typically done on day 1, one week, and at two and/or four weeks old. I always recommend following the dosing instructions given and speaking to your care provider. In addition, some care providers will not perform a circumcision without the shot, so it is important to know your plan regarding this newborn procedure as well. 

If you would like to give your baby oral Vitamin K, the recommended brands are Biotics Research or Natal K. They can be found online at In His Hands birth supply (I don’t benefit from your purchase but you can use the discount code Southward5 to save) or on my Amazon”Birthy” List. 

It’s hard to sift through all of the information regarding newborn procedures to decide what’s right for your family. No matter what you decide about Vitamin K, I hope your decision brings you peace and that your birth team respects your wishes. Don’t forget that you are in charge and that informed consent is your bestie.