Opinion: What Utah parents should know about newborn vitamin K injections

As a hospital-based pediatrician in Utah, I have witnessed an increasing number of parents refuse the vitamin K injection recommended for their newborn infants. I fear that parents who refuse this do so without understanding why it is recommended, and unknowingly cause their newborn unnecessary risk of harm.

Below are 10 important facts every expecting parent should know prior to considering refusing this important supplement.

• All newborns are born with very little vitamin K stored in their body.
• Vitamin K is necessary for the body to form clots and stop bleeding.
• As many as 1 in 60 newborns that do not receive the vitamin K injection at birth will experience bleeding due to low vitamin K.
• Vitamin K deficient bleeding can be visible (such as persistent bleeding from a circumcision) or hidden inside the body (such as intestinal bleeds or brain bleeds).
• Bleeding can occur any time from birth until an infant is 6 months old. Late-onset bleeding (after 3 weeks of age) is much less common, but more serious.
• Half of infants that develop late-onset bleeding bleed into their brains without showing warning signs; 1 in 5 of these infants die . Those that do not die commonly experience brain damage that can cause them to have lifelong difficulty with basic actions like walking, eating and learning.
• Newborns who do not get the vitamin K shot at birth are 81 times more likely to experience severe bleeding than those who do not.
• No other method of vitamin K supplementation is as effective as the vitamin K injection at birth. This includes prenatal and postnatal supplementation, oral vitamin K and infant formula supplementation.
• There is no evidence that vitamin K injection causes any harm to the baby. It is not a vaccine and has been proven to be safe and effective for over 60 years.
• Common reasons parents refuse the vitamin K injection for their infants include: 1) to avoid pain from the injection, 2) a desire to be “natural” and 3) use of another method to supplement vitamin K.

Newborn vitamin K injection refusal is increasingly common and is much higher for infants not born in hospitals. While hospital vitamin K injection refusal rates are approximately 3%, a recent study showed that infants born at home are five times less likely to receive the injection (~15% refusal rate), and infants born in birthing centers are a staggering 10 times less likely (~31% refusal rate).

To put these numbers in perspective, there were 45,774 live births in Utah in 2022 , and infants in Utah are more than twice as likely to be born outside the hospital than the national average (4.4% vs 2.1%). Assuming a 1:3 ratio of birthing center to home births (following the national average), this means that the following numbers of infants will not receive vitamin K injection in the following settings:

• Infants born in hospital: 1,313 (3% refusal rate of 95.60% of all Utah births)
• Infants born at home: 201 (15% refusal rate of 2.93% of all Utah births)
• Infants born at birthing centers: 208 (31% refusal rate of 1.47% of all Utah births)

These numbers suggest that 3.76% (1,722) of Utah infants did not receive vitamin K injection last year, meaning that nearly 30 infants a year could experience unnecessary vitamin K deficient bleeding in our state.

Prior to refusing the vitamin K shot for their newborn, parents should familiarize themselves with the facts about the vitamin K injection so they can be aware of the unnecessary risk they are exposing their infant to. It is safe. It is effective. It saves infant lives every year.

Parents with questions or concerns about the vitamin K injection should seek answers from trusted and evidence-based sources, such as their doctor or on the website for the Centers for Disease Control and Prevention. Information from other sources, particularly social media, is often fraught with misinformation and can perpetuate harmful myths.

Let us work together to protect Utah’s infants by reducing the amount of unnecessary vitamin K deficient bleeding through proper education and by curbing the vitamin K injection refusal rates.

Dr. Nathan Money is an assistant professor of pediatrics at the University of Utah School of Medicine and a fellowship-trained pediatric hospitalist at Primary Children’s Hospital.