Vitamin K in newborn babies

What is vitamin K?

Vitamin K is a vitamin (nutrients your body needs in small amounts to work properly), which occurs naturally in food, especially in liver and some vegetables. We all need vitamin K. It helps to make our blood clot in order to prevent bleeding.

Why are babies offered vitamin K?

Very rarely, a newborn baby does not have enough vitamin K and is at risk of bleeding from their nose, mouth or into their brain. This is called Vitamin K Deficiency Bleeding (VKDB). As the bleeding is inside their body, it may not be possible to see the bleeding.

Whilst this is a rare condition affecting 1 in 10,000 babies born at full term, bleeding which may occur in their brain, can cause brain damage or even death. Giving enough vitamin K supplements shortly after babies are born can remove that risk of bleeding. This is why the Department of Health recommends all newborn babies have vitamin K. However you can decide whether your baby receives the vitamin K supplement, and how it is given. We hope that this information will help you make your choice. 

When do I need to start thinking about this?

You will need to decide within your pregnancy or antenatal period, you’ll need to consider:

• whether or not you would like vitamin K to be given to your baby
• if you do want them to have it, whether you would like for it to be given by mouth or by injection, as vitamin K supplements are given straight after birth. This information will help you to decide what is best for you and your baby.

This information tells you what vitamin K deficiency bleeding is, discusses the benefits of vitamin K supplements, the possible disadvantages of its use, and gives the best current advice. Of course, it is always best to talk the issues through with your midwife, health visitor or doctor.

Do all babies need supplementary vitamin K?

Yes, all babies may be at risk but certain babies are at a higher risk.

Bleeding in the first 24 hours after birth is a particular risk to babies of mothers or birthing people on certain drugs, such as anti-convulsants.

Bleeding after 24 hours following birth is more common and babies at greater risk are those who: 

• are premature, born before 37 weeks of pregnancy
• had a complicated delivery e.g. forceps delivery
• have liver disorders
• cannot or find it hard to feed
• are ill for other reasons
• are fully breastfed are more likely to develop vitamin K deficiency bleeding (VKDB) compared to formula fed. This is because manufacturers add vitamin K to formula milk.

Is vitamin K safe to give to babies?

Yes, in the early 1990s it was suggested that vitamin K injections might increase the risk of leukaemia in children, however there have been many more reports disproving this. Vitamin K has been shown to be safe. Current, well informed scientific opinion is that there is no risk.

What is the risk if I choose for my baby not to have the extra vitamin K supplement?

The risk is very small. Vitamin K deficiency bleeding (VKDB) can happen in up to 1 in 10,000 full term babies if they do not get extra vitamin K.

If vitamin K was not given, of the 800,000 recorded births in the UK every year, 10 to 20 babies could be brain damaged as a result of a bleed in the brain, and 4 to 6 babies could die.

This slight risk is eliminated when your baby is given a vitamin K supplement in sufficient amounts. You can choose to not give your baby the vitamin K injection at birth.

How is vitamin K given?

There are two ways of giving vitamin K to your baby.

By injection

The Rotherham NHS Foundation Trust, Department of Health and the National Institute of Clinical Excellence (NICE) all recommend that all babies should receive a single dose of vitamin K at birth by an injection in their thigh.

Advantages of injection:

• only requires one dose
• it is more effective at preventing vitamin K deficiency bleeding (VKDB)
• quick and easy to give to your baby

Disadvantages of injection:

• it's invasive and can cause pain and a small bruise where the injection was given

By mouth (orally)

You may prefer a different way of giving vitamin K to your baby. In that case, we recommend your baby is given vitamin K orally (by mouth) at birth.

Disadvantages of giving vitamin K by mouth:

• having vitamin K by mouth is not as effective as by injection
• if you are breastfeeding your baby, to get enough protection from oral vitamin K, 2 further doses will be needed, at age 4 to 7 days and at age 4 weeks. If your baby is bottle fed, no further doses are needed after the first dose at birth.

Recognising the warning signs of vitamin K deficiency bleeding (VKDB)

Many babies who later suffer bleeding in the brain have had prior minor bleeds from the skin, nose or mouth. Any minor bleeds or bruising any time in the first six months of life must be looked at urgently.

Any baby who is still jaundiced after 2 weeks of age must be seen by a doctor or health visitor, especially if they are not gaining weight properly, have pale stools and dark urine, or are ill in any way.

It is recommended that all babies are given a vitamin K supplement at birth. 

However, the decision is entirely yours about whether your baby receives extra vitamin K and how it is given. We hope this information has helped you to make your choice.

If you wish to discuss vitamin K further, please speak to your midwife or doctor at your next antenatal appointment or contact the Community Midwifery office on 01709 427253.