Vitamin K for Babies at Birth

What is Vitamin K?

Vitamin K is a vitamin which occurs naturally in food such as green leafy vegetables and some oils such as olive oil. It is made by bacteria in our gut. Vitamin K is needed for our blood to clot properly, stopping us from bleeding too much. 

Newborn babies often do not have enough vitamin k because very little is passed to the baby in the womb from its mother. There are also only small amounts of vitamin k in breastmilk, meaning it can take a while for it to be produced by the baby’s own gut. 

For some babies, not having enough vitamin k may result in them having bleeding problems. This is called Haemorrhagic Disease of the Newborn (HDN). This can lead to bleeding that is difficult to stop any time from birth or up to several weeks old. This can include bleeding from the belly button (cord site) or gut, or more worryingly in the brain. Whilst this condition is uncommon, for some babies it can make them very poorly and occasionally sadly pass away.  

Giving babies extra vitamin K at birth almost completely removes the risk of your baby developing Haemorrhagic Disease of the Newborn. Therefore, the Department of Health recommends that all babies are given a vitamin K supplement at birth, and it has been offered to newborns since the 1950s. 

Why give vitamin K to all babies?

Although there are groups of babies who are particularly at risk of bleeding, it is not possible to identify babies as high or low risk. The range of risk factors are broad, but we know that many of the babies who suffer bleeding had no risk factors. Therefore, it is nationally advised that all babies are given vitamin K. 

What is the risk?

Between 2.5 and 17 out of every 1,000 babies who do not receive vitamin K at birth will have some bleeding, but the risk of serious bleeding is small. About 1 in 10,000 babies who do not receive vitamin K will bleed into their brain, with a third of these suffering serious permanent brain injury or passing away as a result. 

The risk of this happening is almost eliminated by giving babies a vitamin K supplement in sufficient amounts. 

Which babies are most at risk?

• Babies who are born early (before 37 weeks). 
• Babies who have complicated births (such as forceps or ventouse births). 
• Babies who need surgery. 
• Babies who are ill for other reasons. 
• Babies of mothers who have taken some medication (for example, some anti-seizure medication). 
• Babies with bleeding or bruising problems. 

How is vitamin K given?

• Vitamin K can be given in two ways: by an injection, or as a liquid for the baby to swallow. It is usually given as an injection into your baby’s thigh. This gives the most reliable and long-lasting protection. When given as a liquid for your baby to swallow, three doses are needed: at birth, at one week old and one month old - the first dose will be given in the hospital, then you will give the second and third to your baby at home (we will show you how to give it safely before you leave the hospital). 
• The Department of Health advises that if you choose to have doses of vitamin K by mouth for your baby, it is essential for your baby to have the full course to make sure your baby is protected. 

Can vitamin K be harmful?

The risks of vitamin K are very small. If given as an injection, there is a small risk of infection of inflammation at the injection site. 

Concerns about a possible link between vitamin K injections and childhood cancer were raised by a study in the early 1990s. Several large studies have since looked into this further and found that there were no links between children developing cancer or leukaemia and vitamin K. 

Can I say no? Are there any alternative options available?

You have the right to say no to Vitamin K. Giving your baby a Vitamin K supplement is a choice. If you would prefer for your baby not to be given vitamin K, we will arrange a conversation with a member of our neonatal team to support you to make a plan that works for you and your family. This may include giving you information Son things to look out for, causes for concern and what to do if you are worried. 

Recognising the Warning Signs of Haemorrhagic Disease of the Newborn

Many babies who later suffer bleeding in the brain have already had bleeds from the skin, nose or mouth. Any baby with unexplained bruising or bleeding needs urgent medical help. 

Jaundice is a common problem for babies (see here for more information), however if you baby is still jaundiced after two weeks, they must see a doctor or health visitor. This is particularly concerning if they are not gaining weight properly, have pale stools or dark urine, or are ill in any way. 

For more information, please see:

What happens straight after the birth? - NHS (www.nhs.uk)