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The Portland Hospital
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36/40 weeks

Vitamin K

Once your baby is born, he or she may be at risk of a bleeding disorder due to the lack of Vitamin K. The vitamin can be given to your baby in one or two ways. By injection into the muscle of your baby’s leg and in liquid form, through drops into your baby’s mouth. Before your baby’s birth your Obstetric Consultant / Midwife will ask you whether you want this vitamin to be given to your baby and in what form – by intramuscular injection or by mouth. This article has been produced to try and give you the information on which you can make an informed decision.
In Short

If your baby has a vitamin K deficiency, they might bruise or bleed for no apparent reason. Sadly, most babies with HDN show no warning signs before life-threatening bleeds but they might develop any of the following signs:

Bruising that’s particularly around your baby’s head or face.

Bleeding from the nose or umbilical cord.

Skin colour that’s paler than usual, or pale gums in darker-skinned babies.

In babies over three weeks old, the whites of their eyes turn yellow.

Blood in the baby’s poo – it might look black, dark or sticky.

Your baby vomits blood.

If a baby is irritable, excessively sleepy, has seizures or is vomiting a lot, they might have had bleeding in the brain.

What is Vitamin K?

Vitamins are substances which the body cannot make and must obtain from food. Each has a different function in the body. Vitamin K helps to make the blood clot, hence bleeding can develop if not enough is supplied through the diet. Newly born babies have smaller stores of Vitamin K at birth than older children and adults. The reason for this is not known, but it can place them at risk of bleeding. As the medical term for bleeding is ‘haemorrhage’, the illness caused is known as Haemorrhagic Disease of the Newborn or Vitamin K Deficiency Bleeding. It is very rare (affecting only about 10-20 babies per year in the UK) but can be serious as bleeding may cause death or brain damage. Vitamin K Deficiency Bleeding (VKDB) usually appears in the first week of life but can occasionally develop in babies a few weeks or months old.

Giving Vitamin K to Your Baby

Vitamin K can be given as drops into the mouth or as an injection but there is no clear agreement among midwives, doctors and experts as to which is best. Here we will explain the pros and cons of each to help you decide what you would like for your baby.

Injection

  • This is the most effective way of preventing VKDB.
  • It only needs to be given once – at birth – and lasts for months
  • You can be sure it has been absorbed by the body (sometimes babies spit out or bring up the drops).
  • Years ago a group of doctors in Bristol claimed that Vitamin K injection approximately doubled the chance of a baby developing cancer as a child. Despite further research worldwide, nobody else has been able to confirm this finding. Therefore it is felt that the benefits of this type of administration still outweigh any potential risks.
  • The injection usually makes the baby cry for a few minutes.

Drops

  • There are no recorded observations of serious side effects to drops.
  • Drops are less effective than the injection at preventing VKDB. Babies still sometimes develop serious bleeding or bruising. The chance of this happening is about 10 times less than if no Vitamin K is given, but still about ten times more than with the injection.
  • Further doses will be needed – usually when one week old and again at 6 weeks if breastfeeding.
  • You will need to consult your paediatrician or midwife about this.
  • Some babies seem to not like the taste of the drops.

What we Recommend

Firstly, we strongly recommend that all babies are given Vitamin K at birth – either as drops or by injection.

Some babies seem to be at greater risk of developing VKDB. These include:

  • Babies who are ill or have liver problems
  • Babies who are premature.
  • Babies who have been delivered using instruments (Ventouse or Forceps) or who are bruised.
  • Babies whose mothers have been taking certain medicines (especially ones used to treat epilepsy).
  • Babies who had breathing difficulties at birth

Babies in these groups are at increased risk of VKDB and will be given a Vitamin K injection at birth.

If your baby is healthy and is born at the normal time (full term) it is extremely unlikely that he/she will develop VKDB but we still recommend Vitamin K is given. This is especially so if you are breast feeding your baby. Human breast milk contains very low levels of Vitamin K.

It is important to discuss whether you would like your baby to have the drops or injection.

If you decide to give your baby Vitamin K drops please remember that further doses will be needed at the end of the first week and at one month of age. You will need advice from your Paediatrician or Midwife about this.

How would I know if my baby has VKDB?

If your baby has a vitamin K deficiency, they might bruise or bleed for no apparent reason. Sadly, most babies with HDN show no warning signs before life-threatening bleeds but they might develop any of the following signs:

  • Bruising that’s particularly around your baby’s head or face.
  • Bleeding from the nose or umbilical cord.
  • Skin colour that’s paler than usual, or pale gums in darker-skinned babies.
  • In babies over three weeks old, the whites of their eyes turn yellow.
  • Blood in the baby’s poo – it might look black, dark or sticky.
  • Your baby vomits blood.
  • If a baby is irritable, excessively sleepy, has seizures or is vomiting a lot, they might have had bleeding in the brain.

What if I say no to vitamin K for my baby?

Most parents take up the offer of vitamin K but you don’t have to. In babies who did not receive vitamin K at birth, around 0.25% to 1.7% will develop classic vitamin K deficiency bleeding. Five to seven per 100,000 babies will develop late VKDB.

For a list of useful contact details for The Portland Hospital, please click HERE.

DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.