Vit K Shot

[Partaria]

At our first appointment, our HB midwife gave us a list of procedures she usually does just after birth. She told us to look them over, research them, and let her know our preferences regarding them by week 34.

I'm slowly working my way through the list, trying to understand the pros/cons of each.

One she lists is a Vit K shot for the infant just after it's born. Other than not really wanting to prick your brand new life with a needle, does anyone know of other risks for this? I have read a bit online, but I can't really seem to find any negative assoc with this other than the needle.

Anyone else out there made this decision? I've read giving it orally is another alternative...thoughts?

[mitintraining]

You may want to check out the vaccinations thread in the I'm pregnant forum. There are many pros and cons to the use of any vaccination. The main indication for use is a blood clotting disorder in the family, trauma to baby during birth(forcep or vacuum lacerations, intense bruising, etc) or circumcision before the 8th day of life, when Vit. K naturally peaks. There is also an oral form of this vaccination available if the injectable is questionable to you. The cons for the vaccine are going to be the same as every vaccine, the controversial ingredients in the vaccine, the way they are manufactured, the risk of a contamination or other problems with the vaccine, like unknown results 10-20 years down the line. You as the parent need to weigh the risks of the vaccine against the benefits. If your child will not be benefiting from the vaccine, example a girl baby who has no clotting disorder and no trauma at birth, than you are just getting the risks. There are tons of books out there and lots of information on MDC about the risk/benefit decision. Good luck

[St. Margaret]

But the vit K shot is not a vaccine. I think if you search here and possibly in I'm pregnant you'll find more old threads.

There are other options, such as upping your vit K intake (I think it's nettles and alfalfa that help, but look it up b/c I have a cold and my brain's foggy ), or giving oral vit K doses to baby if you are concerned. But then again, some people prefer the shot because then you're not messing with the gut. Or you can skip it entirely, because it seems babies are just naturally this way (although then mom's intake becomes important, IMO). Obviously the blood clotting disorder, birth trauma or circ (hopefully not that!) would make a difference in if you dose baby or not.

Honestly, this is one of those things that I totally can see why people go with every different option. I have yet to see info that convinced me there's some 100% way that's totally best.

[texasfarmom]

We chose not to give the Vit K shot. We did not do oral Vit K or increase my Vit K either. We decided that there was no reason to give our baby something she didn't NEED. I read that the shot can be 20,000-25,000 times the amount of Vit K that someone would take at once normally. YIKES! I also read that it can increase the chances of jaundice.

[peainthepod]

We did a few drops of oral Vitamin K with my first, and none with this one. I trust my body to nourish my baby perfectly, especially since I eat very well and supplement my own diet with prenatals and other vitamins. I won't tamper with her gut unless it's absolutely necessary.

[3xMama]

My mw flat out told me that the vit K shot was basically only for what the pp's have said: birth trauma, circ or a clotting disorder and if baby had none of those, it was unnecessary. As my baby had none of those, we opted against it with our last and will again. I just don't see the reason to give my kiddo something unnecessary, kwim?

[treeoflife3]

Our decision was to wait and see how things were during/after the birth. She came out in great color and there were no birthing issues so I chose not to do vit k. It didn't seem necessary when she seemed to be pretty well and didn't need the extra help. I am not against vit K however and am not bothered by people who choose to do it no matter what. As far as I know, there are no major risks to using it. I don't know if I'd do shot or oral though. I don't like putting anything in baby's tummy except bm at the start but I also don't like needles either!

[raelize]

we didn't do vit K shot with either dds. if i had reason to, i would go with the oral vit k.

our ped thought it was a little reckless to not do the shot, but then when he was doing the heelprick, he could barely get blood (even though her heel was plenty warm from a heat pack). he told us then that he was glad she didn't get the shot since he could barely get enough blood, what would it have been like with the shot?

i would probably get the oral vit k before the birth just in case i needed it, but i wouldnt feel comfortable giving baby a shot.
i do think that with increasing mama's intake the baby will be fine. but if there was a birth trauma or something that made my m/w suggest it, i would do it.

[gravida]

We didn't do it. We decided if there was birth trauma or something we would but we decided it was not something we were going to give without cause.

[Partaria]

Great information. Thanks, everybody!

[Lady Lilya]

We didn't do it.

I've seen a few mentions that it is linked in some way to leukemia. There was some evidence of stem cells (which newborns have a lot of) proliferating in a cancerous way when in the presence of higher levels of vit K.

I've seen articles about other clotting factors besides vit K that are actually higher at birth and decrease slowly over the first few days, just as vit K levels are rising due to nursing.

I have seen data about the clotting disorders that can be remedied by vit K and statistics showing how rare they are. If I had reason to believe that we were at increased risk for one of these, I might consider doing the vit K, but not as a routine step.

I considered the oral version vs the injected. I can see why some would prefer the oral version, but I would be concerned with interfering with the virgin gut.

Mostly I can't believe all babies are born with a defect that needs to be addressed immediately after birth by the medical establishment. Some, sure, but not all. It makes sense to me that there is a reason why vit K levels in a newborn are lower that the levels an adult would have. Even if we don't know what that reason is. (Perhaps it does have something to do with a certain stage of cell proliferation needing a low-K environment to occur properly, but perhaps not.)

[mwherbs]

The shot version processes out of the body a little bit via urine but mainly via intestines through bile , so it will also have an effect on flora. Some of it will be reabsorbed.
Vitamin K is absorbed in the small intestine thru active transport, that region has scant flora and the primary source of vitamin k is diet - breast milk has varying amounts of vit k depending on what mom eats. The more vit K foods mom eats the more will be in her milk. In exclusively breastfed infants mom's milk is the source of vitamin K , normal flora in breastfed infants bifidus and other lactic acid producing strains consume vitamin K but are not producers of vitamin k. Intact in order to culture or produce bifidus bacteria outside the body/breast milk system vitamin K is essential. Bottle fed infants typically have ecoli and other critters that do produce some vit K. What is now thought to be the change at about 8 days is liver function,not flora production, as most jaundice and other things that would be taxing the liver right after birth has pretty much resolved. Prolonged jaundice is one of the conditions that would indicate a potential vit K absorption problem.
The issues of concern is that there are certain metabolic disorders as well as some degrees of liver or gallbladder disfunction that can result in bruising, intestinal bleeding and brain hemorrhage, due to vitamin K deficiency.

You can look at your dietary intake , the RDA which was basically set from studies in the 1930's is 90 micrograms per day for women pregnant or not, most American women of childbearing age eat about half the RDA aprox 50 micrograms, more recent studies on vit K functions in the body suggest 250 micrograms a day minimum. There have been no studies yet to suggest optimal dietary amount for breastfeeding moms , I would suggest shooting for 250 micrograms, which is pretty easy if you eat greens everyday.
You can check your food values out at the USDA nutritional data site it is a little awackward to use or this other site that self mag offers that is a pretty good online tool
http://nutritiondata.self.com/


I wanted to add that the published rates for babies that do not get a shot or oral K is 1-2 per 1000. There are lower incidences published but they are out of total populations instead of measuring numbers of occurrence out of breastfed babies that do not get vit k supplementation.

[MnMtm]

My midwife gave my a study that showed that the vitamin K shot did slightly increase the child's risk for childhood leukemia, but that not getting it did increase the child's risk for hemorrhage, especially if the child was born with forceps or vaccuum extraction. The increased risks for either were about the same, but we decided to forgo it considering that our child had a completely natural and uncomplicated birth, and we did left him intact. I will try to see if I can find the study online, or at least find the paper copy I have of it.

[Marissamom]

Originally Posted by mwherbs

What is now thought to be the change at about 8 days is liver function,not flora production, as most jaundice and other things that would be taxing the liver right after birth has pretty much resolved. Prolonged jaundice is one of the conditions that would indicate a potential vit K absorption problem.

do you have a link to more info about this? I'm interested because DD was jaundice for 3 months, though mildly so, and I'm curious if Vit K could have been a factor.

[mwherbs]

I have info to support giving babies with prolonged jaundice vitamin K.
If that is what you are looking for, the info on vitamin k as a cause of jaundice came from the days when they would routinely supplement newborns with 45 milligrams a day, which is no longer done and hasn't been done since the 1960's.
Here is a link to a 1994 full Tex article that talks about treating prolonged jaundice with vit K
http://www.ncbi.nlm.nih.gov/pmc/arti...8/?tool=pubmed

Then in more recent years prolonged jaundice becomes one of the vitamin K deficiency Bleeds prodromal symptoms along with bruising and intestinal bleeds and blood seeping from umbilicus.it is in the 1999 paper compiled by a committee defining vitamin K deficiency bleeds.

Thromb Haemost. 1999 Mar;81(3):456-61.
Vitamin K deficiency bleeding (VKDB) in infancy. ISTH Pediatric/Perinatal Subcommittee. International Society on Thrombosis and Haemostasis.
Sutor AH, von Kries R, Cornelissen EA, McNinch AW, Andrew M.

Universitäts-Kinderklinik, Freiburg, Germany. [e-mail]
" DIAGNOSIS: In a bleeding infant a prolonged PT together with a normal fibrinogen level and platelet count is almost diagnostic of VKDB; rapid correction of the PT and/or cessation of bleeding after VK administration are confirmative. WARNING SIGNS: The incidence of intracranial VKDB can be reduced by early recognition of the signs of predisposing conditions (prolonged jaundice, failure to thrive) and by prompt investigation of "warning bleeds"."



And here is a quote from a recent study done

Arch Dis Child Fetal Neonatal Ed. 2009 Nov;94(6):F456-60. Epub 2009 May 3.
Vitamin K deficiency bleeding in cholestatic infants with alpha-1-antitrypsin deficiency.
van Hasselt PM, Kok K, Vorselaars AD, van Vlerken L, Nieuwenhuys E, de Koning TJ, de Vries RA, Houwen RH.

Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584EA Utrecht, The Netherlands. [e-mail]


CONCLUSIONS: The risk of VKD bleeding in breastfed infants with A1AD was high and did not correlate with serum level of conjugated bilirubin at diagnosis. A similar absolute risk was previously reported in breastfed infants with biliary atresia under the same prophylactic regimen. This confirms that-without adequate prophylaxis-the risk of VKD bleeding is uniformly high in exclusively breastfed infants with cholestatic jaundice, irrespective of underlying aetiology.


"

[owlgirl]

http://www.vaclib.org/basic/vitamin-k.htm

Here is a link to an article so everyone can take a look. When I read it I was like "finally, some solid info that is evidence based and not fear based disinformation!" Hope you find it useful. I did and confidently will forgo the shot!

[Marissamom]

Originally Posted by mwherbs 

I have info to support giving babies with prolonged jaundice vitamin K.
If that is what you are looking for, the info on vitamin k as a cause of jaundice came from the days when they would routinely supplement newborns with 45 milligrams a day, which is no longer done and hasn't been done since the 1960's.
Here is a link to a 1994 full Tex article that talks about treating prolonged jaundice with vit K
http://www.ncbi.nlm.nih.gov/pmc/arti...8/?tool=pubmed

Then in more recent years prolonged jaundice becomes one of the vitamin K deficiency Bleeds prodromal symptoms along with bruising and intestinal bleeds and blood seeping from umbilicus.it is in the 1999 paper compiled by a committee defining vitamin K deficiency bleeds.

Thromb Haemost. 1999 Mar;81(3):456-61.
Vitamin K deficiency bleeding (VKDB) in infancy. ISTH Pediatric/Perinatal Subcommittee. International Society on Thrombosis and Haemostasis.
Sutor AH, von Kries R, Cornelissen EA, McNinch AW, Andrew M.

Universitäts-Kinderklinik, Freiburg, Germany. [e-mail]
" DIAGNOSIS: In a bleeding infant a prolonged PT together with a normal fibrinogen level and platelet count is almost diagnostic of VKDB; rapid correction of the PT and/or cessation of bleeding after VK administration are confirmative. WARNING SIGNS: The incidence of intracranial VKDB can be reduced by early recognition of the signs of predisposing conditions (prolonged jaundice, failure to thrive) and by prompt investigation of "warning bleeds"."



And here is a quote from a recent study done

Arch Dis Child Fetal Neonatal Ed. 2009 Nov;94(6):F456-60. Epub 2009 May 3.
Vitamin K deficiency bleeding in cholestatic infants with alpha-1-antitrypsin deficiency.
van Hasselt PM, Kok K, Vorselaars AD, van Vlerken L, Nieuwenhuys E, de Koning TJ, de Vries RA, Houwen RH.

Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584EA Utrecht, The Netherlands. [e-mail]


CONCLUSIONS: The risk of VKD bleeding in breastfed infants with A1AD was high and did not correlate with serum level of conjugated bilirubin at diagnosis. A similar absolute risk was previously reported in breastfed infants with biliary atresia under the same prophylactic regimen. This confirms that-without adequate prophylaxis-the risk of VKD bleeding is uniformly high in exclusively breastfed infants with cholestatic jaundice, irrespective of underlying aetiology.


"

thanks for the additional info. it does sound like DD may have been vitamin K at least mildly deficient, I hadn't made any effort of upping my vitamin K levels, so I'm going to have to make extra sure I get my levels up this time.