What are your vitamin K plans? « Back to Group Discussions

[LightForest]

I was talking with my midwife about this today and now I'm not sure what to do! She doesn't stress the need for vitamin K for baby, but if we do want to administer it she recommends that we do injectible vitamin K in order to avoid introducing a foreign (non-colostrum/milk) substance into baby's gut via the oral vitamin K drops. So I'm curious -- what are your plans re: vit K?

If you're planning a homebirth, are you buying vitamin K as a part of your homebirth kit, or is it supplied by your midwife?

Oh, and while I'm listing lots of questions does the fact that I'm drinking lots of nettle tea (I include a lot in my RRL recipe) mean that my own super high vitamin K stores will be passed onto baby at birth? Is my ingestion of vitamin K rich tea going to give the baby a vitamin K boost regardless of whether we give baby oral or injectible vit K at birth??

[withlittlelungs]

We are doing vitamin K. It is the one vaccine I am ok with, plus I don't have the energy to fight hospital workers about it. I was planning on denying the eye ointment but I just found out that it is a state law, which I find utterly ridiculous.

I'm not sure about whether your vitamin K gets passed onto baby in large enough amounts to make a difference, but I am interested in hearing the answer!!

[spughy]

My midwives last time said that mother's stores of vitamin K didn't have any observable effect on baby stores - that vit K is made in the gut and babies didn't start producing it until they had gut bacteria to do it for them.  Just the way it is... 

(BTW Vit K is NOT a vaccine.)

I did the oral for DD but this time, since blood glucose is a concern and I'm going to be asking to have the baby tested for that anyway, I figure one more prick isn't going to do significantly more damage so I will be asking for a vit K injection.  But I do have the option of declining the eye guck - there is no chance in hell I have any of the STDs that it's protective against (unless I have been abducted by STD-infected aliens and am unaware of that) so there is no point in wasting perfectly good medication when there is zero risk.  That's me, looking out for our socialist health care $$$.

[withlittlelungs]

Originally Posted by spughy 

(BTW Vit K is NOT a vaccine.)

Duh, sorry! I meant injection. Blaming the pregnancy brain on that one 

[firespiritmelody]

We'll be getting the injection - having a hb and it is included in the supplies the mw brings with her.

This is a "pick your battles" issue for me that just isn't worth fighting. I'm small framed and have big babies (youngest DD was 9 1/2 pounds) and I have a tendency for them to be posterior. So, the chance of bruising and such is pretty high. I wont be doing eye gunk this time (no longer a state law here) and will NOT be doing hep b. I feel that in our case, getting the vit k is a good choice.

[Melany]

Originally Posted by withlittlelungs 

We are doing vitamin K. It is the one vaccine I am ok with, plus I don't have the energy to fight hospital workers about it. I was planning on denying the eye ointment but I just found out that it is a state law, which I find utterly ridiculous.

I'm not sure about whether your vitamin K gets passed onto baby in large enough amounts to make a difference, but I am interested in hearing the answer!!

You can delay the eye gunk. :) There is no reason baby has to have it within minutes of birth. We were "required" to have it last time and I made them wait until after nursing had been established. I even made them wait on the bath and weighing. Baby was asleep when they finally got to that. :) Baby is super alert right after birth, which is the best time to establish nursing. 

[cocoanib]

We opted out of vit K for DD's homebirth. The midwife had both injectable and oral available.

I didn't feel it was necessary for us, but I was open to it if she had a lot of bruising.

This time, I thought about getting some oral to have at home for our UC. I'm still looking into it.

No erythromycin last time or this time.

[scruffy too]

Originally Posted by spughy 

My midwives last time said that mother's stores of vitamin K didn't have any observable effect on baby stores - that vit K is made in the gut and babies didn't start producing it until they had gut bacteria to do it for them.  Just the way it is... 

I agree (or at least that's what my mat. nurse mom told me when I asked her,) my levels of vitamin K will have NO impact on baby.

I'm opting out.  I *think* my midwife said that if I wanted it, she'd have to know in advance so she could grab some (but I can't exactly remember... pregnancy brain!) 

[LightForest]

Thanks for your input on how baby builds vitamin K. Too bad all my vitamin K stores can't be shared with the little one ;) Oh well.

I'm leaning towards buying the injectible form ($8), and will probably have the midwife administer it after birth. Though I'm tempted to ask baby's MD for his opinion on this - I have to figure out whether to see if he can do the PKU heel prick after the homebirth anyway. My midwife can do these things but I have a feeling that it would be simpler to have the MD do it, in terms of insurance coverage.

The birth of my first daughter also left me feeling like the there was a lag in the continuity of her care between the hb midwife who delivered her (and administered the first dose of oral vitamin K, and submitted the birth certificate paperwork), the NICU (which performed two PKU heel pricks and the hearing screen), and her MD. This "lag" isn't something that I can blame on anyone - I just felt like there were a lot of options to juggle and no one but me was keeping track of what had been done and what hadn't. I was also in a position to really want some things (like PKU) and not others (like eye goop and hep b), so I was doing some juggling of my own between all of those care providers to try to get the outcome I was looking for :)

[jodieanneanton]

Oh..... My..... Goodness.....  I can feel myself getting all fired up!   But it's about something semi-off-topic brought up by withlittlelungs (the state making "laws" that force unnecessary medical treatment onto children against parental wishes).  But first, I will answer the Vitamin K question posed by LightForest and then maybe touch on the eyedrop/state law thing at the end of my post for those that care to know my opinion about that bunch of baloney.

I am a natural lady.  I really believe that humans were designed/evolved (however you believe we got to present times) very well!  The body, when treated correctly, when living as it is supposed to live, generally does things for a reason.  I generally like to err on the side of caution when it comes to putting outside (and unnatural) things into the body...medications (including but not limited to antibiotics), supplements, injections of any kind. In addition, for newborns this means anything orally before a natural interest in food develops.  (This is not to say that things sometimes can go wrong.  They most certainly can! I am grateful that medical advances are around in the case that something goes wrong, but approach treatment with a serious look at risk vs. benefit.)  That being said, I am very weary of any blanket "treatments" for everyone.  (Routine IV antibiotics, eyedrops, vit k, vaccines, Vitamin D drops for breastfed infants, etc.) The purpose of the vitamin K shot is to "treat" the "deficiency" of vitamin K that is present in all newborns.  Ok... Naturally minded parents will often start with the question, "Can I (the mother) increase my vitamin K consumption to pass on to baby in utero?  Or breastfeeding?"  The answer presented to them will inevitably be, "No.  Very little vitamin K can be passed through the placenta or through breast milk. And a mother's stores of vitamin K naturally decline in the third trimester." Hmmmm.... If ALL newborns are born "deficient" in vitamin K (I prefer the phrasing "born with low stores of vitamin K"... How is it a deficiency if it is NORMAL in ALL newborns?) and a mother's stores of Vitamin K during the third trimester naturally decline, is it possible there is a natural reason for this?  That it is a mechanism of design/evolution?  I mean the human race made it all the way to the 1960s without the Vitamin K injection... clearly SOMETHING was working.

The first article I linked (see below) explains more of this in detail including some very interesting info about stem cells in breast milk.  It is also not lost on me that much of the damage to babies that cause the need for thicker (faster clotting blood) is caused due to hospital practices (induction, coached pushing, epidurals and other pain medications, vacuum/forcepts delivery, AROM, etc)  that inflict unnecessary dangers and risks on the newborn.  The second article I linked (again, see below) explains that and more about the "need" for vitamin K.  It also provides great info on how the infants body starts to create vitamin k!  A very interesting read.  The type of Vitamin K in the shot is synthetic and not natural.  This is problematic to me as well.  On top of all of this, I have concerns about additives to the Vitamin K injection and am having a really hard time finding the insert for the injection (made by Merck). 

Here is a good essay that deals with the reason for low vitamin K levels in newborns and just about sums up how I feel about it.

An article that deals with the reasons for early vitamin K deficiency bleeding in newborns can be found here.

Needless to say, we will be declining the Vitamin K shot at birth.

And now on to this whole "state law" business.  I am really sensitive about this type of topic.  And very grateful that I have the right to refuse here in Ohio. But... it's ALWAYS a fight. It just boils my blood that the government believes they have the right to override my parental judgement.  I know my kid better than anyone.  We are supposed to be living in a free society.  With that freedom comes great responsibility.  I take the responsibility to raise my family very seriously.  I research EVERYTHING and I find it incredibly insulting that the government thinks it necessary to step in and override that research and my convictions. I get so worn down sometimes with how much fighting I have to do about EVERYTHING... home schooling, no vaccines, no eye ointment, no vit k, the right to consume raw milk if I so choose...  It is exhausting sometimes. (Off soapbox now... sorry.)

Anyway...

I looked up the law in TX, withlittlelungs.  It is not illegal to refuse the antibiotic eye ointment.  The law is worded in the way that it makes it a misdemeanor for healthcare worker to not administer it, not for the parent to refuse it.  Texas Health & Safety Code. 

§ 81.091. OPHTHALMIA NEONATORUM PREVENTION; CRIMINAL 
PENALTY. (a) A physician, nurse, midwife, or other person in 
attendance at childbirth shall use or cause to be used prophylaxis 
approved by the board to prevent ophthalmia neonatorum.
(b) A midwife is responsible for the administration of the 
prophylaxis to each infant the midwife delivers by:
(1) administering the prophylaxis under standing 
delegation orders issued by a licensed physician; or
(2) requiring the prophylaxis to be administered by an 
appropriately licensed and trained individual under standing 
delegation orders issued by a licensed physician.
(c) Subject to the availability of funds, the department 
shall furnish prophylaxis approved by the board free of charge to:
(1) health care providers if the newborn's financially 
responsible adult is unable to pay; and
(2) a midwife identified under Chapter 203, 
Occupations Code, who requests prophylaxis for administration 
under standing delegation orders issued by a licensed physician 
under Subsection (b) and subject to the provisions of Subchapter A, 
Chapter 157, Occupations Code.
(d) If a physician is not available to issue a standing 
delegation order or if no physician will agree to issue a standing 
delegation order, a midwife shall administer or cause to be 
administered by an appropriately trained and licensed individual 
prophylaxis approved by the Texas Board of Health to prevent 
ophthalmia neonatorum to each infant that the midwife delivers.
(e) Administration and possession by a midwife of 
prophylaxis under this section is not a violation of Chapter 483.
(f) A health care provider may not charge for prophylaxis 
received free from the department.
(g) A person commits an offense if the person is a physician 
or other person in attendance on a pregnant woman either during 
pregnancy or at delivery and fails to perform a duty required by 
this section. An offense under this section is a Class B 
misdemeanor.
(h) In this section, "financially responsible adult" means 
a parent, guardian, spouse, or any other person whom the laws of 
this state hold responsible for the debts incurred as a result of 
hospitalization or treatment.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989. Amended 
by Acts 1991, 72nd Leg., ch. 158, § 24, eff. Sept. 1, 1991; Acts 
2001, 77th Leg., ch. 1420, § 14.772, eff. Sept. 1, 2001.

Now, if it is really really important to you to decline the eye treatment (which is for preventing blindness in the infant in the case that the mother is positive for certain STDs), you have the right to do so.  After reading several threads on various forums, it seems like people have mixed results with declining in the state of Texas.  Some just have to sign a form to decline with no problems. I have also seen stories of CPS being called (though I have seen nothing about infants being taken away). <--I realize this is all anecdotal.  I just wanted to clarify that the law does not prevent you from declining this treatment.  Your course of action will have to do with your comfort level, of course.  There is also nothing that stops you from wiping off as much ointment as you can after application, though this does not prevent all antibiotic exposure, it'd be a better option than nothing.  I also like Melany's advice of delaying eye ointment until as late as possible or at least after nursing is established.

Edited by jodieanneanton - 2/1/13 at 5:41pm

[spughy]

Jodie, I had a long talk with my midwives about the decline in mother's stores of Vit K and the overall "deficiencies" in newborns of Vit K and how it didn't seem logical that if it was a problem for all newborns that it was actually a problem.  I, like you, am inclined towards the natural way of things - but unfortunately, in the natural way of things, newborns sometimes die, and diseases happen even to otherwise healthy full-term infants from mothers in good health themselves - the problem with things like a lack of clotting ability in newborns is that actual fatalities ARE very rare.  They've always been rare, so the effect of this on our evolution is minimal. It's entirely incorrect to assume that just because our species does something naturally that it's always beneficial to the individual.  What it really means is that either there hasn't been selection pressure against the trait, or that it's the lesser of some possible detriments, or that it's beneficial in some non-obvious way.  What appears to be the case is that there hasn't been sufficient selection pressure for humans to acquire a mutation that allows for some form of vitamin K buildup prenatally - and because vitamin K is one of those nutrients that is developed through a symbiotic relationship with our intestinal flora, it's hard to see how a mechanism for that would develop.  As far as maternal stores lowering during the third trimester, I think that's likely a side-effect of the general shift in intestinal flora that seems to be natural in all women during the third trimester.  We don't know why that is yet.  It's possible that it conveys some benefit that outweighs the risks of lower vit K - but we don't know.

You're right in that modern birthing methods can put babies at higher risk for bruising etc.  And I'm not wanting to be an apologist for unnecessary interventions or anything - but we all live modern lives eating modern diets and using modern things like chairs and beds and shoes and things - all of which subtly impact our body alignments, development, and physiological makeup.  (I'm all for trusting bodies to work - but at the same time, I'm not under any illusion that my body is perfect.) Personally, I think these things DO have an effect on how easily we carry and birth our babies, and while absolutely I think a LOT of interventions are unnecessary and motivated by concerns other than mother-baby wellness, it's hard to argue that the development of relatively safe c-section, forceps, vacuum whatzits and so on have been thoroughly detrimental - I don't think it makes sense to think that we can alter our environments far beyond that to which our bodies are adapted without some compensatory technology to make up for our slightly out-of-whack bodies.  But these technologies are far from gentle and perfect.  So what we're left with is a situation in which a baby may need to be quickly removed from the mother because its survival is at stake.  In a more natural environment, it's possible that either the situation wouldn't have arisen OR that the baby would be injured or die.  We have a third option - nearly guaranteed survival with a risk of damage.  Most mothers choose that option - and it makes sense, given that's a real risk in many cases, to have the vit K on hand.

This is just my opinion - I do NOT think such decisions should be mandated by the state (if the state mandates such things then the state is essentially admitting massive failure of its own education systems) and I think with that logic, someone might find it reasonable to have the vit K on hand but opt to not use it if the birth is uncomplicated and baby is unlikely to have sustained bruising.  I think if I went that way I would be SO completely paranoid that the baby would be dropped or accidentally sustain a bonk to the head or something soon after birth that I would find it hard to sleep - but I'm kind of neurotic right after birth anyway and I can appreciate that some mothers would be more comfortable with the risk associated with their own clumsiness than the risks associated with injecting a vitamin into a baby so soon after birth.  I don't swing that way, but I can completely understand how others would and that's fine.   I just think that it's possible - not certain, we just don't know enough - but possible, that dismissing the potential benefits of administering vit K at birth is an example of what evolutionary psychologists term "naturalistic fallacy" - that just because we evolved that way, it's what we SHOULD do.  Most of the time people talk about naturalist fallacies in connection with concepts associated with social darwinism, but I think that it can apply in this context as well.

[LightForest]

jodieanneanton, !

i really do appreciate this conversation - it's a topic WORTH getting fired up about! i feel SO lucky to have easy pregnancies that make me an easy candidate for midwifery care, and to live in a place where i have access to care providers who actually believe in informed parental decision making and low, low intervention!

your mention of blanket treatments for the masses reminds me of something funny (to me) that's happened a couple of times in the last month. some stranger asks me about my ultrasounds in one way or another, and i say that we haven't had any ultrasounds... i don't really want to get into it with strangers, but i also don't want to lie...

ANYWAY, the response EVERY TIME has been "oh. they LET you do that? i thought they MADE you do that" (get ultrasounds).

i am dumbfounded and saddened by this attitude!!! but i guess i'm pretty naive... i thought more people realized that most of these decisions CAN BE up to them... but i guess that would require lots more effort, and the average person finds comfort in a smart person in a white coat just telling them the formula to follow.

[jodieanneanton]

Spughy, I don't necessarily disagree that NO ONE should give their infant vitamin K.  If certain risk factors were present, it would certainly be something I would consider.  Like I said above, 

Quote:

Originally Posted by jodieanneanton 

  (This is not to say that things sometimes can go wrong.  They most certainly can! I am grateful that medical advances are around in the case that something goes wrong, but approach treatment with a serious look at risk vs. benefit.) 

Ah! There is so much in your post I'd love to reply to, but I am a sleepy lady... and DH needs the computer.   So, tomorrow I will be back! 

[spughy]

I look forward to your return!!!  I do enjoy a nice academic civilized debate   I am not mentally capable of mustering any further coherencies at this point in the evening either though.
 

Edit to add: you know you're no longer able to even pretend to be cool, when your Friday night consists of bailing out of an online debate about vitamin injections because you're just too tired.

[Chapsie]

Originally Posted by spughy 

I look forward to your return!!!  I do enjoy a nice academic civilized debate   I am not mentally capable of mustering any further coherencies at this point in the evening either though.

 
Edit to add: you know you're no longer able to even pretend to be cool, when your Friday night consists of bailing out of an online debate about vitamin injections because you're just too tired.

Spughy, you are so funny! I have literally laughed out loud MANY times when reading your posts.

As a newborn nurse, I give vit k injections and erythromycin eye ointment every day I work. Jodie, tomorrow, I will see if I can get a Merck insert for the vit K for you!

In NYS (looks like a similar law to that in Texas), as a health care worker attending deliveries, I must legally administer vit k (1 mg which is a 0.5 ml injection in the baby's thigh) and place the erythromycin in the baby's eyes within 1 hour of birth. I can be "sanctioned" if I don't. (That's what the law says... Don't really know what being "sanctioned" entails exactly, haha).

If a parent refuses the vit k and erythromycin, then CPS is supposed to be called (which I also find ridiculous). I have never ever ever seen CPS actually do anything in that case, though!

In Bible times, baby boys were circumcised on the 8th day. I'm pretty sure the baby develops his own vit k by that point. . I always thought that was a neat tidbit. Today, baby boys are circumcised as early as 12 hours! Good thing they got that vit k injection, right?? (Being a little facetious here.)

I was just going to have the midwife give the meds because I figured I didn't have a choice...

[jodieanneanton]

Originally Posted by LightForest 

ANYWAY, the response EVERY TIME has been "oh. they LET you do that? i thought they MADE you do that" (get ultrasounds).

i am dumbfounded and saddened by this attitude!!! but i guess i'm pretty naive... i thought more people realized that most of these decisions CAN BE up to them... but i guess that would require lots more effort, and the average person finds comfort in a smart person in a white coat just telling them the formula to follow.

Yes.  It actually pains me when I hear things like "You can do that?" in regards to medical care, too.  I was talking about declining hatting baby at birth with some of my family and got a whole bunch of weird looks  and comments of that nature.  I tend to have more faith in the human body than most, though.  And I am often suspicious of the medical field (Not individuals, mind you, just the whole system and how it 'works')... especially because of all the money to be made by cooporations and connections to politics, etc. That is why I choose to research EVERYTHING to come up with a solution to "problems" that I am comfortable with.  My decisions to forgo many things are well thought out, not a response to a fad or trend.

Originally Posted by spughy 

I look forward to your return!!!  I do enjoy a nice academic civilized debate   I am not mentally capable of mustering any further coherencies at this point in the evening either though.
 

Edit to add: you know you're no longer able to even pretend to be cool, when your Friday night consists of bailing out of an online debate about vitamin injections because you're just too tired.

  I have never been cool.  hahaha!  And I stopped my pretending to be cool when 7 pm became "too late" to go anywhere. My kids think I am cool though (for now, lol).  I was just given thanks upon thanks from DD2 for giving her oatmeal with honey AND ciminin (cinnamon).

Originally Posted by Chapsie 


As a newborn nurse, I give vit k injections and erythromycin eye ointment every day I work. Jodie, tomorrow, I will see if I can get a Merck insert for the vit K for you!


In Bible times, baby boys were circumcised on the 8th day. I'm pretty sure the baby develops his own vit k by that point. . I always thought that was a neat tidbit. Today, baby boys are circumcised as early as 12 hours! Good thing they got that vit k injection, right?? (Being a little facetious here.)

I was just going to have the midwife give the meds because I figured I didn't have a choice...
 

Chapsie!!!!!!!!  It would be sooo cool to see the actual insert for the VitK injection!!!!! :D  Wahooey!!!  I am feeling so excited about this!!!  (Just another sign of how (un)cool I really am! )  Re: Circumcision.  I LOVE when things fall into place like that.  An infant naturally develops stores of vitamin K through gut flora, colostrum and mother's milk in the first week.  It is so interesting that traditional hebrew culture's tradition of circumcision was practiced after that point.  I feel like a lot of times, we are trying to fix things that we screwed up in the first place...  You mentioned this surgery on an infant less than one day old causes them to "require" the vitamin K injection.  Another (off topic) example I like to use is that we are told to stop eating diets containing fat (No butter, no red meat, no lard, no whole milk products, etc.) then we are warned against going into the sun "unprotected."  Then, all of a sudden, people realize that there is an epidemic of Vitamin D deficiency in our country and we need supplements!!!!!!!  (Nevermind that we cut off our source of Vitamin D (the sun) and our means of naturally processing it (fat)!) Also... You ALWAYS have a choice... Your course of action just depends on your conviction/decision and then comfort level with the consequences of that choice.

-------------------------------

Onto my response to you, Spughy, in a second post....

[jodieanneanton]

Here are some of my concerns regarding Vitamin K injection at birth:

- the form of vitamin K routinely given to newborns is a synthetic version of the vitamin (this carries a load of possible risks)

- It is given in extremely high dosage (so the baby's levels of Vitamin K become much higher than an adults)

-It is injected (Ouch, stress for baby in very fragile and important first hour of life, etc)

- It is injected into the muscle tissue (Warned against in insert literature from what I have read...again, I do not have access to the insert at this time)

- Can cause severe allergic reactions

- Other side effects include jaundice (which includes its own set of risks), Pain, swelling, or soreness at the injection site may occur. Temporary flushing, taste changes, dizziness, rapid heartbeat, sweating, shortness of breath, or bluish lips/skin/nails may also infrequently occur. (Link) None of this is something I want to subject my infant to if they are not at risk for problems.

-Actual cause of Hemorrhagic Disease of the Newborn is unknown.  Vitamin K is said to have helped in some cases, but with very few poorly controlled studies, it is not conclusive in my mind.

Originally Posted by spughy 

Jodie, I had a long talk with my midwives about the decline in mother's stores of Vit K and the overall "deficiencies" in newborns of Vit K and how it didn't seem logical that if it was a problem for all newborns that it was actually a problem.  I, like you, am inclined towards the natural way of things - but unfortunately, in the natural way of things, newborns sometimes die, and diseases happen even to otherwise healthy full-term infants from mothers in good health themselves - the problem with things like a lack of clotting ability in newborns is that actual fatalities ARE very rare.  They've always been rare, so the effect of this on our evolution is minimal. It's entirely incorrect to assume that just because our species does something naturally that it's always beneficial to the individual.  What it really means is that either there hasn't been selection pressure against the trait, or that it's the lesser of some possible detriments, or that it's beneficial in some non-obvious way. This is what I think is the situation at hand.  The first article I linked in my above post talks about the stem cells present in cord blood (and the importance of waiting to clamp) and even breast milk!  These healing and powerful stem cells can easily move through the thin blood that babies are naturally born with.  When Vitamin K is injected into the newborn (at levels WAY higher than what is considered normal for an ADULT), their blood thickens, requiring the naturally healing stem cells to now have to move through "sludge, not nicely greased blood vessels full of blood which can allow stem cells easy access to anywhere" in the infant's body.   What appears to be the case is that there hasn't been sufficient selection pressure for humans to acquire a mutation that allows for some form of vitamin K buildup prenatally - and because vitamin K is one of those nutrients that is developed through a symbiotic relationship with our intestinal flora, it's hard to see how a mechanism for that would develop.  As far as maternal stores lowering during the third trimester, I think that's likely a side-effect of the general shift in intestinal flora that seems to be natural in all women during the third trimester.  We don't know why that is yet.  It's possible that it conveys some benefit that outweighs the risks of lower vit K - but we don't know.  I have a problem with the fact that we are treating EVERY infant for something that we don't understand.  I also am uncomfortable with the lack of studies on the vitamin K injection (alone and also in conjunction with other injections infants receive), ESPECIALLY in newborn babies born naturally (not pre-term, vaginally, no induction, no epidural, no forcepts/vacuum, delayed clamping of cord, quick establishing of breastfeeding, etc) to low-risk healthy mothers.  This is the situation I find myself in.  I am also uncomfortable that it is just given.  Parents are often not informed of side effects or even WHY the medical establishment believes that Vitamin K is essential for the well-being of ALL newborns.

You're right in that modern birthing methods can put babies at higher risk for bruising etc.  And I'm not wanting to be an apologist for unnecessary interventions or anything - but we all live modern lives eating modern diets and using modern things like chairs and beds and shoes and things - all of which subtly impact our body alignments, development, and physiological makeup.  (I'm all for trusting bodies to work - but at the same time, I'm not under any illusion that my body is perfect.) In a situation where a woman is taking care of her health (nutritionally, chiropractic, holistic care, etc), I think it is personally reasonable to forgo the Vitamin K shot.  (It is a drug, not free of side effects!)  Personally, I think these things DO have an effect on how easily we carry and birth our babies, and while absolutely I think a LOT of interventions are unnecessary and motivated by concerns other than mother-baby wellness, it's hard to argue that the development of relatively safe c-section, forceps, vacuum whatzits and so on have been thoroughly detrimental Of course they are not thoroughly detrimental.  Like I said, I am happy that medical advances exist where we need them.  However, I think that oftentimes they are used defensively or after a unnecessary induction (for example).  It is clear that many women are induced for conveinience's sake... whether their own or their doctors...leading to the situation where a baby experiences heightened levels of trauma (Which would perhaps lead to a forced need for a product that wouldn't have been needed in the first place.  I mean, I had a friend when I was pregnant with DD1 who talked her doctor into inducing at 38 weeks simply because she wanted her baby to have an April birthstone!  (Though that was not what she told him, that was her real and true reasoning.)   - I don't think it makes sense to think that we can alter our environments far beyond that to which our bodies are adapted without some compensatory technology to make up for our slightly out-of-whack bodies.  But these technologies are far from gentle and perfect.  So what we're left with is a situation in which a baby may need to be quickly removed from the mother because its survival is at stake. Like I said, in a situation where baby's health has been compromised in some way, Vit K would be a reasonable consideration.  In a more natural environment, it's possible that either the situation wouldn't have arisen OR that the baby would be injured or die.  We have a third option - nearly guaranteed survival with a risk of damage.  Most mothers choose that option - and it makes sense, given that's a real risk in many cases, to have the vit K on hand.  <--- I need some clarification on what you mean by this...

This is just my opinion - I do NOT think such decisions should be mandated by the state (if the state mandates such things then the state is essentially admitting massive failure of its own education systems) and I think with that logic, someone might find it reasonable to have the vit K on hand but opt to not use it if the birth is uncomplicated and baby is unlikely to have sustained bruising.  I think if I went that way I would be SO completely paranoid that the baby would be dropped or accidentally sustain a bonk to the head or something soon after birth that I would find it hard to sleep - but I'm kind of neurotic right after birth anyway and I can appreciate that some mothers would be more comfortable with the risk associated with their own clumsiness than the risks associated with injecting a vitamin into a baby so soon after birth.  This is pretty much where I am at.  To me, the risks of the injection (and the cumulative effect of the many injections and procedures) don't override the belief that I have that the blood of a baby is thin for a reason (again, the article I previously linked explains the need for thin blood) I don't swing that way, but I can completely understand how others would and that's fine.   I just think that it's possible - not certain, we just don't know enough - but possible, that dismissing the potential benefits of administering vit K at birth is an example of what evolutionary psychologists term "naturalistic fallacy" - that just because we evolved that way, it's what we SHOULD do. The fact that we "don't know enough" of the potential benefits of administering Vitamin K leads me think that it is silly at best, detrimental at worst to routinely administer this drug to all infants regardless of risk category.  Most of the time people talk about naturalist fallacies in connection with concepts associated with social darwinism, but I think that it can apply in this context as well.

For the record, I don't think we are completely off base in our view of this topic.  We just came to different conclusions!

[babytoes]

I love a good well mannered debate. 

I am siding with Jodie, though. I do not do vaccines or any of the routine birth things. I feel as though God made our bodies perfectly, and how we enter the world is the way it is intended. That being said, the lack of studies makes me believe full heartily that it is a useless injection. I also am the type that does not go along with the medical community, and if anything I will push back twice as hard. When DP and I were only dating for a few months we had a fairly heated debate about vaccines and the general pharmaceutical community. Later in our relationship, while discussing having a baby (when would be the right time, etc.) I told him there was no way on earth I would have a baby if I had to fight him about vaccines, Tylenol, antibiotics, or any other pharmaceutical/medical related problem that reared its head with our child. He told me he trusted me and my judgment, and that he would not fight me on any decision I made. I think I may have taught him something!! 

I didn't do the Vit K before, and I won't be doing it this time. As far as I am concerned there is a reason babies are born without it, and we may not understand it, and it may baffle the researchers, but there is a reason.

[spughy]

Originally Posted by jodieanneanton 

Here are some of my concerns regarding Vitamin K injection at birth:

- the form of vitamin K routinely given to newborns is a synthetic version of the vitamin (this carries a load of possible risks)

- It is given in extremely high dosage (so the baby's levels of Vitamin K become much higher than an adults)

-It is injected (Ouch, stress for baby in very fragile and important first hour of life, etc)

- It is injected into the muscle tissue (Warned against in insert literature from what I have read...again, I do not have access to the insert at this time)

- Can cause severe allergic reactions

- Other side effects include jaundice (which includes its own set of risks), Pain, swelling, or soreness at the injection site may occur. Temporary flushing, taste changes, dizziness, rapid heartbeat, sweating, shortness of breath, or bluish lips/skin/nails may also infrequently occur. (Link) None of this is something I want to subject my infant to if they are not at risk for problems.

-Actual cause of Hemorrhagic Disease of the Newborn is unknown.  Vitamin K is said to have helped in some cases, but with very few poorly controlled studies, it is not conclusive in my mind.

For the record, I don't think we are completely off base in our view of this topic.  We just came to different conclusions!

Yup, agreed.  I think the points you raised are largely valid (although I'm not entirely sure about the scientific validity about the relative viscosity of newborn blood - I need to do some more reading on that).    My previous birth experience WAS highly traumatic for my baby, despite it being a vaginal delivery with no forceps or vacuum - I pushed her out VERY quickly and she was poorly positioned with a nuchal hand.  If I were a midwife, I would be a lot pushier about vit K for first-time moms with desk jobs - much less so for multipara mothers who had previously normal vaginal births and were physically active most of the day.  I do object to it being mandatory - it is not, here, nothing is.  Things are highly recommended but all the decisions are up to the parents (although in certain cases, like when fertility treatments are used, the physician may require parents to agree to certain procedures or to go with the physician's judgement in order for fertility treatments to proceed - there is a definite sense of "if you really want a baby, you do it our way or we don't help you.")  There probably ARE pushy doctors who try to guilt parents into things - I'm afraid those types are universal - but all they can do is be pushy and obnoxious and I have no personal knowledge nor have I heard many stories of this here.  There are rarely *legal* repercussions for parents who refuse treatments like vit K or eye guck or whatever, although if it's in the context of overall questionable parenting that leads to harm for the child, then social workers may get involved.  But there are no laws about these things, only guidelines, and since individuals are not required to pay for most treatments, the only reason to use the treatment or refuse it is information-based (and, admittedly, the advice of medical professionals - which unfortunately most of the people I know would rather rely on than their own research.  So be it.  This, I *definitely* view as a failure of our education system.)   And while there is some profit motive involved in treatments even under our system, I don't think it's quite as rampant as under a for-profit system overall.  A midwife (and I believe OBs as well) are paid a flat fee for each maternity patient, and the cost of the medication is covered separately - there is no fee for the midwife, OB or nurse for administering it, so no financial benefit to anyone except the company providing it for it to be used - and, while not as prevalent a motive as it should be, there is a sense of responsibility for everyone to try to SAVE the medical system money since it's funded by tax dollars.  This is why our provincial medical system head honchos are now trying to promote homebirths and midwifery - it's much less expensive and evidence shows no additional risk for your average pregnancy.   

So having been under the care of a midwives under a social healthcare system, and never having experienced any actual pressure to use or not use any particular treatment or medication for either myself of my child(ren), I tend to end up sort of down-the-middle in terms of what I'll go for and what I won't and it's usually based on a combination of my research, my midwife's preference, and my DH's comfort level with whatever is under discussion.  I'm not trying to imply that your distrust of the medical system is a knee-jerk reaction to simply being TOLD what to do - but I do think that a system that is driven by a combination of profit and legal concerns will necessarily encourage a default position of "no treatment" among people who are even slightly naturally questioning or critical.  It is unfortunate, and I think it also leads to a slight confirmation bias on the side of - for lack of a better term - alternative crunchy-granola theories and practices.  Now, I'll freely admit to being DEFINITELY on that side of most things!  And I FULLY agree with you on the lack of decent fats in the diet and sun exposure and vit D deficiencies, BTW.  But I don't feel the same... urgency or about things like vit K and vaccinations and whatnot - partly because my natural tendencies are more "huh, I'll look into that", partly because (unfortunately) as an older mom I don't GET attitude from most professionals about most stuff, and partly because our system doesn't seem to utilize the same kind of scare tactics and hyperbole that yours does. And maybe (as I have been informed by my husband) that my overall manner precludes people giving me a hard time about anything - I don't know about that, but apparently I sort of exude "I don't take shit from anyone".  Probably a good thing, but I don't like to be a scary or difficult patient!  So that may explain partly why you and I can actually agree on most things regarding the vit K shots and come to different conclusions.  And I think your conclusion is just as valid for you as mine is for me.  And now I am going to go read more about how vit K is synthesized or derived, and the viscosity of newborn blood.

Also, I'm pretty sure the vit K preparations the midwives use here are from the compounding pharmacy, not packaged from Merck.  Still most likely synthetic though - I'm not sure how it's derived but I can ask.  My midwife will either know or be able to find out.  I'll let you know. It's possible that's an option - purchasing your own vit K compound that doesn't have as much crap in it (and doesn't funnel money to Big Pharma).

(Clarification on "Most mothers choose that option - and it makes sense, given that's a real risk in many cases, to have the vit K on hand.  <--- I need some clarification on what you mean by this..."  What I meant is that especially for first-time moms, when you go into labour you don't really know what's going to happen.  There is always a possibility you will end up in a situation where forceps or a vacuum are used or you need a c-section, or even if the situation requires that the cord be cut immediately rather than waiting - if you've previously declined the vit K and there is none available, your baby might well survive birth but face problems with bleeding from birth injury.  I think it makes more sense to say "I MIGHT want my baby to have a vit K injection.  Please have it on hand and we will decide once the birth is complete."   Sorry I wasn't clearer.)

(Oh, apparently I DON'T get to read up on all that, I get to go to the playground with DD.  So later for that then. )

[LightForest]

Did anyone see the finale of 30 Rock where they spoof mommy message boards? SUCH a friggin hilarious example of an innocent question bringing up button-pushing issues... It's right at the beginning of the show, if anyone wants to see it on hulu...

Now, back to the discussion...