vitamin k and breech baby

[paranoidprego]

I am 39 week tomorrow. I found another OB who will deliver my breech baby naturally. Before I knew he would be breech, I had my pediatrician write an order for the vitamin K to be withheld at birth (my dd did not get the shot). I understand that there might be significant bruising with a breech delivery. So my question is: should I just get the vitamin K shot with a vaginal birth? or the oral dose? or If I end up in a c-section, is the vitamin K shot necessary at all? The pharmacy I go through has a prescription for oral vitamin K that I had my pediatrician call in today, but they said they cannot fill it until the baby is born due to the fact that the shelf life is not long and not knowing when the baby will be born. So they will not fill it just yet.

Does anyone know which is better to do and under these circumstances? I'm sorry if this doesn't make any sense. Thanks so much!

[Reha]

I know you didn't ask this question, but there is another Vitamin K option (that is recognized by the medical world). Mephyton tablets. They are shelf stable, and we crush about 1/4 of a tablet with a bit of colostrum or water and give it to baby (for parents who want Vit. K but don't want the shot). So, that is another possibility you can look into if you want.

As far as the necessity of Vit K, can you not make that decision after the birth, once you see bruising? Also, I'm not so sure that an in-labor cesarean would avoid bruising. If your baby's bum is engaged, it can still cause some bruising.

I'm not advocating Vit. K one way or another. Just saying that if it is something you don't want, it would be ideal to wait until birth and see if there is any obvious bruising.

[daintyfrump]

Are neonates producing enough bile salts to utilize the Vit K1?

http://www.fda.gov/medwatch/SAFETY/2...ephyton_PI.pdf

Add:
So there is plain ole' cholate in colostrum, but I can't find how much and if that affects the absorption.

[paranoidprego]

i was wondering about the bile salts too.

[maxmama]

Breech babies are at higher risk for intracranial bleeds, though (increased pressure of the aftercoming head), regardless of any bruising, so I would definitely consider the vitamin K. Remember too that the oral absorption can be variable from baby to baby, and oral doses need to be repeated, while the injection is a one-time deal.

[mwherbs]

one of the reasons I would recommend a vitamin K shot over oral vitamin K- beyond the head bruising there is also the nether parts tend to be more swollen and bruised. trauma uses up body stores of vitamin K- partly because it is anti oxidant and it is also anti-inflammatory as well as clotting/anti-clotting factors
as for a vitamin K tablet ? we use oral drops and they are absorbed you can tell the difference in clotting when doing the metabolic screening

[bcrn]

Ask for the injection to be give very slowly while the babe is on the breast, usually by the time they realize what i have done, there is one squeak,then right back to nursing,with minimum interruption.

[maxmama]

Originally Posted by bcrn

Ask for the injection to be give very slowly while the babe is on the breast, usually by the time they realize what i have done, there is one squeak,then right back to nursing,with minimum interruption.

Really, a longer injection time? I usually do it while the babies are nursing, but do it fast, with a 25-g or smaller 5/8" needle. By the time the baby even blinks, the needle's out.