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<p>How many of these are you planning to give to the staff? How many do you expect them to read?  BEcause this does start to be an issue - if you come in with 20 pages of research and reasoning, does anyone on shift actually have time to review them?  Or do they get shoved into a file labeled "birth plan" and never looked at?</p>
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<p>If you present doctors around here with a giant sheaf of previously unknown patient information, they are not going to have time to read it.  Or maybe one of them has time, and heaven knows if word gets around.  Or maybe one person starts reading and their eyes glaze over when you define HDN for them - they know what HDN is, and they probably feel like you should know that they know, so they start off feeling condescended to, and then they recall that they are busy and never look at page two.</p>
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<p>There is actually no need to persuade the hospital staff of anything.  All you need to do is make it clear that you refuse consent.  I think you would be better served by a single sheet with a big bold header reading:  WE DO NOT CONSENT TO THE FOLLOWING STANDARD PROCEDURES, followed by a list.  You can bring a ton of copies and hand them out.  It's just one page.</p>
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<p>If anyone wants to argue with you, make them come in and do it from scratch.  Don't give them a cheat sheet of points to rebut.</p>
 

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Agree with meepycat! Also, the hospital will likely have its own forms for refusing consent for suggested procedures. We do at my hospital.<br>
I agree with the one page form, but would state it even more kindly. I worded it like this:<br>
Yes, we are interested in these: (or whatever you want)<br>
Hearing screen<br>
Newborn screen<br>
Breastfeeding help<br><br>
No, thanks, we decline:<br>
Vitamin K (unless bruising present)<br>
Erythromycin<br>
Etc.<br><br>
Also, the jaundice check is not necessarily a blood draw. We routinely do a transcutaneous bilirubin (skin check) first and then move to a blood draw with high levels from that screening.
 

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<p>So, here's the problem (in my experience) with explaining to people what you know:  It always has holes.  Explanations are tricky.  It's sometimes better not to give them.</p>
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<p>You absolutely have the right to refuse the Vitamin K shot.  You are the parent, you are the person on the line for doing what is best for your child, and no one should ask you to substitute their judgment for yours. </p>
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<p>The waiver you've written here contains a lot of info straight from Robbie Davis-Floyd, whose citations don't allow you to read the actual articles (I've run Google Scholar searches and not been able to find them).  The newest citation in it is 25 years old, which makes them pretty out of date.  You stop quoting Davis-Floyd after the Trevathan citation, but the next sentence after that citation in <em>Birth as an American Rite of Passage</em> is "In about 1 out of 200 babies, even in those that are breastfed, however, there is significant danger of hemorrhage."  If you get a doctor who knows this (either because it was taught in medical school or because he's seen the text in question), that doctor now <em>has</em> to refute your form and ask you to reconsider, because you have given them a document that could be used in court as evidence that your refusal was inadequately or incorrectly informed.</p>
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<p>Just saying no is simpler all around.</p>
 

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<p>You might want to read this:</p>
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<p><a href="http://cestsibonblog.wordpress.com/2014/03/07/why-it-happened-the-truth-about-vitamin-k-deficiency-bleeding/" target="_blank">http://cestsibonblog.wordpress.com/2014/03/07/why-it-happened-the-truth-about-vitamin-k-deficiency-bleeding/</a></p>
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<p>This mother had an all natural birth with midwives at a birth center.  She did not give her child a vitamin K shot.</p>
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<p>Her daughter needed brain surgery from an intracerebral hemorrhage.  She almost died.</p>
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<p>You say you've done your research.  I can't imagine what research you've found that says the risks of Vitamin K outweigh the benefits.  Vitamin K is NOT well-transmitted through breast milk.  </p>
 

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<div class="quote-container" data-huddler-embed="/community/t/1398864/vitamin-k-refusal-would-like-your-input-good-bad-changes#post_17588172" data-huddler-embed-placeholder="false">Quote:
<div class="quote-block">Originally Posted by <strong>Chknlovr</strong> <a href="/community/t/1398864/vitamin-k-refusal-would-like-your-input-good-bad-changes#post_17588172"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a><br>
 
<p>You might want to read this:</p>
<p> </p>
<p><a href="http://cestsibonblog.wordpress.com/2014/03/07/why-it-happened-the-truth-about-vitamin-k-deficiency-bleeding/" target="_blank">http://cestsibonblog.wordpress.com/2014/03/07/why-it-happened-the-truth-about-vitamin-k-deficiency-bleeding/</a></p>
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<p>This mother had an all natural birth with midwives at a birth center.  She did not give her child a vitamin K shot.</p>
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<p>Her daughter needed brain surgery from an intracerebral hemorrhage.  She almost died.</p>
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<p>You say you've done your research.  I can't imagine what research you've found that says the risks of Vitamin K outweigh the benefits.  Vitamin K is NOT well-transmitted through breast milk.  </p>
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<p><br>
I was just coming here to post that link.  By the time you notice something "concerning", your child would likely already be hemorrhaging.  The insignificant benefits of refusing Vit K do not outweigh the risks, even if they are remote.  I refused Vit. K with my first two out of ignorance; I will not make that mistake with my next child.</p>
 

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Does the AAP support oral dosing of vitamin K? Everything I've seen on their site recommends intramuscular injection. Maybe I'm looking in the wrong spot. Please let me know where you found the information about AAP and oral administration.<br><br>
<a href="http://pediatrics.aappublications.org/content/112/1/191.full.pdf" target="_blank">http://pediatrics.aappublications.org/content/112/1/191.full.pdf</a>
 

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<p>By the way, that's not an informed consent.  You don't list the risks of refusing the shot, and you don't show an understanding of the complications (saying you will watch your newborn closely is an example of this- HDN is not visible!).  </p>
 

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<p>There are some stats concerning frequency/rarity here: <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6245a4.htm" target="_blank">http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6245a4.htm</a></p>
 

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<p>My understanding is that oral Vitamin K does not prevent late onset VKDB as well as the IM injection. Unless you are in NYS, however (where Vitamin K is mandated by law) you may ask to have it administered. </p>
 

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<p>If I was a doctor, I'd be annoyed getting a form that has several paragraphs of basic, slightly wrong, information about the Vitamin K shot before the refusal. Why don't you just skip the TL;DR and just put that you refuse it?</p>
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<p>Why would they care if you're monitoring your newborn? As people have mentioned, things like brain bleeding aren't always apparent anyway.</p>
 

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Hey, I see that op's posts are deleted and I think it's wise advice to not get into explanations when refusing consent. But I have to say that I think it's not cool to spring stories on pregnant mom that include another baby's brain bleeding and almost dying. Sharing research is great, but I think it should be soft-served a bit or have a trigger warning. I cannot handle that kind of blunt talk when pregnant. Planning to refuse a vitamin k shot isn't such an emergency that you need to shock someone into action.
 

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I agree the story is disturbing, but it is what the shot is for, and why it's given. Negative outcomes have a legitimate place in this conversation.
 

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<div class="quote-container" data-huddler-embed="/community/t/1398864/vitamin-k-refusal-would-like-your-input-good-bad-changes#post_17592395" data-huddler-embed-placeholder="false">Quote:
<div class="quote-block">Originally Posted by <strong>salr</strong> <a href="/community/t/1398864/vitamin-k-refusal-would-like-your-input-good-bad-changes#post_17592395"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a><br><br>
Hey, I see that op's posts are deleted and I think it's wise advice to not get into explanations when refusing consent. But I have to say that I think it's not cool to spring stories on pregnant mom that include another baby's brain bleeding and almost dying. Sharing research is great, but I think it should be soft-served a bit or have a trigger warning. I cannot handle that kind of blunt talk when pregnant. Planning to refuse a vitamin k shot isn't such an emergency that you need to shock someone into action.</div>
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<p>Seriously?  The point was to show that refusing a vitamin K shot CAN be an emergency.  Sorry you thought it wasn't "cool" to share the link.  I think it wasn't cool that the poor baby had to have brain surgery and almost died.</p>
 

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I'm sorry, what I meant was that the decision making process and time frame was not an emergency. So, this person can think about it some more if they want to. They don't have to decide in the next ten minutes.
 

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<p>That doesn't make the HDN stories irrelevant though.  The decision process can take some time, but we shouldn't conceal information that should be considered (like the fact that some babies experience dangerous bleeding that could be prevented by Vitamin K), and we shouldn't soft-pedal the risks (some babies die from that bleeding, some are permanently disabled, and there are not necessarily early symptoms that would alert parents to seek medical care before their children suffer lasting harm).</p>
 
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