With the intent to reduce Vitamin K Deficiency Bleeding (VKDB) in infants, the American Academy of Pediatrics recommends an intramuscular injection of .5 – 1.0 milligrams of Vitamin K (phytonadione) into the thigh of every newborn within one hour of birth. VKDB was formerly known as Hemorrhagic Disease of the Newborn. All newborns normally have prolonged clotting times, but the abnormal condition of VKDB occurs in 0.01% - 1.5% of those who have not received a Vitamin K injection. VKDB is near confirmed when a bleeding infant has a prolonged prothrombin time (PT) together with a normal fibrinogen level and platelet count. Rapid correction of the PT and/or cessation of bleeding after Vitamin K administration confirm the diagnosis of VKDB. In national surveys researching millions of babies conducted from 1980 forward, almost all of the babies who had VKDB were breastfed. Most breastfed babies have an adequate Vitamin K supply and do not have bleeding episodes when they are NOT treated with Vitamin K. Most formulas have Vitamin K added.
An early warning sign of VKDB is visible bleeding evidenced by skin bruising or blood seepage from any body opening which can quickly lead to internal hemorrhage. In approximately 30-60% of cases, concealed internal bleeding is from fragile capillaries in the brain and can result in severely delayed development or death. If such bruising or bleeding occurs in an infant, it is imperative that a health professional be notified immediately. Medical intervention and Vitamin K administration are needed swiftly before seizures begin; internal bleeding may sometimes occur without visible outward signs.
If a baby is circumcised, he must be observed carefully afterwards for hemorrhage. It is normal for a baby girl to have an occasional spot of vaginal bleeding caused by hormones transferred from the mother. A few drops of blood from the umbilicus are also normal, but it should not continue.
Vitamin K Deficiency Bleeding can occur as early as within 24 hours of birth. A Vitamin K injection may be particularly warranted if the birth has been unusually traumatic or if certain maternal drugs have been used during the pregnancy (these may include anticonvulsants, cephalosporin antibiotics, tuberculostatic agents and Vitamin K antagonists). A reported link between intramuscular Vitamin K and childhood cancer prompted a number of studies that have yielded inconsistent results. All other studies have shown no increased risk of cancer.
As the state of Virginia does not permit midwives to possess, prescribe, or administer medications, we are unable to provide your baby directly with the intramuscular vitamin k shot. If you desire this treatment for your baby, you will need to seek a family physician, pediatrician, or obstetrician that is willing to administer it in his/her office within 24 hrs of birth. Oral administration is an option, but we use an non-prescription, plant based alternative that is not FDA approved. It is your legal right to refuse this procedure.
Please look over the following article and the studies cited by the author:
Evidence Based Birth Article on Vitamin K