Vitamin K for your baby

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When your baby is born you will be asked whether you would like them to have a vitamin K supplement. The Department of Health recommends that all babies are given a vitamin K supplement at birth. This information is to help you understand why, and what your options are.

What is vitamin K?

We all need vitamin K. It is produced naturally in our bodies by friendly bacteria in our gut.
It occurs naturally in food, especially green vegetables and olive oil.

Why do we need vitamin K?

Vitamin K helps our blood to clot and to prevent bleeding problems but our bodies cannot store it very well. Newborn babies will have received some vitamin K through the placenta but at times this is not enough. This means that a small number of newborns do not have enough vitamin K to clot their blood.

Why does my baby need extra vitamin K?

Newborn babies are born with very low levels of vitamin K. At birth the amount of vitamin K stored in the liver is between 30% and 60% of the amount stored by an adult. It will take time for your baby’s gut to produce the bacteria needed for more vitamin K. This means that your baby’s vitamin K levels can quickly become depleted. We do not know why babies are born with low levels of vitamin K.

What is Vitamin K deficiency bleeding (VKDB)?

A small number of babies, about one in 10,000 develop a rare but serious disorder called ‘vitamin K deficiency bleeding’ (VKDB).

Vitamin K deficiency bleeding, or VKDB, occurs when babies cannot stop bleeding because their blood does not have enough vitamin K to form a clot. The bleeding can occur anywhere on the inside or outside of the body. When the bleeding occurs inside the body, it can be difficult to notice. Commonly, a baby with VKDB will have bleeding into their intestines, or into their brain, which can lead to brain damage and even death.

There are three types of VKDB

Type of VKDBWhen it occursCharacteristics
Early onsetWithin 24 hours after birthMainly found in babies whose mothers used certain medications such as medicines to treat epilepsy, blood clotting and tuberculosis. These can interfere with how the body uses vitamin K.
Classical2 days – 1 week after birth

  • Bruising

  • Bleeding from the umbilical cord

Late Onset1 week – 6 months after birth
(Commonly 2-8 weeks after birth)

  • 30-60% of babies have bleeding within the brain

  • Tends to occur in breastfed babies who have not received extra vitamin K

Signs and symptoms of VKDB

Unfortunately, in most cases of VKDB, there are no warning signs before a life-threatening event starts.
Babies with VKDB might develop any of the following signs:
Bruises, especially around the baby’s head and face.
Bleeding from the nose or umbilical cord.

Skin colour that is paler than before. For babies with a darker complexion, the gums may appear pale.

Prolonged jaundice (after two weeks of age).

Pale stools (poo) or dark wee.
Irritability, seizures, excessive sleepiness or a lot of vomiting (possible signs of bleeding in the brain).

Which babies are more at risk from VKDB?

  • Babies born prematurely (before 37 weeks)
  • Babies whose mothers have been taking certain medications for epilepsy, blood clots or tuberculosis
  • Babies born with the help of forceps or ventouse
  • Babies with liver disease (which may look like jaundice lasting more than two weeks)
  • Babies who don’t feed or find it hard to absorb feeds
  • Babies who are ill in the early days
  • Some babies who do not fall into any of the high-risk groups above will develop VKDB. The Department of Health recommends that all newborn babies are given a vitamin K supplement at birth to help protect against this condition.

What are the risks of vitamin K for my baby?

In the past there were concerns over the possible link between giving vitamin K to newborn babies and leukaemia or cancer in childhood. However, a careful review of data from the UK Children’s Cancer Study Group in 2003 found no evidence that this increases the risk of children developing leukaemia or any other cancer.

How is vitamin K given to my baby?

There are two ways your baby can have vitamin K. Either by injection or by mouth.

By injection

Vitamin K can be injected by the midwife after birth. It is usually into the baby’s thigh muscle. It will be offered soon after birth. As with any injection, your baby will feel some pain and may experience a little bleeding and bruising in the muscle at the place where the injection goes in. If you wish to, you can comfort your baby by cuddling or feeding them while it happens. Only one injection is needed.

Due to the higher risks of bleeding and the potentially serious consequences, we recommend vitamin K by injection to all babies who are born prematurely, or who are identified to be at increased risk of VKBD.

By mouth

This method is just as effective, but because we cannot be certain how much your baby will swallow and absorb it will need more than one dose. Two doses are advised for all babies. The first dose will be offered soon after birth and the second at one week of age.

For babies who are exclusively breastfed, it is recommended that a third dose is given at one month.

Breastfeeding and VKDB

Breastfeeding gives babies the best start in life. Breast milk has many health benefits both for mother and baby. Breast milk contains small amounts of vitamin K.

Exclusive breastfeeding for the first four to six months gives your baby the best chance of avoiding allergies in later life. Babies who are breastfed for the first three months of life continue to have lower rates of infection in the first year of life.

The only reason that breastfed babies are at greater risk of vitamin K deficiency is that vitamin K is added to artificial milk. Artificial milk cannot match the benefits and advantages of breast milk. It is not advised to give artificial milk because of the added vitamin K.

Does my baby have to have vitamin K?

All parents have a choice, and this is one of the earliest decisions you will have to make on behalf of your baby. We suggest asking your midwife or doctor questions while in pregnancy to help make a decision that is right for your baby and you.

Explanation Point

TermDescription
Vitamins‎Vitamins are substances our bodies need, which we get from either the foods we eat or from a multivitamin.

Vitamins are normally stored in the body. A person without enough of a vitamin or vitamins stored in the body is ‘vitamin deficient’ or has a ‘vitamin deficiency’.
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