What is it and why it’s needed?
Vitamin K helps the blood to clot and babies are naturally born with low levels of it. Our placentas can only pass small amounts during pregnancy and breastmilk carries very low levels of vitamin K, so it would not be enough for newborns. Babies do not have the bacteria that naturally produces vitamin K in their gut biome as yet, this will develop overtime but in the interim a vitamin K deficiency can cause a bleeding disorder called haemorrhagic disease of the newborn (HDN), also known as vitamin K deficiency bleeding (VKDB). The deficiency can also cause other long term health issues and can be fatal in rare cases. When your baby is born you will be offered extra vitamin K to help prevent HDN and other issues in the early hours to months of their life.
Options!
This leads us to the options provided after delivery, you may have researched this extensively and detailed what you want on your birth plan like I did. Or you might be unsure and feel slightly woozy on the idea of injecting your precious newborn so soon.
You will be offered vitamin K as an injection for your baby, this is one dose, and it is very quick. If you prefer, you can opt for the oral dosage instead, but you will need further doses to ensure your newborn gets what they require (They might spit it up or squirm when giving it to them).
Remember
It is recommended that all newborn babies should have vitamin K at birth, if you are unsure about your preferences ask your midwife at your check-ups or ask before you leave the hospital/birthing centre. It is very important for baby, and it is also important for new parents to have informed choice. You can also decline altogether but with this decision I encourage parents to do their research.
Injection vs Oral Dose
I chose the injection and included this on my birth plan as I preferred that it was one dose and research suggested that it is more effective for preventing HDN. It is intramuscular and injected through the thigh (those cute little thighs!) The downside was the little whimper when it was administered and a light bruise, it is the invasive option after all but highly effective. The thought of the newborn moments can sound a tad brutal, lights, cold weighing scale, hungry, and injection. BUT it is super quick, and they are over it the moment you feed them. Remember lots of skin-to-skin cuddles and feeds and it will be a fleeting moment for all of you. This was my thoughts on the topic and experience.
The oral option is easier to administer as the non-invasive option, this will be administered by your midwife with two doses in the baby’s first week and the last dose at one month. You can also add this baby’s bottle which is nice and easy. The disadvantage is that babies are so prone to vomiting and spitting up at this stage in life, there would be no guarantees that this would be absorbed.
Signs for vitamin K deficiency
Baby might bruise or bleed for no apparent reason. This is unsettling but important to know, most babies with HDN show no warning signs before life-threatening bleeds, they might develop the following symptoms:
Bleeding from the nose of umbilical cord
Bruising (mainly around the head or face)
Pale skin or gums especially in darker skinned babies
Whites of the eyes turn yellow (when over 3 weeks old)
Blood in bowel movement and/or vomit
Moody, lethargic, seizures or vomiting a lot
**If little one has any of these symptoms go to the hospital immediately for further checks on bleeding.
HDN/VKDB Summary
Early HDN can happen because of the drugs/medication taken during pregnancy passed through the placenta and inhibited vitamin K for baby. Newborns can develop early HDN within the first 24 hours after birth.
Classic HDN happens when babies do not get enough vitamin K through breastmilk. This develops between day 1 -7 of baby’s life.
Late HDN is linked to babies not absorbing vitamin K because of liver disease or not getting enough vitamin K in their feeds. Late HDN is also often linked to high rates of infant deaths caused by internal bleeding. This develops between 2 – 12 weeks old.
(Sankar et al, 2016)
Risk Factors for HDN
Breastfed babies are more at risk to developing HDN than formula fed babies, this is because formula is supplemented with more vitamin K than you would typically get in breast milk.
Just for your information, other risk factors include:
Babies born before 37 weeks
Bruised during birth
Born using forceps, ventouse or caesarean section
Had breathing difficulties at birth
Had liver problems or were born feeling poorly
Mother took medication for epilepsy, to prevent clots or for tuberculosis during pregnancy
For further information on the topic check out Dr Sara Wickman’s website here.
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