Vitamin K for newborn babiesInformation leaflet for parents

www.elht.nhs.uk

What youneed toknow

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What is Vitamin K and does my baby need it?

Vitamin K is a substance that isnaturally present in the body. It playsan important part in helping bloodto clot. At birth, a baby has very lowstores of Vitamin K and these arequickly used up over the first fewdays of life. This leaves the babyvulnerable to severe bleeding(haemorrhage) because they are lessable to get their blood to clot. Theymay develop a condition calledHaemorrhagic disease of thenewborn (HDN). HDN is a rare butserious, and sometimes fatal,bleeding disorder. HDN can occur upto six months of age, and can almostalways be prevented by giving extraVitamin K.

What are the benefits of givingVitamin K?

NICE guidelines (1) recommend thatall newborn babies should be given adose of Vitamin K to prevent HDN.

However, it is your choice. Pleaseread this leaflet carefully beforemaking your decision.

Which babies are at greater risk ofbleeding

Babies who are at risk cannot all beeasily identified, but there are somebabies who have an increased risk:

Babies who:• are premature (born before 37

weeks of pregnancy)• are failing to take or absorb feeds• had a complicated birth• are ill in the newborn period• have mothers who have been

taking certain medication (e.g.some anticonvulsant drugs, andsome anticoagulant therapy, ordrugs to treat tuberculosis).

• have liver disease (which may showitself as jaundice lasting more thantwo weeks), or have othersymptoms e.g. pale stools and ordark urine

• have bleeding or spontaneousbruising in early infancy or who areill from other causes.

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How is Vitamin K given?

There are two ways of giving Vitamin K – by injection or by mouth.

By injection: a single dose of Vitamin K injected soon after birtheffectively prevents HDN in virtuallyall babies (2).

NICE Guidelines (1) recommend thebest method of administration is byinjection.

If you do not wish your baby to receivean injection, Vitamin K can be givenorally, although it is not as effective.

By mouth: Vitamin K can be given bymouth but doses must be repeated asthe absorption is unreliable. Onedose of oral Vitamin K is given atbirth, and another at one week.Breastfed babies need another doseat one month of age, as Vitamin K isadded to formula milk. Anadvantage of oral Vitamin K is thatthe baby avoids an injection.

Arrangements must, however, bemade to ensure that allrecommended oral doses are given,at the right time, to all babies, inorder to prevent HDN. GivingVitamin K by mouth is not suitablefor some babies (3):

The following group of babies needVitamin K by injection:

1) Babies who are premature or sickshould be given the vitamin byinjection.

2) If, while you were pregnant, youtook medication for epilepsy,blood clots or tuberculosis.

Vitamin K Facts

Does Vitamin K have any sideeffects?

In the 1990s some studies raisedconcern about a possible linkbetween childhood cancer andinjected Vitamin K given to newbornbabies. However, more recentresearch has shown there is noincreased risk of cancer followingVitamin K administration.

What are the risks if I choose not tolet my baby have Vitamin K?

The risk of HDN is small, about 1 inevery 10,000 babies could be affectedif Vitamin K were not given. Thismeans for a baby born within EastLancashire Hospitals NHS Trust (whichcovers all babies born in Burnley andBlackburn), where there are in theregion of 6,000 births per year, therecould be one case of HDN every 11⁄2years.

Although the likelihood of a babyhaving Haemorrhagic Disease of theNewborn is very small, theconsequences if this happens can bedevastating.

Recognising Warning Signs of HDN (1)

If you choose for your baby not tohave Vitamin K, it is important toobtain early treatment to reduce theseverity of the disorder should itoccur. The following symptoms maybe indicative of early HDN:

• Spontaneous bruising• Bleeding from nose and umbilicus• Prolonged jaundice (after two

weeks of age)• Pale stools (poo) or dark urine

More Information

This leaflet is intended to be used tosupport discussion with your midwifeor doctor. If there is anything you donot understand or are unsure aboutplease ask.

Resources

MIDIRS informed choice leaflets:www.choicesforbirth.orgNational Childbirth Trust:www.nctpregnancyandbabycare.com/

References

1. NICE Clinical Guidline 37 (2014)Postnatal Care

2. Department of Health (1998)Vitamin K for new born babiesPLO/CNO/998/4 London availableat www.dh.gov.uk/Publications

3. National Health and MedicalResearch Council www.nhmrc.gov.All guidelines & Publications 2010.

For general enquiries please contact the switchboard on:01254 263555 or 01282 425071.

Tel: 01254 263555.Email: contact@elht.nhs.ukWebsite: www.elht.nhs.uk

Version 9, Issue Date: March 2017. Review Date: March 2020.Author: Family Care.

ID Number: WOMENSH-OO9-vitamink-2017.