Making an informed decision about Vitamin K

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Pregnancy is a really exciting time. A creative, bonding and blossoming time. But it's also a time where families need to make a lot of decisions, including decisions about the health and well-being of their child. One of those decisions will be whether or not their newborn will receive a Vitamin K injection at birth. To keep this in perspective, in the grand scheme of life it is a small decision. After all, it is only one vitamin. However, it is important that this decision is an informed one because it contains risks and benefits for the newborn.

When making an informed decision during pregnancy, BRAN is a very useful tool. This can be used when you discuss your options about a medical decision with your LMC or when doing your own research on a topic. When choosing whether or not your baby will receive a Vitamin K injection, this is what BRAN may look like:

-Benefits. What are the pro's if our baby receives a Vitamin K injection?

-Risks. What con's come with giving our newborn an injection? What risks does the product itself have? Can very high doses of Vitamin K negatively impact on stem cell transfer? Which babies are most at risk of Hemorrhagic Disease of the Newborn (HDN)?

-Alternatives. What are our choices? Would oral Vitamin K be suitable for our newborn?

-No/nothing. We have the option of declining a Vitamin K injection. Or perhaps we might need to ask for more information and time to help us make an informed decision.

The most important thing to remember is that this is your decision. Don't take your ability to make informed decisions about your newborn's health and well-being for granted. Spend time doing your research and ask your LMC for information on Vitamin K. Then feel proud that you made the best decision you could at the time, with the information you had. What more could you ask of yourself than that?

Here's some good articles to get you started on your decision making journey:

Vitamin K: An alternative perspective by Dr Sara Wickham

Vitamin K Video Series by Evidence Based Birth

Code of Health & Disability Services Consumer Rights

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MAKING AN INFORMED CHOICE ABOUT VITAMIN K

Rosemary (4 of 22)

VITAMIN K AT BIRTH? How do you make an informed decision?

Questions to ask when making your decision include:
-Differences between Vit K injection and oral supplement
-Does optimal cord clamping & bacteria from vaginal birth & skin to skin make a difference to baby's Vit K levels?
-What is Vitamin K Deficiency Bleeding and what are the risks of my baby getting it?
-Are Vit K levels in breastmilk low, and what are researchers comparing breastmilk to?
-If all babies are born with low levels of Vit K, is it really a deficiency?

The article "Revisiting vitamin K and the newborn: what have we learned in a decade?" highlights some of the important questions that parents need to ask, as well as what has changed in the research on Vitamin K Prophylaxis in the last 10 yrs. sarahwickham.com

"Greer has also added to our knowledge about vitamin K in breast milk. This is a controversial topic because some of the research cited to support the claim that breast milk contained ‘low’ levels of vitamin K (a term that always begs the question of exactly what breast milk is being compared to as a standard) was carried out at a time when women were not being supported to breastfeed in ways that are now considered optimal. Although Greer (2004) argued that the levels are still not high enough (which again could be said to fuel the notion that the postnatal period is dangerous for babies), he did demonstrate that levels were about twice the average of some of these earlier reports.
In the same year, a Japanese study (Kojima et al 2004) found that the concentration of vitamin K in breast milk varied according to the diet of the women concerned, implying that maternal nutrition may be a factor.

...there also exists the view that the tendency to VKDB may be iatrogenic and the result of medicalised birth. Expressed more in verbal conversation, on internet blogs and in discussion articles, one recently published example can be found where Cranford
(2011) questioned whether modern birth practices stress the clotting system of the newborn, arguing that trauma caused by medicalised birth, limited early breastfeeding and practices such as early cord clamping and circumcision can deplete a newborn of its clotting factors. While some of these arguments (namely limited early breastfeeding and circumcision) are already widely accepted to be risk factors for VKDB and early cord clamping is considered by a number of people to be a likely culprit, research is needed to support or refute the idea that other practices can lead to VKDB. It is important to note that some of the babies who have gone on to develop VKDB have been born physiologically, at home and outwith the presence of medical intervention
(Brousseau et al 2005)."

Thanks to Bloom Birth Photography and the special family that has given permission for their picture to be used.