Q: I am pregnant and concerned about the vitamin K injection that is given to newborns. I have heard that it may increase my baby’s risk for childhood leukemia. Is this true? Are there any alternatives to a vitamin K shot at birth?
Routine vitamin K injections for newborns have been the standard of care and recommended by the American Academy of Pediatrics since 1961. Vitamin K administration at birth prevents a rare but life-threatening disease called vitamin K deficiency bleeding (VKDB), which was previously referred to as hemorrhagic disease of the newborn.
When babies are born, they have lower levels of vitamin K and are at increased risk for spontaneous bleeding. If this bleeding occurs during the first week of life, it is called early vitamin K deficiency bleeding and most commonly presents with bleeding from the skin, gastrointestinal tract or surgical sites (e.g. circumcision). Late bleeding occurs in babies between 2 and 12 weeks of age and causes a spontaneous brain hemorrhage in 50 percent of the cases.
Early bleeding occurs in about one out of 100 infants who do not receive vitamin K supplementation. The incidence of late bleeding is four to seven per 100,000 live births. Intestinal malabsorption and exclusive breastfeeding are both associated with an increased risk of late bleeding. A single dose of intramuscular vitamin K given at birth is virtually 100 percent effective for preventing both early and late vitamin K deficiency bleeding. Oral vitamin K is less effective.
Controversy over vitamin K administration at birth arose in the 1990s when a study from Great Britain suggested a link between childhood leukemia and intramuscular vitamin K given at birth. Numerous studies since have failed to show any correlation between the two. In 2000, an extensive medical review demonstrated no evidence of a link between vitamin K injection at birth and cancer in childhood.
The American Academy of Pediatrics released a policy statement in 2003 stressing the importance of vitamin K injection at birth – particularly in exclusively breastfed infants.
