Why Do Newborns Need a Vitamin K Injection at Birth?
Babies usually have vitamin K injections after they are born. This vitamin is considered to be very crucial for babies’ health, and its deficiency in their bodies can cause serious and fatal health conditions.
But before discussing what vitamin k deficiency is, let’s start by explaining what is vitamin k and what does it do.
In general, vitamins are organic substances needed in small quantities to sustain life. Which usually the body does not produce enough of or doesn’t produce them at all. We usually get the amounts we need from food sources.
Vitamin K plays an important role in the function of several proteins, including but not limited to proteins involved in blood clotting, which is the ability of the blood to turn from liquid to solid. It’s needed in the body to make substances called “clotting factors”, that can help the body form clots and stop bleeding.
Where Do We Get Vitamin K From?
We get vitamin K from food such as green leafy vegetables (like spinach or molokhieh), green vegetables (such as broccoli), meat and eggs. Some vitamin K is made by the good bacteria in our intestines.
What Is 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 and is rapidly corrected by vitamin K supplementation. Infants who do not receive the vitamin K shot at birth can develop VKDB at any time up to 6 months of age.
There are three types of VKDB, based on the age of the baby when the bleeding problems start:
1. Early onset VKDB: it happens during the first 24 hours of life, mostly occurs in newborns of mothers on certain medications that inhibit vitamin K, such as some anti-seizure medications, and some anti tuberculosis.
Usually its presentation is severe, with internal bleeding in the abdomen (Intra-abdominal hemorrhages) and swelling and bleeding of the scalp (Cephalus hematoma) and bleeding in the brain (intracranial bleeding).
2. Classic onset VKDB: occurs between 24 hours and seven days of life. Presentation may be milder than the early onset VKDB symptoms, but can also lead to significant blood loss, symptoms include: skin bruising, bleeding from the umbilical cord site, skin puncture site that will not stop bleeding to name a few.
3. Late onset VKDB: occurs between 2 to 12 weeks and could happen up to 6 months of life. bleeding in this category could be very severe, could lead to brain and nervous system damage as well as death.
Bleeding could occur suddenly without warning and may manifest by lethargy (lack of energy) or seizure.
This type of VKDB is very rare but children who did not receive vitamin K shot at delivery are 81 times more likely to develop late bleeding compared to newborns who had their vitamin K shot.
All Newborns Have Low Vitamin K Levels, Why?
At birth, newborns have little Vitamin k, because it does not transfer well through the placenta from the mother to the growing fetus, and the liver of the growing fetus doesn’t store vitamin k.
Newborn’s intestine is considered relatively sterile and does not have enough good bacteria to produce vitamin K, and while breastfeeding has an immense health benefits for the newborn, but breastmilk is low in vitamin K. Also, newborns and infants do not consume solid foods until 4 to 6 months of age, so they cannot get their vitamin K from food.
All newborns should receive their vitamin K shot after delivery. It is a routine procedure, not somethings moms additionally ask for. It’s recommended by the World Health Organization: “All newborns should be given 1 mg of vitamin K intramuscularly after birth (i.e. after the first hour by which the infant should be in skin-to-skin contact with the mother and breastfeeding should be initiated).”
The dose is higher compared to the recommended daily dose, but this is because very little part of the dose goes directly into the newborn’s blood stream to prevent low levels of vitamin K in the days following the delivery, and what’s absorbed gets stored in the liver to make more clotting factors.
The rest of the dose is stored in the muscle where the injection was given (usually thigh), and slowly released over the course of months to help prevent late onset VKDB.