Parents increasingly refusing vitamin K shots raises risk of infant brain bleeding

A review has found that parents are increasingly refusing vitamin K injections for their newborns, an intervention that lowers the risk of life-threatening brain bleeds in babies. Babies have naturally low levels of vitamin K, making this supplement essential for blood clotting, the researchers stress. 

Although vitamin K deficiency bleeding is rare, it can cause an intracerebral hemorrhage, a type of stroke, when a blood vessel bursts in the brain, leading to lifelong brain conditions. “Late vitamin K deficiency bleeding often presents with intracranial hemorrhage, carrying 15-20% mortality and up to 50% long-term neurological disability,” the study details.

The researchers flag that more parents who refuse vitamin K have broader healthcare hesitations and a higher chance of refusing vaccines, even though the vitamin shot is not a vaccination.

“Vitamin K at birth is safe and effective, and while refusal is still uncommon, with rates in the US remaining under 1% in most hospitals, our review found in recent years there have been increases in parents refusing this supplement for their newborns,” says study author Kate Semidey, M.D., of Florida International University in Miami, US. 

“This trend is concerning because our review also found that babies who do not get the vitamin K injection are 81 times more likely to develop vitamin K deficiency bleeding.”

Low rates but rising trend

The preliminary systematic review finds that vitamin K refusal remains low. However, refusal rates rose in Minnesota from 0.9% in 2015 to 1.6% by 2019. Rates in the US states of California, Connecticut, and Iowa ranged from 0.2% to 1.3%, with over half of hospital staff reporting they perceived more parents were refusing vitamin K.

Refusal rates ranged from 1% to 3% in Canada, New Zealand, and Scotland, with some birthing centers reporting over 30% rejection in these countries.

The researchers examined 25 studies, spanning two decades. These reports investigated the rates of vitamin K refusal and incidences of deficiency-related bleeding. They also recorded parents’ reasons for refusal and possible reasons linked to vaccines.

Rates of complications 

The review reveals that among babies who had vitamin K deficiency-related bleeding, approximately 14% of the babies died, and around 40% suffered from long-term neurological disabilities, such as cognitive impairment, seizures, or motor deficits. Also, 63% of infants had brain bleeds.

Moreover, parents who refused vitamin K for their babies were also more likely to skip other recommended health protections. 

For instance, US parents refusing vitamin K were 90 times more likely to refuse the hepatitis B vaccine and eye medicine meant to protect newborns from potentially blinding infections.

Also, Canadian parents who refused vitamin K were 15 times more likely not to vaccinate their child by 15 months old. In New Zealand, they were 14 times more likely.

Parents said they were concerned about their babies’ pain and believed in inaccurate information about the preservatives in injections.

“Our findings point to an urgent need for health care professionals to provide prenatal counseling to parents to ensure they understand that vitamin K can dramatically reduce preventable brain injury and its lifelong impact,” says Semidey.

The researchers caution that their review’s limitation is that it only analyzed previous publications rather than tracking infants over time, meaning it does not account for the precise risk for individual babies.

The findings will be presented at the American Academy of Neurology’s 78th Annual Meeting (April 18–22) in Chicago, US, and online.