In most countries of the world, vitamin K is administered to newborns in the maternity hospital as a preventive measure for various complications. Many parents consider the injection to be a vaccination, which leads to the refusal of an important procedure. Vitamin K injections for newborns can prevent hemorrhagic disease. The prevalence of a rare pathology does not exceed 0.5%. However, its complications sometimes lead to death.
Vitamin K injection helps prevent serious complications in newborns
Why is a vitamin K injection given immediately after birth?
Vitamin K is necessary for normal blood clotting in children and adults. Some children (more and more of them lately) are born with low levels of this vitamin, due to the immaturity of the liver and gastrointestinal tract, where vitamin K is synthesized. In utero, the baby cannot receive vitamin K because it is not absorbed through the placenta. Breast milk contains very little of it. This condition can cause bleeding called hemorrhagic disease of the newborn (HDN). Internal bleeding in the brain and other organs can cause serious damage, sometimes even death.
Despite the fact that this disease is rare (the causes and what percentage are indicated below), vitamin K is administered intramuscularly to everyone as a preventive measure, the basis is protocol No. 152 of 04/04/2005 for a medical examination of a healthy newborn child (https://sop.com .ua/regulations/2340/2592/2593/420061/), changes since 2010, paragraph 10.
Three forms of vitamin K
There is a large group of forms of vitamin K that are similar in their chemical composition and effect on the body (from vitamin K1 to K7). The most interesting of them are the two main forms that exist in nature: vitamin K1 and K2 .
Vitamin K1 (phylloquinone and its isomers: phytomenadione, phytonadione) - occurs naturally in plants, especially green leafy vegetables, which are the main pharmaceutical raw materials for the production of isomers. Only the natural form of vitamin K is completely SAFE for newborns and does not cause toxicity even in large dosages! How it works: it targets the liver, participates in the production of proteins that regulate blood clotting and thrombus formation.
Vitamin K2 (menaquinone) is a substance that is synthesized in the human body by microorganisms (saprophytic bacteria) in the small intestine. How it works: It affects the walls of blood vessels and bones more than the liver tissue. Its main task is the correct distribution of calcium in the body.
Vitamin K3 (menadione) is a synthetic form that is clearly toxic, interfering with the function of glutathione, a natural antioxidant in the body, resulting in damage to cell membranes, especially over time. Menadione also causes toxic reactions in liver cells, weakens the immune system, causes abnormal red blood disorder, and also leads to cytotoxicity (cell death). It is important to note that there was toxicity in infants injected with this synthetic vitamin K3. Widely used in the food industry and livestock farming.
Deficiency Prevention
Preventive measures can only be taken by a woman carrying a baby. You can improve your newborn's condition with diet or supplements.
Diet for mom
Pregnant women and nursing mothers may benefit from the following foods to increase their K concentration:
- white cabbage, cauliflower, broccoli;
- green tomatoes;
- green leafy vegetables;
- soybean and olive oil;
- dairy products;
- walnuts;
- eggs;
- pig liver.
A woman who is breastfeeding must consume these products so that the baby receives the substance he needs with milk.
Taking supplements
There are no studies to show that supplementation by a pregnant woman reduces the risk of hemorrhagic disease in infants. But there are results from using supplements during breastfeeding. Taking a K2 supplement at a dosage of 2 to 5 mg per day reduces the level of deficiency in a breastfed baby.
Parents expecting a new addition to their family must choose their own strategy for dealing with their newborn. There are no mandatory vaccinations in Russia; you will have to decide for yourself whether to use drops for prevention or rely on doctors who will give an injection in case of risk. But even if you decide to take a preventive course, you need to consult a pediatrician.
If you have had experience using drugs against hemorrhagic disease of newborns, please share your information.
There are three types of vitamin K deficiency
Early HDN occurs within 24 hours of birth.
It occurs almost exclusively in infants of mothers taking drugs that inhibit vitamin K, such as anticonvulsants (carbamazepine, phenytoin and barbiturates), antituberculosis drugs (isoniazid, rifampicin), some antibiotics (cephalosporins) and vitamin K antagonists (coumarin, warfarin). The clinical picture is severe: head hematoma, intracranial and intra-abdominal hemorrhage. The incidence in newborns without vitamin K supplementation varies from 6% to 12% .
Classic HDN occurs between the 1st and 7th days of life.
Associated with delayed or insufficient nutrition. Clinical manifestations are mild: skin bruises, bleeding in mucosal tissue (mouth, nose, throat, intestines, uterus, urethra), bleeding from the umbilical cord or circumcision site. However, blood loss can be significant, and intracranial bleeding, although rare, does occur. Frequencies range from 0.25% to 1.5% in older reviews 19 and 0–0.44% in more recent ones.
Late TTH occurs between 2 and 12 weeks.
Most cases occur between 3 and 8 weeks of age. Associated exclusively with breastfeeding. The clinical picture is severe: mortality is 20%, and intracranial bleeding is 50%. Survivors suffer permanent neurological damage. The incidence in fully breastfed infants who did not receive vitamin K at birth is 1/15,000 to 1/20,000 . Children with cholestasis syndrome are at particular risk.
(Source 1, Source 2)
Daily norm
According to data approved in 2000 by the American National Academy of Sciences, the human body needs natural vitamin K1 daily from food.
Daily intake of phylloquinone
| Category of people | Age | Daily dose, microgram |
| Newborns and toddlers | Up to 6 months | 2 |
| Children | From 7 months to a year | 2,5 |
| From one year to 3 years | 30 | |
| From 4 to 8 years | 55 | |
| Teenagers | From 9 to 13 years | 60 |
| From 14 to 18 years old | 75 | |
| Men | Over 18 years old | 120 |
| Girls, women | Over 18 years old | 90 |
| Pregnant girls | ̶ | 90 |
As you can see, the body’s need for vitamin K1 increases many times over with age. If a six-month-old baby needs 2 micrograms of the nutrient per day to meet the daily requirement, an adult man needs to eat 60 times more daily - 120 micrograms of the compound.
Increased risk factors for tension headaches
Even any point is sufficient for the risk of bleeding in an infant:
- premature babies, low birth weight
- delivery using forceps or vacuum extraction
- caesarean section (the baby's microflora remains sterile after such a birth)
- very fast or long labor, especially in the second stage of labor (expulsion of the fetus)
- maternal intake of antibiotics, anticoagulants, anticonvulsants during pregnancy, especially in the first trimester
- undetected liver disease, stress on the liver after hepatitis B vaccination
- administering medications to a newborn for any reason
Data taken from an article by Dr. Joseph Mercola, USA - https://1796web.com/vaccines/opinions/vitamin_k.htm, but most of the information is out of date at the moment.
I would like to add some additional information based on new facts about the risk factors for late TTH: Bleeding due to vitamin K deficiency can happen to any child, whether early or long-term, trauma or no trauma. Researchers have not been able to pinpoint which children are most at risk. This is why doses of vitamin K are prescribed to all newborns or those whose mothers intend to breastfeed exclusively.
In fact, there is no recent evidence to support the theory that babies born by forceps or by Caesarean are at higher risk of bleeding.
One of the largest 2013 studies on the topic in Southeast Asia followed Thai women during pregnancy and after birth and examined risk factors for vitamin K deficiency. The researchers labeled infants as "high risk" for vitamin K deficiency if they had small for gestational age, born prematurely, or born by cesarean section or vacuum delivery. The researchers found no difference in the percentage of infants with vitamin K deficiency between low- and high-risk infants.
Regarding insufficient breastfeeding in the first hours of life, there is an association between insufficient breast milk in the first few days of life and classic TTH. And it is theoretically possible that a traumatic experience at birth will cause a baby to bleed more often during the first week of life if they have low vitamin K levels. But the study (see above) did not support the theory that traumatic deliveries are directly linked to vitamin K deficiencies.
Thus, the most important risk factors for TTH are exclusive breastfeeding and avoidance of vitamin K. Evidence does not support the theory that trauma at birth has anything to do with TTH.
Side effects from the injection that you are not warned about
There are four main areas of risk associated with this injection:
- A study published in 2004 found that very early pain or stressful experiences have long-term adverse effects in newborns, including changes in the central nervous system and changes in the sensitivity of the neuroendocrine and immune systems into adulthood. A defenseless and innocent baby will have to overcome emotional trauma to achieve health.
- The amount of vitamin K given to newborns is much higher than the recommended daily dose for adults. In recent years, the situation has begun to change for the better; in any case, you should consult your pediatrician about the dose that is suitable for your child.
- An injection for a baby’s weak and immature immune system creates an additional risk of introducing infection from the environment, which contains dangerous infectious agents. As well as irritation of the injection site or damage to nerves and muscles, since the injection is made deep into the muscle. This is a rare complication, but still.
- The injection solution contains preservatives that are toxic to the baby's immature immune system. There are currently 2 forms of vitamin K used for injection: Kanavit, Konakion (K1 as phytomenadione) and a cheaper option - Vikasol (K3 as menadione, menadione). Both are synthetic forms, the latter is even more active and stronger.
Vikasol gives a lot of side effects, even if you do not consider the preservatives in the composition: facial hyperemia, itching, bronchospasm, hemolytic anemia, cytotoxicity of liver cells leading to jaundice, tachycardia. Our official medicine does not confirm this. For these reasons, the US has banned the use of synthetic K3 to treat vitamin K deficiency.Kanavit, Konakion was developed and approved for use solely on the basis that it appears to cause less hemolysis. It is a synthetic petrochemical derived from 2-methyl-1,4-naphthaquinone in a polyethoxylated castor oil or polysorbate-80 base. Although these drugs are easier to tolerate, in the annotations we see the following adverse reactions: skin rash, burning pain and inflammation at the injection site, cardiovascular collapse, bronchospasm, problems with the gastrointestinal tract.
There was also a reported case in 2014 of anaphylactic shock due to intramuscular administration of vitamin K1 in a newborn.
The poor mother has to make a choice and purchase one drug or another. As far as I know, it is difficult to get Kanavit or Konakion in Russia; they do not produce it or import it.
Sources of phylloquinone
The largest amount of vitamin K1 is concentrated in foods of plant origin.
Namely, in parsley, spinach, nettle leaves, green salad, wheat bran, unrefined olive oil (cold pressed).
Phillachonins are resistant to high temperatures and can withstand boiling water. Thanks to this, saturating the body with this nutrient is a real task. Foods containing vitamin K1
| Product name | Amount of phylloquinone per 100 grams of product, micrograms |
| Leafy vegetables | |
| Parsley, raw | 1630 |
| Beet green leaves, boiled | 492 |
| Fresh spinach | 481 |
| Boiled green turnip | 366,4 |
| Green onion | 206,1 |
| Green lettuce leaves, raw | 172 |
| Raw cabbage | 59 |
| Cabbage, pickled | 56,3 |
| Vegetables | |
| Green peas, canned | 20,9 |
| Fried potato | 4,5 |
| Mashed potatoes with milk and butter | 6 |
| Boiled potatoes | 2,1 |
| Baked potatoes with skins | 2 |
| Vegetable oils | |
| Olive | 47,4 |
| Sunflower | 5,0 |
| Dairy | |
| Margarine (80% fat) | 92 |
| Salted butter | 7 |
| Whole cream | 3,1 |
| Cheese | 2,2 |
| Nuts, seeds | |
| Pine nuts | 52,8 |
| Roasted pumpkin seeds | 46,5 |
| Walnuts | 2,8 |
| Roasted sunflower seeds | 2,8 |
| Bread and flour products | |
| Shortbread cookies | 9 |
| White bread | 3,1 |
| Low-fat oatmeal cookies | 1 |
| Rye bread | 0,3 |
| Pasta | 0,1 |
A simple solution that replaces a vitamin K injection
According to the world's best expert on vitamin K - Associate Professor of the Department of Biochemistry at the University of Maastricht (Netherlands) Dr. S. Vermeer, there are safer and non-invasive (that do not disturb the natural integument) ways to replenish the level of vitamin K in a newborn that do not have dangerous consequences. We are talking about oral intake of natural vitamin K, which eliminates overdose and reduces the risk of bleeding and jaundice, as well as pain at the injection site and exposure to harmful preservatives. At the same time, vitamin K is absorbed through the intestines, as it is intended.
Is it really that simple, I suggest you dig deeper and turn to official sources...
Other materials about modern obstetric practice
- A synthetic vitamin K injection for my baby? No, thanks!
- Fraudulent and deceitful medical policies, procedures and protocols for active labor management versus the natural birth tradition
- Medical interventions during and after childbirth. Questions and answers
- Standard obstetric procedures and their relationship to autism
- Cord clamping and neonatal jaundice
- Umbilical cord clamping: a monument to obstetric stupidity
- Questions about prenatal ultrasound testing and the alarming increase in autism cases
- How I led my son to autism
The Science behind Oral Vitamin K vs Injectable Vitamin K
Recent studies show:
- the chance of late TTH is 1 in every 15,000-20,000 children when vitamin K is not given,
- if an infant has one oral dose of vitamin K (1-2 milligrams) at birth, the risk drops to 1 in 25,000-70,000 children,
- The odds of late-onset HDN in a newborn are reduced to 0.1 per 100,000 children when the child is given 1.0 mg of synthetic K1 at birth.
In 2003, Swiss surveillance adapted recommendations for preventing vitamin K deficiency following a 6-year follow-up : “3 2 mg oral doses of vitamin K1 adequately prevent children from all types of HDN. The main risk factors for HDN in infants are parental refusal of Vitamin K prophylaxis or unrecognized cholestasis due to biliary atresia in the baby.”
In 2008, a comparative analysis of the effectiveness of various vitamin K administration regimens among infants with biliary atresia was carried out in Holland and Denmark : “A daily dose of 25 mcg of vitamin K does not prevent bleeding, but 1 mg weekly oral prophylaxis provides significantly higher protection for these infants and has similar efficacy as 2 mg intramuscular prophylaxis at birth."
And a more recent study in 2021 did not support the effectiveness of oral regimens versus the injection in infants with cholestasis.
A 2006 study of preterm infants reported an interesting finding: “To protect against bleeding due to vitamin K1 deficiency, preterm infants receiving a 0.2 mg dose intramuscularly should receive vitamin K supplementation during breastfeeding.”
What are the benefits of vitamin K injection?
- Very effective in preventing classic and late-onset TTH
- The shot has a slow-release effect over time from the injection site, which provides sufficient amounts of vitamin K1 until levels in the child's blood reach completely natural levels.
What are the benefits of oral vitamin K?
- Easy to give, non-invasive, no harmful substances in the composition
- The 3-dose regimen reduces the risk of classic and late-onset TTH, but not as much as the injection
- A weekly regimen appears to protect children with undiagnosed gallbladder problems as much as the shot
Conclusions: The effectiveness of oral prophylaxis is related to the dose and frequency of administration. Most multidose oral regimens provide protection for all but a small number of infants with gallbladder or liver disease. However, looking specifically at vitamin K levels, it was found that a vitamin K shot resulted in elevated blood levels over one week and one month compared to a single oral dose. And in all this time, none of the studies specifically looked at whether there were any side effects from the injection.
Injection scheme
Why do you need an allergen test for a child under one year old, how to donate blood
A single injection is usually not enough to compensate for the lack of substance. Typically, several procedures are prescribed, for which a scheme has been developed:
- injection immediately after the baby is born;
- second injection after a week or 10 days;
- third injection at 1 month of age.
Important! In the Russian Federation, this scheme is used to replenish vitamin K deficiency in newborns at risk.
Since the injection of the drug is optional, the mother must agree to it in writing. Otherwise, the injection will not be given.
There are no routine tests that can determine whether a child needs vitamin K supplementation. Doctors are guided only by whether the baby is at risk.
Injection to baby
The injection method is into the thigh muscle from the front.
Which Vitamin K1 drops to use and what dosage
Many scientific articles state that oral vitamin K1 is not available in the United States. This is because there is no FDA-approved oral version available for sale. However, all English-language sources for purchasing high-quality vitamin K1 in drops lead to Bio-K-Mulsion from the American manufacturer Biotics Research .
It contains another isomer of phylloquinone, phytonadione , created in the laboratory from naturally occurring bacteria. Of course, it is also synthetic, like Kanavit, but it is much safer to take orally than by injection, and has the advantage that few drops are required per dose. Natural K1 drops require 40 to 150 drops to achieve a similar dosage. This may not be appropriate for an infant.
And where can you buy the liquid oral form of vitamin K1? Unfortunately, my favorite store iherb did not have vitamin K1. You can just as easily make a purchase on Amazon; at the end of the post I will talk about two more important related products needed after childbirth.
Biotics Research - Bio-K-Mulsion 1oz, 30 ml
Active Ingredients: Vitamin K (as K1-phytonadione) This is a manufactured form of vit k1 as the real form is unstable and too strong. This product is made from naturally occurring bacteria to achieve a stable and beneficial form.
Four drops (0.16 ml) provide 2 mg of vitamin K1. Bio-K-Mulsion® delivers Vitamin K1 (500 mcg per drop) in emulsified liquid form to aid in the absorption and utilization of this important vitamin. Vitamin K oil has been dispersed into microscopic particles to promote better absorption.
Other Ingredients: Water, gum arabic oil and sesame oil.
Dosage regimen: 2 mg (4 drops) within 6 hours after birth, on the 7th day of life - 1 mg (2 drops) and then weekly for the first 3 months of life. If the child burps within 1 hour of oral administration, this dose should be repeated.
If the seller has run out of Bio-K-Mulsion, there is still a good option from a highly rated American manufacturer - Herb-Science
Herb-Science, Liquid Vitamin K1 Drops, 1 Fluid oz, Alcohol Free
Active Ingredients: Vitamin K (as K1-phylloquinone) Serving Size: 1 dropper (0.8 ml) contains 120 mcg of liquid vitamin K1 Cold processed to protect compounds. Contains no alcohol, sugar, salt, yeast, wheat, gluten, corn, soy, milk, egg, shellfish and no artificial preservatives. Other Ingredients: Safflower Oil.
Dosage regimen: 2 mg (16 pipettes is 13 ml) within 6 hours after birth, on the 7th day of life - 1 mg (8 pipettes is 6.4 ml) and then weekly for the first 3 months of life. If the child burps within 1 hour of oral administration, this dose should be repeated.
It is important to remember that this fat-soluble vitamin cannot be absorbed on an empty stomach . Therefore, it is given before or after breastfeeding and care is taken to ensure that the baby does not burp.
Many mothers have got the hang of it: they put a drop of vitamin K on their finger and squeeze out fatty colostrum there and let the baby suck, and so on 4 times :)).
One of the difficulties of taking vitamin K this way is maintaining the dosage schedule for 3 months. Although you can set a reminder on your smartphone. The fact is that repeated doses reduce the further risk of developing late HDN, which can occur even in completely healthy children during an ideal birth.
Oral administration
An alternative to intramuscular injections is oral administration of the drug according to the following scheme:
- 2 mg immediately after birth;
- 2 mg at 4-6 days of age;
- 1 mg at 4-6 weeks of age.
Another option is to take 1 mg of the drug once a week after taking 2 mg of the drug orally in the maternity hospital until the age of three months.
Oral administration of the drug
There are contraindications for the oral route. It is not suitable for newborns:
- premature;
- with cholestasis (impaired bile secretion);
- with disruption of digestive processes and absorption of substances in the small intestine;
- whose mothers received medications that interact with drug metabolism.
Important! The intestinal absorption of vitamin K is not clear. The effect of using it in this way for children at risk is much lower, so today it is an unreliable alternative.
The drug is available in drops. The advantage of the oral method is that you can take it at home. Dr. Komarovsky notes the positive effect of vitamin K2 on bone growth, so supplements containing this substance will be beneficial for any child.
If the baby is absolutely healthy, the decision to inject vitamin K is entrusted to the parents. However, for children at risk, the benefits far outweigh the side problems.
What prevention strategy should you choose for your child?
Of course this is a very difficult choice. My goal was to provide more information so that you can draw your own conclusions and evaluate the risks of different routes of vitamin K administration.
The table at the bottom of this post contains approved preventive methods from different countries.
The intramuscular route of administration of vitamin K has been widely accepted as it virtually eliminates the possibility of life-threatening tension-type headache. At the same time, the Italian Society of Neonatology recommends taking oral drops after the injection to prevent late bleeding, especially in premature infants.
In any case, in all countries except the United States, parents have the right to refuse the injection and document oral vitamin K intake by notifying their birth team. The Danish regimen of 2 mg oral vitamin K after birth and 1 mg weekly appears to protect children at increased risk who have undiagnosed gallbladder disease, but not 100%. It is important to adhere to all weekly doses to ensure this regimen helps reduce the risk of late-onset TTH.
Using the same source, I would like to draw your attention to the facts for which it is simply necessary to use a vitamin K injection:
- Once the diagnosis of HDN has been confirmed, intravenous administration is advisable, determined by the doctor;
- Premature newborns will not physically be able to “digest” oral medications;
- Infants of mothers taking medications that inhibit vitamin K
Lately, there have been a lot of myths, misconceptions and misinformation spreading across the internet and social media about vitamin K. It is important that parents look at the facts before making such an important decision.
What do you need to do before the baby is born?
- Whether or not you agree to have a vitamin K injection for your child is ultimately a personal choice. At least now you have information with which you can make an informed decision.
- During childbirth, anxiety makes it very difficult to keep in mind that your baby should not get an injection. So it might be helpful to have someone at the birth, such as your spouse, to remind the staff that your baby shouldn't have the shot.
- Remember that you must be proactive. Typically, nurses never ask permission to give a vaccine or vitamin K injection, as this is standard practice and does not require separate consent. Therefore, you must be very careful and persistent in your demands.
- Please remember - you must show maximum perseverance and perseverance in order to force your desires to be taken into account. The system will fight you tooth and nail, because its representatives are sincerely convinced that they know better. It's worth the extra protection for your newborn.
