AAP emphasizes need of Vitamin K for newborns amid rising parental refusal

The American Academy of Pediatrics (AAP) in its recently released policy announcement has emphasized the need for newborns for vitamin K amid rising parental refusal. According to the policy statement, parents should ensure that their newborn gets a dose of vitamin K after birth for preventing a potentially life-threatening bleeding disease. 

Vitamin K is needed for the formation of blood clots and to stop bleeding. Babies are born with very small amounts of vitamin K storage in their bodies that can result in serious bleeding problems like vitamin K deficiency bleeding (VKDB) that can lead to brain damage and death. 

Since 1961, the AAP has recommended that newborns receive a dose of vitamin K to prevent vitamin K deficiency bleeding. However, the AAP said, that owing to the more parents refusing the shot for newborn infants or choosing alternate and less effective methods, the incidence of VKDB appears to be on the rise. 

Ivan Hand, MD, FAAP, and other members of the AAP's Committee on Fetus and Newborn, Section on Breastfeeding, and Committee on Nutrition wrote. "exclusively breastfed infants who do not receive vitamin K prophylaxis at birth are particularly at risk because breast milk "provides relatively low levels of vitamin K." 

"This illness is relatively rare in the United States today because we have offered this dose of vitamin K to infants," Hand said in a statement. "This bleeding disease can be devastating and is totally preventable, and so we urge parents to ask questions if they have concerns."

According to Hand and the team, in recent years, there has been an increase in parental refusal leading to an increase in late-onset VKBD. They said parental objections are usually related to belief systems, infant welfare, and outside influencing factors.

"Families may believe a 'natural' birth is best and want to avoid what seems to be a painful intervention in the process," they wrote. "There was also a strong association between the refusal of both ocular prophylaxis and hepatitis B vaccine with the refusal of vitamin K. Parental reasons for refusal of intramuscular vitamin K administration included lack of understanding of the indication for vitamin K, belief that it was unnecessary, concern about the pain of the injection, and concern related to the preservative in the formulation."

Hand and colleagues suggested that pediatricians address parental concerns before birth and that VKDN should be considered when evaluating bleeding in the first 6 months of life, even in infants who received prophylaxis and especially in those who are exclusively breastfed.

"We understand parents want the best for their children, and we, as pediatricians, share that goal," Hand said. "We strongly recommend that parents bring their questions to us and help us understand any concerns."

Reference:

AAP. American Academy of Pediatrics policy statement: Newborns require vitamin K shortly after birth to prevent bleeding disease. Accessed Feb. 22, 2022.