A concerning trend is emerging: more and more parents are choosing to decline vitamin K shots for their newborns, a decision that could have serious, even fatal, consequences. This shift, detailed in a recent study published in the Journal of the American Medical Association, has experts deeply worried.
Babies are born with very low levels of vitamin K, an essential nutrient that helps the blood clot. Without it, they are vulnerable to significant bleeding shortly after birth. To combat this, hospitals in the United States began administering vitamin K shots to newborns within their first six hours of life back in the early 1960s. These shots are designed to prevent bleeding in various areas, including the gastrointestinal tract and the brain.
Dr. Kristan Scott, a neonatologist at Children’s Hospital of Philadelphia and the lead researcher of the study, noted an increase in parents refusing the shots in his own practice, which prompted the research.
"The increase is not surprising, but the degree to which it did increase did catch me off guard," Dr. Scott admitted.
The study analyzed data from the Epic Systems’ Cosmos database, which tracked whether infants received a vitamin K shot. The data included over 5 million babies born in 403 hospitals across all 50 states, between 2017 and 2024. The results revealed that approximately 4% of babies – around 200,000 – did not receive the vitamin K shot during this period. The percentage rose from under 3% in 2017 to over 5% in 2024. The trend was most pronounced among non-Hispanic white babies.
The rise in refusals accelerated during and after the COVID-19 pandemic, the study found.
Dr. Scott pointed out that there haven't been any major policy changes regarding vitamin K shots from hospitals, nor have medical organizations altered their recommendations. This suggests that the rise in parents declining the shots is primarily due to parental choice.
It's worth noting that this trend isn't entirely new. A 2016 study in the journal Hospital Pediatrics explored the reasons behind parental refusal of the vitamin K shot.
But here's where it gets controversial: Widespread misinformation on social media and growing vaccine skepticism are likely contributing factors to this trend, according to Dr. Tiffany McKee-Garrett, an associate professor of pediatrics at Texas Children’s Hospital in Houston, who was not involved in the new study.
Dr. McKee-Garrett emphasized that a vitamin K shot is not a vaccine, but a supplement derived from a plant.
Dr. Ivan Hand, director of neonatology at NYC Health + Hospitals Kings County in Brooklyn, has also observed this trend in his practice.
"I think this comes from general mistrust in authority that started probably in the later part of the 2010s," said Dr. Hand, who wasn't involved in the new research.
In 2022, Dr. Hand co-authored an American Academy of Pediatrics policy statement on parents refusing vitamin K shots for newborns.
The statistics are stark: Newborns who don't receive a vitamin K shot are more than 80 times more likely to experience bleeding due to vitamin K deficiency compared to those who do get the shot, according to the Centers for Disease Control and Prevention. This bleeding can occur up to six months after birth.
"We are creating a population of newborns who are at risk of bleeding," Dr. Scott warned, explaining that this can range from bruising and blood loss when the umbilical cord is cut, to gastrointestinal bleeding. "Bleeding into the brain is what we really worry about, essentially a stroke," he added. "That can ultimately cause death."
It remains unclear whether the observed decline in infants receiving the shot correlates with a rise in vitamin K deficiency bleeding cases.
Dr. Hand hasn't seen an increase in his practice, but he only sees infants shortly after birth. Dr. Scott anticipates further research will reveal an increase in bleeding events.
"We know unequivocally that when infants do not receive vitamin K, they are at increased risk of bleeding," Dr. Scott stated, noting that CHOP has seen not only an increase in vitamin K refusal but also an increase in bleeding cases.
Dr. McKee-Garrett has heard reports of vitamin K deficiency bleeding in Houston, a condition that was extremely rare for decades after vitamin K shots became widespread in the U.S.
"It’s a preventable disease, so we shouldn’t be seeing it at all," Dr. Hand emphasized.
In some countries, oral vitamin K supplements are given to babies. However, these supplements can be inconsistent, and each baby's digestive system absorbs different amounts of the nutrient, Dr. Hand explained. Breast milk is also not a sufficient source of vitamin K to prevent deficiency. Moreover, oral supplements require multiple doses, whereas the shots only need to be given once. Studies in Europe have shown that while oral vitamin K supplementation may be effective in the first week of life, it may be less effective at preventing late-onset vitamin K deficiency bleeding, which can occur up to 6 months of age.
"That late-onset bleeding, the bleeding that occurs internally, has a 20% mortality rate," Dr. McKee-Garrett noted. Some studies have found it to be as high as 50%.
Because vitamin K shots have been a standard practice in the U.S. for over 60 years, parents may not fully understand the risks of forgoing the shot, Dr. Hand suggested.
"These treatments have been so effective that people don’t understand the consequences. They have never seen babies with severe bleeding, so they think it doesn’t exist," he said. "But you don’t see it because we are treating these kids."
What do you think? Are you surprised by the increasing hesitancy towards vitamin K shots? Do you think the benefits outweigh the risks? Share your thoughts in the comments below.
