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Vitamin K                 

Vitamin K is a shot given after the birth to help your baby blood to clot. Babies are not born with intact clotting factors. This starts for babies on day 7 to 8th of their life. It was when the Lord told the Jews to circumcise their babies. Thus a perfect time, as babies own clotting factors began. The giving of the vit K shot became popular after births were often being done with the use of forceps. This is because of the extra trauma to the baby’s head by using forceps, so the shot helped prevent bleeding in the brain. Today we are still using this state law to give vit K routinely, despite the fact that forceps are not being used as much or if at all.

Oral Vit K

Vit K can be given orally, and families are requesting that it be given this way.  Vitamin K– 2-4 mg is given after the first good feeding, then 2 mg is given again at 2-4 weeks, and 2 mg is given again at 6-8 weeks. (this is the most common dosage and times given.  There are other suggested dosages and times).

Vit K injection

Right after the birth a shot can be given to the newborn in the                                        thigh.  This shot should be given right away. Not days later. 

Vitamin K has been linked to jaundice, and even a potential                                           increase in childhood leukemia. There are dangers of giving                                               this shot.

If you are having your baby boy circumcised, then you need to discuss giving vit K. If you choose not to give it, then you should wait one week or two weeks after the birth to do the circ.

VITIMAN K DEFICIENCY

Maternal causes of Vitamin K deficiency bleeding:

  • An unhealthy diet or a mal-absorption disorder. Eating green vegetables and whole grains is especially important.

  • Not nursing long enough or frequently enough. This effects how much vitamin K the baby gets in breast milk. Breast milk contains small amounts of vitamin K and studies have been shown that VKDB occurs primarily in babies who don’t get enough nourishment in the first days of life.

  • medications taken during your pregnancy. antibiotics, aspirin, sulfa medications, iodine, chemotherapy, radiation, anticoagulants, anticonvulsants, anti tubercular, barbiturates.

  • Maternal diabetes, toxemia, or placental problems

  • Your liver functions

  • Undue stress during the pregnancy can effect how well the baby’s liver functions.

NEWBORN CAUSES OF VITAMIN K DEFICIENCY BLEEDING

  • Poor feeding, or not nursing enough

  • Gastro-intestinal disease or cholestasis (blockage of the bile drainage ducts in the liver, caused by hepatitis, undeveloped bile ducts or other congenital defects, or infection) Prolonged or pronounced jaundice is a sign of these.

  • a difficult birth or a birth trauma

  • hypoxia (lack of oxygen)

  • pre-maturity. This is because the liver is immature so functions less effectively

  • medications that the mother has taken during pregnancy or labor, or that the baby has been given as a newborn.

  • diarrhea longer than 3 days.

How do I know if my baby is developing Vitamin K deficiency bleeding (VKDB)

*baby bruises easily without any trauma

*pale

*difficult in breathing

* Prolonged jaundice

*Blood in the urine or stool (after the meconium is done)

*bleeding from the nose, mouth, or other sites

*poor feeding (remember a baby that will not nurse is a sick baby)

            What is vitamin K and why is it important?

The following is taken from the CDC web site @ this link: https://www.cdc.gov/ncbddd/vitamink/facts.html

 

Vitamin K is a substance that our body needs to form clots and to stop bleeding. We get vitamin K from the food we eat. Some vitamin K is also made by the good bacteria that live in our intestines. Babies are born with very small amounts of vitamin K stored in their bodies, which can lead to serious bleeding problems if not supplemented.

                 What is Vitamin K Deficiency Bleeding or 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. The bleeding can occur anywhere on the inside or outside of the body. When the bleeding occurs inside the body, it can be difficult to notice. Commonly, a baby with VKDB will bleed into his or her intestines, or into the brain, which can lead to brain damage and even death. Infants who do not receive the vitamin K shot at birth can develop VKDB at anytime up to 6 months of age. There are there types of VKDB, based on the age of the baby when the bleeding problems start: early, classical and late-onset.

  • Early and classical VKDB are more common, occurring in 1 in 60 to 1 in 250 newborns, although the risk is much higher for early VKDB among those infants whose mothers used certain medications during the pregnancy.

  • Late BKDB is rarer, occurring in 1 in 14,000 to 1 in 25,000 infants.

  • Infants who do not receive a vitamin K shot at birth are 81 times more likely to develop late VKDB than infants who do receive a vitamin K shot at birth.

    What things should I look for in my baby if I think he or she might have VKDB?

Unfortunately, in the majority of cases of VKDB, there are NO WARNING SIGNS before a life-threatening event starts. Babies with VKDB might develop any of the following signs:

  • Bruises, especially around the baby's head and face

  • Skin color that is paler than before. For darker skinned babies, the gums may appear pale

  • Bleeding from the nose or umbilical cord

  • After the first 3 weeks of life, the white parts of your baby's eyes may turn yellow.

  • Stool that has blood in it, is black or dark and sticky (also called tarry), or vomiting blood

  • Irritability, seizures, excessive sleepiness, or a lot of vomiting may all be signs of bleeding in the brain

             

                                             Type of VKDB

When it Occurs

Characteristics

Early

0-24 hours after birth

  • Severe

  • Mainly found in infants whose mothers used certain medications  (like medicines to treat seizures or isoniazid) that interfere with how the body uses vitamin K

Classical

1-7 days after birth

  • Bruising

  • Bleeding from the umbilical cord

Late

2-12 weeks after birth is typical, but can occur up to 6 months of age in previously healthy infants

  • 30-60% of infants have bleeding within the brain

  • Tends to occur in breastfed only babies who have not received the vitamin K shot

  • Warning bleeds are rare

 

           What is the reason someone might not want to have the Vitamin K shot?

The following information is taken from the following site: https://evidencebasedbirth.com/evidence-for-the-vitamin-k-shot-in-newborns/

 

                                  What is Vitamin K and what does it do in the body?

 

Vitamin K is a fat-soluble vitamin needed for blood clotting. It is named after the German word for clotting-Koagulation. We cannot make Vitamin K ourselves, and we do not store it very well in our body. We get Vitamin K1 (also known as phylloquinone) from leafy green vegetables. We can also get Vitamin K2 (menaquinone) from bacteria that live in our intestinal tracts. Vitamin K1 from plants makes up about 90% of our overall Vitamin K levels, while Vitamin K2 from bacteria makes up only about 10% of our overall Vitamin K intake.

 

                             Why do breastfed babies not have enough vitamin K?

There are two main reasons why babies do not have enough vitamin K in their system. First, babies are born with very limited amounts of Vitamin K. Their levels are lowest at days 2-3 and do not reach adult levels until about 6 months of age. The levels are low because:

~Very little vitamin K1 transfers from the mother to the baby through the placenta

~Babies do not have enough bacteria in their intestines to make Vitamin K2.

~Second, breast milk has very tiny amounts of Vitamin K. Colostrum has about 2 micrograms of vitamin K per liter, while mature milk has 1 microgram per Liter.

 

Virtually all babies with late VKDB are exclusively breastfed. When studies looked closely at infants who develop late VKDB, they found that mothers of these babies had normal levels of Vitamin K in their milk supply. It is thought that maybe some of these babies had a problem with absorbing the Vitamin K from their mother's milk.

 

Does eating a maternal Vitamin K rich diet during pregnancy and nursing help Vitamin K levels in Newborns?

 

There is no good evidence that giving the mother extra Vitamin K during pregnancy can prevent VKDB in infants.

If all infants are born with low Vitamin K levels, is it really a deficiency or is this the natural design of human beings?

 

Why are babies born with insufficient Vitamin K? Obviously, it is impossible for us to know why this happens.

 

There are a couple of possibilities, and there isn't really much research to inform this...but here are a few theories:

  1. VKDB, although catastrophic when it happens, is rare. So if you are looking at this as a case of “survival of the fittest”, perhaps there is not a pressing need for newborns to be born with higher levels of Vitamin K.

  2. When infants are born, many of their systems are not fully developed yet. For example, their nervous system and immune system are immature. It is possible that maybe an infant's clotting system also needs time to mature and come into its full strength.

  3. Perhaps there is a reason we don't know of that leads to low transmission of Vitamin K from mom to baby before and after birth. Maybe there is an unknown beneficial mechanism that is preventing some kind of environmental toxin from reaching the baby, and this mechanism also has the side effect of keeping Vitamin K from reaching baby in sufficient quantities through the placenta and breast milk.

 

                 What is the exact number of lives saved with the Vitamin K shot?

The statistics vary from country to country. In European countries, when they went from no Vitamin K1 to giving Vitamin K1 shots, researchers estimate that this probably prevented anywhere from 4 to 7 cases of late VKDB per 100,000 infants .

 

Foods rich in Vit K1: Leafy green vegetables, such as spinach, kale, and swiss chard. Cabbage, Cauliflower, Broccoli, turnips, Brussels sprouts, Avocado, Banana, Kiwi, Soy Bean oil. Remember, there is not evidence that eating foods rich in Vit K will help the baby, but they will not hurt either!

 

Vaccinations 

I will discuss the one that is given after the birth, not all of the vaccinations that your child may receive.  This one is the Hep B.  It is usually given right after the birth. 

 

                                        HEP B                  

                                        This vaccine is now mandated in most states to be given at                                                  birth. You will not find too many home birth midwives that will                                            give this shot, if any at all. You can start this vaccine at birth or                                          at 2 months of age. I would ask you, do you or your babies father have hepatitis? Have you been exposed to this? Assess your risk first and then discuss it with your care giver.