IM Vit K Avoidance at Birth: Alternatives?

Hemorrhagic disease of the newborn (HDNB) was first identified over a century ago, and presents as unexpected bleeding, often with gastrointestinal hemorrhage, ecchymosis and, in many cases, intracranial hemorrhage. In newborns, HDNB is typically caused by vitamin K deficiency as neonates are innately deficient in vitamin K secondary to very little vitamin K transferred through the placenta to fetuses in utero, limited liver storage of vitamin K, and low amounts of vitamin K in breast milk. IM administration of vitamin K for prevention of vitamin K deficiency bleeding (VKDB) has been a standard of care since the American Academy of Pediatrics recommended it in 1961. Despite the success of prevention of VKDB with vitamin K administration, the incidence of VKDB appears to be on the rise. This increase in incidence of VKDB is attributable to parental refusal as well as lowered efficacy of alternate methods of administration. Can parents decline this injection for their babies? In this episode, we will review IM Vit K neonatal administration and discuss the controversial data regarding Vit K oral supplementation.