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Vitamin K Injection for Newborns

The Vitamin K injection has been given to newborns since the 1960s in Australia. It is recommended as the ‘gold standard’ method of preventing serious bleeding known as Vitamin K Deficiency Bleeding (VKDB) which is a life-threatening condition in babies.

What is vitamin K?
  • Vitamin K plays an important part in our bodies’ natural blood clotting system, which is what stops excessive bleeding.
  • It is given as a supplement to babies because they are born with very low levels. Vitamin K can safely be given to newborns as a single injection at birth (which is preferred) or by mouth as a liquid in three separate doses.
  • It is found commonly in leafy green vegetables and is also produced by our gut bacteria.
  • Vitamin K is not a vaccine.
Why do newborns become deficient in vitamin K?
  • Babies are born with only small amounts of vitamin K in their bodies.
  • Breast-milk is a poor source of vitamin K, even when a mother has normal vitamin K levels. Babies that are exclusively breast-fed actually have an increased risk of VKDB. Most baby formulas will contain small amounts of vitamin K.
  • Vitamin K is stored in our livers, your baby’s liver cannot properly store or use vitamin K yet.
  • Babies only start to get adequate amounts of vitamin K when they start to eat a balanced solid food diet and form ‘good gut bacteria’ at around 6 months of age.
What is the recommendation for my baby?
  • All babies in Australia are recommended to receive the vitamin K injection (Konakion® MM). This is a single injection of vitamin K into the muscle, given soon after birth.
Side effects of the vitamin K injection:
  • Pain
  • Bruising/swelling
  • Few cases of scarring at the injection site
  • Elevated bilirubin (rare)
  • One single case report described an allergic reaction in a newborn (Note: newborns are less likely to have severe allergic reactions due to their immature immune systems)
How is oral vitamin K given?

The liquid is given by mouth in three doses:

1. At birth
2. Day 3-5 of age
3. At four weeks of age

This is provided in a take-home pack for parents at the hospital.

is oral vitamin K as good as the injection?
  • The vitamin K injection given at birth is the best method of preventing VKDB.
  • Oral vitamin K is not absorbed as well as the injection.
  • To make sure oral vitamin K is as effective as possible all three doses need to be given exactly as directed and your baby needs to take the full dose each time – forgetting or missing doses will not provide your baby with adequate protection.
  • If your baby is experiencing diarrhoea or vomiting when giving an oral dose, you should seek medical advice as the dose may need to be repeated.
  • Oral vitamin K is NOT recommended when mothers need to take certain medications during their pregnancy (consult your doctor if you take medications regularly).
What is Vitamin K Deficiency Bleeding?

VKDB is a potentially fatal condition in babies due to dangerous bleeding caused by low levels of vitamin K.

There are three types of VKDB-

  • Early – 0-24hrs post-delivery
  • Classical – 1-7 days after birth
  • Late – Typically 2-12 weeks after birth but can occur up to 6 months after birth.
Signs and symptoms of VKDB:

Although the bleeding could be visible, bleeding can also occur in areas inside the body such as the brain or intestines where you won’t be able to see it immediately. This could mean a delayed diagnosis and worse outcome.

  • Unexplained/easy bruising
  • Bleeding from the nose, umbilical cord, mouth or gums
  • Pale skin
  • Blood in the urine, stool or vomit
  • Jaundice (yellow skin)
  • Irritability, seizures, increased sleepiness, vomiting, poor-feeding
  • Full and bulging fontanelles (soft spot on the head)
  • Excessive bleeding with cuts, blood tests or surgical procedures

It is strongly recommended to avoid any surgical procedures if your baby has not had their vitamin K injection at birth.

Consequences of VKDB:
  • Severe blood loss leading to blood transfusions
  • Emergency surgery
  • Bleeding in the brain causing seizures, learning difficulties, cerebral palsy and life-long disabilities
  • Death
Is my baby at increased risk of VKDB?

They may be if:

  • They are exclusively breast-fed
  • If you had an assisted vaginal delivery with a vacuum-cup or forceps, or the Doctor had to use forceps during a Caesarean-section.
  • If you took certain medications during pregnancy – e.g., medications for epilepsy, blood clots or tuberculosis.
  • If your baby was unwell at birth or was on long term antibiotics.
  • If your baby has medical conditions – e.g., liver disease, cystic fibrosis or coeliac disease.
  • If your baby was premature, especially if they experienced feeding difficulties.

Last updated 20 Jul 2022