Vitamin K is recommended for newborns to prevent a rare bleeding disorder that can result in long-term brain damage and death.
In 2013, the Centers for Disease Control and Prevention reported on a cluster of four cases of vitamin K deficiency bleeding in infants in Tennessee, all among infants whose parents had refused the vitamin K prophylaxis. To determine the prevalence of vitamin K refusal and the characteristics of parents who refuse vitamin K for their newborns, researchers in Alberta, Canada, analyzed a cohort of all live births between 2006 and 2012.
In the study, "Neonatal Vitamin K Refusal and Nonimmunization," published in the September 2014 Pediatrics (published online Aug. 18), study authors report that 99.7 percent of children received vitamin K and 0.3 percent declined.
Midwife-assisted deliveries were more likely to be associated with vitamin K refusal, compared to births attended by a physician. Parents who had a planned delivery at home or in a birth center were also more likely to decline vitamin K compared to parents who delivered in a hospital. Children whose parents declined vitamin K were 14.6 times more likely to be unimmunized with recommended childhood vaccines by age 15 months, compared to children who received vitamin K. The study data do not indicate reasons parents refused vitamin K for their newborns, but study authors hypothesize it could be due to differing advice from birth attendants, personal beliefs about childbirth and health care, or safety concerns. The study highlights the need for physicians to provide anticipatory guidance about vitamin K to parents planning a home birth or midwife-attended delivery.
Study authors also conclude it provides an opportunity to identify a subset of vaccine-hesitant parents who are likely not to immunize their children, and to engage them with targeted information starting at birth rather than waiting until scheduled immunizations are missed.