Vitamin K Injections for Newborns

The administration of the vitamin K injection to day-old infants is a widely accepted medical practice aimed at preventing serious bleeding conditions. However, this practice has generated controversy, with some parents and healthcare providers advocating for more natural approaches. This article explores the importance of vitamin K for newborns, the potential risks associated with the injection, and alternative strategies for ensuring adequate vitamin K levels.

Vitamin K and Newborns: An Overview

Vitamin K plays a crucial role in blood clotting and preventing Vitamin K Deficiency Bleeding (VKDB) in newborns. Since newborns have naturally low levels of vitamin K, many countries, including the United States, administer a vitamin K injection shortly after birth to prevent VKDB. This practice is endorsed by the American Academy of Pediatrics and other health organizations due to its proven efficacy in preventing potentially life-threatening bleeding in infants.

VKDB Mortality ​Incidence Rates

1. Early VKDB: Very rare, primarily seen in infants whose mothers took medications that interfere with vitamin K metabolism, such as certain anticonvulsants, antibiotics, and anticoagulants.
2. Classical VKDB: 0.25% to 1.7% without prophylaxis.
3. Late VKDB: 4.4 to 7.2 per 100,000 infants without prophylaxis; <1 in 100,000 with prophylaxis.

aluminum exposure

Newborns are exposed to aluminum through various sources, including vaccines and the vitamin K shot administered shortly after birth. Aluminum is used as an adjuvant in many vaccines to enhance the immune response. However, the package insert for Pfizer’s vitamin K formulation explicitly warns that the product "contains aluminum that may be toxic," and notes that "premature neonates are particularly at risk." Despite this warning, it is common practice to administer vitamin K shots to preterm infants, raising significant safety concerns.

​WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they required large amounts of calcium and phosphate solutions, which contain aluminum. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration. 

Learn more About aluminum

In the first few years of life, children receive multiple vaccines, many of which contain aluminum. At two months old, an infant may receive up to 1,225 micrograms of aluminum from vaccines in a single well-baby visit. By 18 months, the cumulative exposure can reach 4,925 micrograms. This substantial exposure level occurs without thorough regulatory assessment of its safety. The situation is further complicated by the presence of mercury in some influenza vaccines, which, when combined with aluminum, can have synergistic toxic effects, exacerbating potential health risks .

​Infants, particularly in their first year, are highly susceptible to aluminum bioaccumulation. Reports highlight high levels of absorbable aluminum in infant formula and parenteral nutrition solutions given to premature babies. Researchers have suggested that these findings may represent the "tip of an iceberg," warning that aluminum is a "significant component of newborns’ exposure to xenobiotics and contaminants." The pathological consequences of aluminum overload during the perinatal period can persist into adulthood, raising serious long-term health concerns .

​The routine administration of vitamin K injections and multiple aluminum-containing vaccines in early childhood presents a significant source of aluminum exposure. Given the potential risks, particularly for premature infants and the cumulative effects over time, it is crucial to reevaluate these practices. Further research and regulatory scrutiny are necessary to ensure the safety and well-being of the youngest and most vulnerable members of our population.

Injection Safety Concerns

Despite its widespread use, the vitamin K injection has faced criticism from some quarters. Critics argue that the risk of VKDB is minimal and that the injection, which contains synthetic vitamin K (phytonadione) and other additives (including aluminum), may pose potential risks to infants.

​Reported side effects include:

• Cardiac Disorders: Tachycardia, hypotension
• General Disorders: Generalized flushing, pain, swelling, and tenderness at the injection site
• Hepatobiliary Disorders: Hyperbilirubinemia
• Immune System Disorders: Fatal hypersensitivity reactions, anaphylactic reactions
• Neurologic: Dysgeusia, dizziness
• Pulmonary: Dyspnea
• Skin and Subcutaneous Tissue Disorders: Erythema, pruritic plaques, scleroderma-like lesions, erythema perstans
• Vascular: Cyanosis

Deaths have occurred after intravenous and intramuscular administration​.

Additionally, there is a risk of hemolysis, jaundice, and hyperbilirubinemia, particularly in premature infants, if an overdose of phytonadione injectable emulsion occurs.

Vitamin K functions

Vitamin K is a fat-soluble vitamin essential for several bodily functions, including blood clotting and bone health. It exists in two primary forms: Vitamin K1 (phylloquinone) and Vitamin K2 (menaquinone). Both forms play distinct roles in the body.

Functions of Vitamin K1 (Phylloquinone)

• Blood Clotting (Coagulation)
  1. Activation of Clotting Factors: Vitamin K1 is crucial for the synthesis of several proteins that mediate coagulation, particularly prothrombin (factor II) and factors VII, IX, and X. These proteins are essential for blood clotting and wound healing .
  2. Conversion to Active Forms: It helps convert these clotting factors into their active forms, which can bind calcium ions and participate in the clotting cascade.
• Osteocalcin Activation: Vitamin K1 assists in the carboxylation of osteocalcin, a protein necessary for binding calcium to the bone matrix, thereby contributing to bone mineralization and strength .
• Regulation of Calcification: Vitamin K1 also helps prevent the calcification of blood vessels, reducing the risk of cardiovascular diseases by regulating proteins like matrix Gla-protein (MGP), which inhibit vascular calcification .

Functions of Vitamin K2 (Menaquinone)

• Activation of Clotting Factors: Both MK-4 and MK-7 play crucial roles in the synthesis of proteins required for blood clotting, such as prothrombin. This function is essential for preventing excessive bleeding.
• Reduction of Inflammation: Some studies suggest that vitamin K2 has anti-inflammatory properties, which may help reduce the risk of chronic inflammatory diseases.
• Cellular Growth and Health: MK-4, in particular, is involved in the regulation of cellular growth and apoptosis (programmed cell death), playing a role in cancer prevention and overall cellular health.
• Bone Health
  1. Enhancement of Osteocalcin: Similar to K1, Vitamin K2 plays a crucial role in bone health by aiding the carboxylation of osteocalcin. This form of Vitamin K is particularly effective in supporting bone density and reducing the risk of fractures .
  2. Support for Bone Formation: It also stimulates bone formation by enhancing the function of osteoblasts, the cells responsible for building new bone tissue .
• Prevention of Arterial Calcification: Vitamin K2 is known for its role in reducing arterial stiffness and preventing calcification of arteries, which can help lower the risk of atherosclerosis and related cardiovascular conditions .
• Metabolic and Hormonal Health
  1. Regulation of Glucose Metabolism: Some studies suggest that Vitamin K2 can improve insulin sensitivity and reduce the risk of type 2 diabetes by enhancing glucose metabolism .
  2. Hormonal Balance: K2 has also been implicated in the regulation of sex hormones, contributing to reproductive health and overall hormonal balance .​

Both forms of Vitamin K have been shown to support detoxification processes indirectly through their roles in overall health maintenance:

• Support Liver Function: The liver is the primary site for Vitamin K storage and use, particularly in producing clotting factors. By supporting liver function, Vitamin K can help maintain efficient detoxification processes .
• Antioxidant Properties: Vitamin K has antioxidant properties, which can protect cells from oxidative stress and damage, a key component of effective detoxification .

​Overall, both Vitamin K1 and K2 are vital for maintaining various physiological processes, with each form offering unique benefits that contribute to overall health.

Natural Alternatives & Dietary Sources

Advocates for a more natural approach suggest that proper maternal nutrition during pregnancy can help ensure adequate vitamin K levels in newborns. A diet rich in natural vitamin K from sources such as green leafy vegetables, fermented foods, and animal products is recommended. Colostrum, the first form of breast milk, is also naturally rich in vitamin K and can help boost the newborn's levels.

Natural Sources of Vitamin K1 (Phylloquinone)
Vitamin K1 is primarily found in green leafy vegetables. Some of the best sources include:

1. Kale
2. Spinach
3. Collard Greens
4. Swiss Chard
5. Turnip Greens
6. Broccoli
7. Brussels Sprouts
8. Cabbage
9. Green Tea
10. Herbs (Cilantro, Parsley)

Natural Sources of Vitamin K2 (Menaquinone)
Vitamin K2 exists in several subtypes, with MK-4 and MK-7 being the most studied and understood. Vitamin K2 is found in certain animal products and fermented foods.
MK-4 (Menaquinone-4)

• Animal Products:
  1. Liver: Beef, pork and chicken liver are rich in MK-4.
  2. Egg Yolks: A significant source of MK-4.
  3. Dairy Products: Full-fat (ideally raw and pasture-raised) dairy products such as butter, cheese, and whole milk.
  4. Fish (Salmon, Mackerel)
  5. Chicken: Particularly the dark meat.

MK-7 (Menaquinone-7)

• Fermented Foods:
  1. Natto: Fermented soybeans are the richest source of MK-7.
  2. Fermented Vegetables: Foods like sauerkraut and kimchi can contain MK-7.
  3. Cheeses: Certain fermented cheeses, such as Gouda, Jarlsberg, and Edam, are good sources of MK-7.
  4. Fermented Dairy Products (Kefir, Yogurt)​

​Incorporating these foods into a diet can help ensure adequate intake of both vitamin K1 and K2, supporting overall health and specific functions such as blood clotting and bone health.

Oral Vitamin K Supplementation

Some parents and healthcare providers prefer oral vitamin K supplementation as an alternative to the injection. While it may require multiple doses and is considered less effective, by the conventional medical system, than the injection, it is an option for those concerned about the injection's potential side effects. Ideally, vitamin K is provided via the maternal colostrum supply.

Infant Mortality in the United States

A critical point raised by critics of routine medical interventions for newborns is the high infant mortality rate in the United States. According to data referenced by various studies, the U.S. has one of the highest first-day infant mortality rates among developed countries. This statistic raises questions about the overall approach to neonatal care, including the administration of vaccines and other interventions.

"An estimated 11,300 newborn babies die each year in the United States on the day they are born. This is 50 percent more first-day deaths than all other industrialized countries combined. The 33 other industrialized countries for which there are data have a combined total of 7,500 first-day deaths each year."

United states compared to other first-world nations

The vitamin K injection for newborns is a standard medical practice in many countries to prevent a rare but serious condition called Vitamin K Deficiency Bleeding (VKDB). However, the approach to administering vitamin K can vary between countries, influenced by cultural norms, healthcare policies, and parental preferences.

Nations Where Vitamin K Injection is Not Universally Administered:

1. The Netherlands: Vitamin K is commonly administered orally rather than by injection. Newborns receive an oral dose at birth and continued supplementation for breastfeeding infants.
2. Sweden: Both oral and injection methods are used, with oral administration being more common.
3. Germany: Vitamin K is typically given orally in multiple doses rather than via injection.
4. Japan: The oral method is preferred, with doses administered during health checkups.
5. Switzerland: Oral vitamin K supplementation is the standard, although injections are available in some cases.

When comparing neonatal and infant mortality rates between the United States and countries like the Netherlands, Sweden, Germany, Japan, and Switzerland, notable differences emerge.

Neonatal Mortality Rates
​(per 1,000 live births)

Country	Neonatal Mortality Rate
United States	3.9
Netherlands	2.4
Germany	2.3
Switzerland	2.2
Sweden	1.4
Japan	0.9

Infant Mortality Rates
​(per 1,000 live births)

Country	Infant Mortality Rate
United States	5.4
Netherlands	3.5
Switzerland	3.6
Germany	3.3
Sweden	2.1
Japan	2.0

These statistics indicate that the United States has higher neonatal and infant mortality rates compared to these other developed nations.

It’s important to note that while the U.S. invests significantly in healthcare, these investments do not always translate into better outcomes in certain health metrics, such as infant mortality.

Conclusion

The debate over the necessity and safety of the vitamin K injection for newborns reflects broader discussions about medical interventions in early childhood. "The Nourishing Traditions Book of Baby & Child Care" provides a perspective that emphasizes natural methods and maternal nutrition to ensure adequate vitamin K levels in newborns. While the scientific consensus supports the vitamin K injection to prevent VKDB, it is essential for parents to be well-informed and consult with healthcare providers to make the best decisions for their infants. Individual circumstances and health conditions should always be considered to provide the best care for each child.

Learn More: Nourishing Traditions

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References

Miller NZ, Goldman GS. Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity? Human & Experimental Toxicology. 2011;30(9):1420-1428. doi:10.1177/0960327111407644

Y. de Vries J, Pundir S, Mckenzie E, Keijer J, Kussmann M. Maternal Circulating Vitamin Status and Colostrum Vitamin Composition in Healthy Lactating Women—A Systematic Approach. Nutrients. 2018; 10(6):687. https://doi.org/10.3390/nu10060687

https://labeling.pfizer.com/ShowLabeling.aspx?id=5392​

​Shaw, C. A., & Tomljenovic, L. (2013). Aluminum in the central nervous system (CNS): toxicity in humans and animals, vaccine adjuvants, and autoimmunity. Immunologic Research, 56, 304-316.