Melanie Cole, MS (Host): Welcome to LifeCast, the podcast from the specialists at Infirmary Health. I'm Melanie Cole. And today, we're talking about newborn vitamin K shots, what you need to know. Joining me is Dr. Jessica Kirk. She's a pediatric hospitalist with Thomas Hospital.

Dr. Kirk, thank you so much for joining us today. Tell us what is vitamin K, and why is it beneficial to our bodies?

Jessica Kirk, MD: Thank you for having me. Vitamin K is pretty straightforward. It's a vitamin that all humans require to clot their blood. And the reason we're talking about it today is because babies don't have enough at birth and they need a little bit extra.

Melanie Cole, MS: Okay. Thank you for that. So, why is a vitamin K shot given to newborns after birth?

Jessica Kirk, MD: So babies are born with not as much vitamin K as they need, and that's for several reasons. One, it's not readily available in breast milk. Two, they can't produce a lot in their intestines yet. And three, it doesn't cross the placenta well. And so since the early 1970s, we've been supplementing newborn babies with a shot of vitamin K to help them clot their blood.

Melanie Cole, MS: What happens if a newborn doesn't receive the vitamin K shot?

Jessica Kirk, MD: So if a newborn does not receive vitamin K, they are at a much higher risk of having what we call vitamin K deficiency bleeding. They're actually at an 81 times risk of developing this type of bleeding if they don't get the vitamin K shot. And this type of bleeding can be bleeding into their tummies, their intestines. It can be bleeding into their brain, bleeding out of their umbilical stump. Very serious, serious bleeding.

Melanie Cole, MS: Wow, this is really an important shot to get. Can you tell us, Dr. Kirk, some myths that you've heard surrounding the vitamin K shot?

Jessica Kirk, MD: Yes, I'd love to share these, because for the first 20 years that I've been a pediatrician, I would say virtually 100% of babies in the newborn nursery received vitamin K. We've been giving it steadily to almost every baby in the US since the early '70s, 1970s. And lately, we've had a lot more refusals. So, I think going over the things that people might hear out in public that we can kind of get some better information on are super important.

So, the first myth is if you don't give the vitamin K shot, nothing bad's going to happen to your baby. Most babies don't have this problem. And it's true that most babies don't have significant deadly bleeding from vitamin K deficiency, but it's very easy to prevent it in the ones that do.

And so, even if your baby doesn't have any trauma, no bumps, no falls, your baby can still develop vitamin K deficiency bleeding. And so even if your baby is perfectly safe at home in their crib and just sleeping, they can actually develop this bleeding. So, it's highly recommended that you get this even if your baby doesn't have any trauma or you think you don't have any family history.

The second myth is that it's unnecessary because your baby eventually makes their own vitamin K. And that's true, your baby will eventually make their own vitamin K by the first few weeks of life, but the danger period is that day two through day seven of the newborn period.

The third myth is that the preservatives in it are unsafe. And I will tell you that the preservatives in it are very minimal. They're very safe for newborns, and your baby is probably getting exposed to a lot more preservatives outside the vitamin K shot than they are with it. However, a lot of hospitals provide preservative-free vitamin K, including here at Thomas Hospital. And if that's something that you would like for your baby, all you have to do is request it, and we'll provide the preservative-free version.

The fifth myth is that it can lead to childhood cancer, and I'll just say, I don't know where this myth came from, but I have heard it talked about in public. And all I can say is it is patently false. The vitamin K shot is safe, it is effective, and it has no link with childhood cancer. The reason we know this is because we've been giving it since the early 1970s, and we've tracked those cohorts of children over decades and decades, and there's been no increased risk of cancer from the vitamin K injection.

Melanie Cole, MS: Thank you for going over those myths and clearing some of them up, because this is really the science. And as you say, it's been around since the '70s, and I think that we really need to trust the experts such as yourself. Now, you mentioned that now you're getting refusals. Why are some parents declining to give their newborn that vitamin K shot?

Jessica Kirk, MD: It really is surprising to pediatricians that we've had so many people refuse the vitamin K injection, especially since it's a vitamin, and most people are into giving their babies vitamins.

I think perhaps it's gotten lumped into the vaccine category, even though it itself is not a vaccine. I feel like maybe it's gotten grouped in with vaccine refusal. But just to reassure parents, it's been around for a very long time. It's very safe, and it's a one-time dose of a vitamin.

Melanie Cole, MS: That was really an excellent explanation. Good points that you made, because I'm sure that sometimes there is a confusion with a vaccine versus a shot of a vitamin. So, thank you for clearing that up as well. Are there any side effects to it?

Jessica Kirk, MD: Very minor side effects. This is one of our lower side effect medications. And so, of course, there's the initial pinch with the injection and a little bit of soreness at the site. We highly recommend that parents feed their baby either with bottle or breastfeeding before and after just to give them some comfort. But yeah, besides the pain and a little soreness, no, no known significant side effects. It's extremely safe.

Melanie Cole, MS: Dr. Kirk, how is vitamin K given to the newborns?

Jessica Kirk, MD: So in the US, the only FDA-approved version is a single injection of vitamin K. And the oral drops, which some parents may ask about, are actually not FDA-approved in the US, and that's for several reasons.

So, one, each baby absorbs the oral medication at a different rate, so we don't know exactly how much they're getting. But also, they have to have several doses of the oral medication, and their time period where they're most at risk of that bleeding is the time period where we'd be building it up by the oral medication. And so, we give one injection in the first six hours after birth. It's stored in the liver, and it protects the baby for that critical time period in the first week or two.

Melanie Cole, MS: That's really great for parents to hear and reinforcing as well. Dr. Kirk, you're a hospitalist, but where are you located if someone wants to talk with you?

Jessica Kirk, MD: Sure. Myself and my partners are at Thomas Hospital, part of the Infirmary System. We started our pediatrics program there in 2019 right before COVID hit, and we cover the inpatient service, meaning if a child is ill enough to need to stay overnight in the hospital, my group will take care of them. And we also consult down in the emergency department. So if there's a child that comes in to the ER at either Thomas or our freestanding ER at Malbis, we can actually give advice to the ER doctors about all those pediatric patients.

Melanie Cole, MS: Tell us just a little bit more about Thomas Pediatrics and what conditions you treat and your team that's involved.

Jessica Kirk, MD: So, my team currently has three wonderful pediatricians, myself, Dr. Danielle Gilliam, and Dr. Robin Boyer, and we treat traditional pediatric problems like asthma, stomach viruses, RSV, dehydration, all sorts of injuries. We work with orthopedics and ENTs. Anything that doesn't require an ICU for a child or a very specific subspecialist, we can usually manage at Thomas, and we love to do so.

Melanie Cole, MS: Dr. Kirk, you've given us really great information today. Give us some final thoughts and your best advice about parents advocating for their child and asking the questions that they would like to ask, but also trusting the science, trusting the experts, and any questions and advice you'd like to offer about vitamin K.

Jessica Kirk, MD: Thank you so much. I would just like to remind everyone that's listening that you know your child best, and I know it's hard to know them yet when they're newborns, but parents have a parental intuition. And whenever they have a question or concern, I hope they feel open to asking any of their medical care providers the questions that they have, and to get a second opinion on anything they might read online just to see how accurate or in line with mainstream it might be.

And then, I'd also like to remind everybody that pediatricians, we spend our life dedicated to the health of all children, and we dedicate our lives to learning about what's best for them and what's safest for them, and that we would never recommend anything that we thought would be harmful to a child. We just want what's best for your child.

Melanie Cole, MS: I'm so glad you said that, Dr. Kirk, because our pediatricians really are the gold standard. You are there to help us parents raise our kids happy and, most importantly, healthy as well. So, thank you for all the great work that you're doing as a pediatrician.

And for more information, go to infirmaryhealth.org. And if you enjoyed this podcast, please share on your social media and subscribe, rate, and review on your favorite podcast apps. I'm Melanie Cole, and this is LifeCast, the podcast from the specialists at Infirmary Health. Thanks for listening and stay well.