Some Alberta doctors say they’re seeing a recent and concerning trend of new parents either questioning or refusing vitamin K injections, which have been given to newborns as standard practice for decades.
Canadian babies have been routinely given vitamin K shots because they’re generally born with low levels of the vitamin, which is important for blood clotting to prevent serious bleeding.
The Canadian Paediatric Society, along with other high-profile medical organizations, recommends all babies get the shot within six hours of birth.
“I have seen a significant increase in the number of people who are saying they don’t want to give vitamin K to their baby,” said Calgary-based high-risk obstetrician Dr. Stephanie Cooper.
Cooper said parents tell her they don’t trust the injection but are unable to articulate why.
Others, she said, are falling prey to misinformation on social media platforms such as TikTok, and some parents mistakenly believe the injection causes autism.
“I’m worried because this is just one of many things where people are making choices about medical decisions … and using sources of information that are not based on science or experience or evidence,” she said, noting she’s seen the change over the last couple of years.
“There will be people who potentially will follow this trend … and there will be tragedies as a result.”
Risk of serious bleeding
Babies are typically born with low levels of vitamin K, which is one of the factors needed to clot blood, because very little is passed along through the placenta. Breast milk doesn’t provide a significant amount of vitamin K, and it takes time for infants to develop the ability to produce their own.
Calgary pediatrician Dr. Carrah Bouma said vitamin K injections have been given safely for decades.
“It’s been standard of care in Canada since the 80s and recommended since the 60s,” she said.
Babies who don’t get a vitamin K shot, given in a thigh muscle, are at risk of spontaneous bleeding, according to Bouma, who works at the Peter Lougheed Centre, Alberta Children’s Hospital and in a community practice.
“I have serious concerns that infants are going to bear the complications of severe and preventable side effects such as a serious gut bleed, a serious brain bleed that could leave a baby with lifelong deficits such as cerebral palsy or the need for ICU level of care,” said Bouma.
Hemorrhaging can also occur during procedures such as circumcisions or tongue-tie reversals, doctors warn.
According to the U.S. Centers for Disease Control, a condition known as vitamin K deficiency bleeding (VKDB) can develop anytime in the first six months of a baby’s life, which can lead to brain damage and even death.
“If a baby has a stroke because they don’t have enough vitamin K, we can’t go back and make that stroke go away. We can’t take away the injury that occurred,” said Cooper.
While the vast majority of families Bouma deals with agree to the vitamin K shot, she’s seeing increased hesitancy.
“Families I have found over the last year or so have not wanted that injection; they’ve wanted to give oral medication,” she said.
Those parents, she said, are also refusing the drops given through the hospital pharmacy and opting to get them on their own, which is also a concern for her.
The Canadian Paediatric Society recommends the injection over the drops, which have to be given over a number of weeks. It warns that parents should be cautioned that the drops are not as effective, and that babies receiving them are still at risk of bleeding, including in the brain.
Bouma said a lack of trust seems to be at the heart of some of the resistance she’s seeing.
“It’s safety profile is excellent. There are really no downsides to giving vitamin K and really no side effects beyond that of an injection,” she said, noting those side effects can include some pain and bruising at the injection site.
U.S. organization notes increased vitamin K refusal
Another high-profile medical organization, the American Academy of Pediatrics, noted increasing resistance from parents.
“In recent years, there has been an increase in the number of parents who refuse [vitamin K injections] for their newborn infants and a resultant increase in the number of cases of late-onset VKDB,” the association said in a 2022 policy statement.
“Because VKDB remains a relatively rare occurrence, most families are unaware of the serious consequences of the disease and must be counselled on the risk of refusal.”
Publicly available data shows vitamin K uptake for Alberta newborns rose to 95.71 per cent in 2023 from 92.76 per cent in 2007.
CBC News asked Alberta Health Services and the province for more recent data. Neither provided an answer.
The older data shows a drop in uptake in the south zone (to 94.05 per cent in 2023 from 97.3 per cent in 2007). The north zone remained relatively steady with rates of 93.9 per cent in 2023 and 94.04 per cent in 2007. The rest of the zones saw overall increases.
The province identified a similar concern over a decade ago, highlighting clusters of higher refusal rates in Grand Prairie County in the north zone, the Cochrane and Springbank areas in the Calgary zone, and Red Deer County in the central zone.
At the time, recommendations were made to increase parent education about the health risks associated with rejecting vitamin K.
