What No One Tells You About Newborn Vitamin K

Making informed decisions for your newborn can feel like navigating a tidal wave of contradictory advice, especially when it comes to routine procedures like the vitamin K shot. As both a labor nurse who's cared for countless babies and a mom who's stood in your shoes, I created this episode to cut through the noise with evidence, empathy, and respect for your values.

Vitamin K is essential for blood clotting, and all newborns—regardless of how healthy the pregnancy was—are born with extremely low levels, about 1/50th of what adults have. The vitamin K shot provides protection during those vulnerable first months when even a small internal bleed could become serious. While vitamin K deficiency bleeding is rare, occurring in roughly 1 in 6,000 babies who don't receive supplementation, it can be devastating when it happens.

We dive deep into the questions parents really struggle with: If babies are born with low vitamin K, isn't that natural? What about ingredients like polysorbate 80? Doesn't breast milk provide everything babies need? Could oral vitamin K work instead? Will the shot disrupt those precious first bonding moments? Each concern is addressed with current research, practical experience, and an understanding that these questions come from a place of love and protection.

Beyond just facts and figures, we explore the emotional and spiritual dimensions of this decision. For families wondering if interventions contradict their faith in God's design, we consider how human babies are uniquely dependent creatures—perfect but not complete—and how scientific advancements might be viewed as extensions of divine care rather than contradictions.

The episode wraps with a practical decision-making framework called the BRAIN model (Benefits, Risks, Alternatives, Intuition, and what happens if you do Nothing), helping you sort through your options with clarity rather than fear. Whether you choose the shot, explore alternatives with medical guidance, or decide on another pa

Join the Bump & Beyond Online Community for moms & moms-to-be!

Coaching offer

Kelly Hof: Labor Nurse + Birth Coach
Basically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!

Chapters

• 0:00 Introduction to Birth Decisions
• 2:31 What is Vitamin K and Why It Matters
• 9:43 Understanding Vitamin K Deficiency Bleeding
• 17:12 Why Some Parents Decline the Shot
• 20:14 Addressing Common Concerns
• 27:32 Oral Vitamin K Alternatives
• 35:32 Polysorbate 80 and Dosage Questions
• 45:59 Skin-to-Skin and Medical Procedures
• 50:29 Debunking Health Concerns
• 54:11 Decision-Making Framework and Support

Transcript

Speaker 1: 0:29

Hey friend, welcome back to the Birth Journeys Podcast. I'm your host, kelly Hoth, transformational prenatal coach, labor nurse, mom of two and someone who's walked beside hundreds of families as they prepare to bring their babies into the world. Whether this is your first time here or you've been tuning in for a while, I want you to know you're in the right place if you're creating an informed, empowered and emotionally grounded pregnancy and birth journey. I know how confusing it can feel to sort through all the information out there. There's a tidal wave of advice coming at you from your provider, from social media, from friends and family, and so much of it feels urgent, emotional and contradictory. One source says this is dangerous, don't do it. Another says you're irresponsible if you don't. It all tugs at your heart because, at the end of the day, you just want what's best for your baby, and that's where so many of us get stuck. You're told over and over that doing what's best means making the right decision, whether that's breast or bottle feeding, epidural or unmedicated, vaginal or cesarean birth, or accepting or declining something like the vitamin K shot, and when both sides feel compelling, it can be incredibly overwhelming. That's why I created this podcast and it's also why I offer one-on-one prenatal coaching to help you sort through all the noise, understand what matters most to you and build the tools and confidence to make choices from a place of strength and clarity, not fear or pressure. So today we're diving into one of those tricky topics that often leaves parents unsure and uneasy the vitamin K injection that's routinely given to newborns within the first few hours after birth. Here in the US, there's been a lot of controversy and misinformation swirling around this, and I want to approach it with evidence, empathy and alignment. My goal is not to scare you, it's not to shame you and it's certainly not to tell you what to do. I want to give you the full picture so you can make the best choice for your baby and feel really solid in that decision, whatever it looks like.

Speaker 1: 2:42

So what is the vitamin K shot and why is it given? Vitamin K helps blood clot. Without it, even a small internal bleed can be serious. Without it, even a small internal bleed can be serious. All newborns, no matter how healthy they are, are born with very low levels of vitamin K. According to the CDC, it's about 1 50th of what an adult has. I know what you might be thinking Babies are smaller than adults. Don't they need less? That's a fair question, but even small babies need enough vitamin K to safely form clots. Without it, a small bleed inside the body, especially in the brain or intestines, can quickly become life-threatening. That's why the vitamin K shot is offered within the first few hours after birth. It's one small injection in the thigh that gives your baby a store of vitamin K to last until they're eating solid foods and their body can start making it.

Speaker 1: 3:40

So what happens if a baby doesn't get vitamin K at birth? If you've tried looking this up, you might have seen some big numbers floating around, like the CDC and the American Academy of Pediatrics, saying that babies who don't get the shot are 81 times more likely to get something called late-onset vitamin K deficiency bleeding. That sounds huge, right, but what does that actually mean? Let's break it down and look at the real numbers behind that. First, what is vitamin K deficiency bleeding? It means the baby doesn't have enough vitamin K to help their blood clot. That can lead to serious bleeding, sometimes in the brain. For starters, it's important to know that there are actually three kinds of vitamin K deficiency bleeding. Early vitamin K deficiency bleeding happens in the first 24 hours and is usually linked to certain medications the birthing parent took during pregnancy. Classic vitamin K deficiency bleeding shows up between days 2 and 7. It might look like bruising, bleeding from the cord or bleeding in the poop. Late vitamin K deficiency bleeding is the one we worry about the most. It happens between two weeks and six months and usually shows up out of nowhere, often with brain bleeds. So when we hear the CDC say that babies are 81 times more likely to get late-onset vitamin K deficiency bleeding without the shot, they're comparing babies who got the shot, meaning they have a 1 in 400,000 chance of late vitamin K deficiency bleeding to those who didn't, being 81 times more likely to get late-onset vitamin K deficiency bleeding. So let's clarify where those numbers come from.

Speaker 1: 5:27

Some studies have tried to count how often this bleeding actually happens. A big study by Dr Sutherland and colleagues in the Journal of Pediatrics 1993, looked at breastfed babies in the US who didn't get vitamin K and found that late vitamin K deficiency bleeding happened in about 1 in 6,000 to 9,000 babies. Another study by Dr Ichiro Iwamoto in Pediatrics International in 2003 found a similar number around 1 in 5,800 to 1 in 7,000 babies in Japan. But then there's another number that might surprise you 2 in every 100. That's about 2%. Where does that come from? That's about 2%. Where does that come from?

Speaker 1: 6:12

The number includes all types of vitamin K deficiency bleeding early, classic and late. It's used by sources like the CDC, the American Academy of Pediatrics and HealthyChildrenorg to show the total risk when a baby doesn't get any vitamin K Not the shot and not the oral version either. So here's a simple way to think about it. The 2-in-1 number is the big picture. How many babies might bleed at any point without any form of vitamin K? The 1-in-5,000 to 9,000 number zooms in on just late-onset vitamin K deficiency bleeding.

Speaker 1: 6:50

The 1-in-400,000 number is for babies who get the shot. That's how rare vitamin K deficiency bleeding. The 1 in 400,000 number is for babies who get the shot. That's how rare vitamin K deficiency bleeding becomes with the shot. And all of this matters because most babies who get vitamin K deficiency bleeding are breastfed and haven't received any vitamin K. Why? Because breast milk, while amazing in so many ways, just doesn't have enough vitamin K to fully protect babies. Shearer's study in blood reviews showed that breast milk usually has only 1-2 micrograms of vitamin K per liter. But to be fully protected. Babies need blood levels closer to 3.5 micrograms per liter. That's why the vitamin K shot works so well. It gives babies enough to store in their liver and use slowly over time. It helps bridge the gap until their bodies can make enough and absorb enough on their own. So, yes, vitamin K deficiency bleeding is rare, but when it happens it's dangerous and the difference in risk between getting the shot and not getting any vitamin K is big.

Speaker 1: 7:57

For some parents, that's enough to feel confident saying yes. For others, it's important to explore all the options and understand the numbers before deciding, and if you're still weighing the options, just know you're not expected to have all the answers. Your job is to ask the questions and my job is to make sure you have honest, clear and caring information so you can make a decision that truly feels right for your family. So let's talk about how common it is to decline the shot. Most parents in the US do choose the shot. Refusal rates in hospitals are generally under 2%, but that number is higher in out-of-hospital births, like home births or birth center births, where 10 to 30% of parents may decline it, depending on the region. A cluster of cases in Tennessee in 2013 happened at a birth center where 28% of parents had declined the shot. Four babies from that group developed vitamin K deficiency, bleeding. All of them needed medical treatment. That story has been cited a lot in the vitamin K conversation because it highlighted the connection between declining the vitamin K shot and the risk of late-onset bleeding. But it's also just one example and every family's context is different. So why are some parents saying no?

Speaker 1: 9:16

If you've been researching this topic, you've probably come across a wide range of opinions, stories and personal beliefs that can make this decision feel confusing or even emotional. In the next part of this episode, I'm going to walk you through some of the most common concerns and objections to the vitamin K shot. Things like worries about ingredients, beliefs about what's natural, oral alternatives and fears around disrupting bonding time after birth. These aren't just surface level concerns. For many families, they run deep and are tied to values, experiences, culture, religion or even past trauma, and they deserve to be heard with respect. So let's take a look at the controversies and questions that make this such an emotional and personal decision for many parents.

Speaker 1: 10:01

In recent years, more parents have started questioning the injection. Some of the concerns I've heard include if babies are born with low vitamin K. Maybe they're meant to be that way. Isn't there enough vitamin K in breast milk or cord blood? I don't want chemicals or preservatives injected into my baby's body. I prefer oral or natural alternatives. It feels like an unnecessary intervention during the golden hour and I hear you. These concerns come from a place of love and protection. You want to do what's safest and most respectful for your baby's body. That's not wrong.

Speaker 1: 10:38

Let's walk through common questions and objections one by one and consider each with science and compassion. Question one If God made babies perfect, why would they need extra vitamin K? This is one of the most heartfelt and spiritually rooted questions I've come across. For many families this isn't just about medicine. It's about faith. It's about trusting in God's design and wondering whether saying yes to something like a vitamin K injection might somehow mean going against their faith. If that's something you've been wrestling with, I want you to know you are not alone. These aren't silly questions. They are sacred ones.

Speaker 1: 11:18

It's true that babies are born with very low stores of vitamin K. It's not found in the cord blood in meaningful amounts. It's barely present in breast milk, and even fortified formula doesn't provide enough to reliably prevent vitamin K deficiency bleeding. That can feel unsettling, especially if you believe deeply that breast milk is perfect and that God doesn't make mistakes. But here's a perspective that might help soften that tension.

Speaker 1: 11:46

Being born perfect doesn't always mean being born complete. Human babies are incredibly dependent. Always mean being born complete. Human babies are incredibly dependent. Unlike other mammals, they can't walk, can't feed themselves, can't regulate their own temperature and they lack the muscle strength to even hold up their heads. Why? Because their brains are designed for something bigger for connection, for learning, for problem solving and for relational growth. That very dependency nurtures the uniqueness that makes us human. In fact, many refer to the first few months after birth as the fourth trimester, because babies are essentially still finishing their development outside of the womb. Human babies are born earlier than other animals because our brains are too large to allow us to stay in utero any longer, so we're born needing extra help.

Speaker 1: 13:34

Perfect but incomplete, and maybe vitamin K is just one more example of something that wasn't meant to be built in but instead meant to be received. Maybe the way we receive it through science, medicine, shared wisdom and the people who've dedicated their lives to learning how to protect life isn't a detour from God's plan, but actually a reflection of it. There's a story you might have heard that speaks so clearly to this. A man was caught in a flood. He prays for God to save him. A rowboat comes by and he says no thanks, god will save me. Then a motorboat, then a helicopter. No thanks, god will save me. Then a motorboat, then a helicopter. Each time he waves them off, trusting that God will intervene. When he drowns and meets God in heaven, he asks why didn't you save me? And God replies I sent you a rowboat, a motorboat and a helicopter. What more were you waiting for? Sometimes God's help doesn't come in a way we expect, but that doesn't make it any less divine. Maybe this little injection, this quiet act of protection, isn't a rejection of faith, but an expression of it, a way of saying I see the boat, I trust the message, I receive the help.

Speaker 1: 14:49

Question two Isn't there enough vitamin K in colostrum, breast milk or from delayed cord clamping? This is another thoughtful and common question, because many of us are taught that colostrum is incredibly rich in nutrients which it is and that delayed cord clamping offers so many benefits which it absolutely does. So it's natural to ask if we're already doing these good, supportive things. Shouldn't that be enough? Colostrum and delayed cord clamping offer numerous benefits, but when it comes to vitamin K, they don't provide sufficient amounts to prevent vitamin K deficiency bleeding.

Speaker 1: 15:28

Colostrum, the first milk produced after birth, does contain vitamin K, but in very low amounts. A study published in the American Journal of Clinical Nutrition found that colostrum contains approximately 3.39 micrograms per liter of vitamin K1, and mature milk contains 2.87 micrograms per liter. To put this into perspective, infants require about 1 microgram of vitamin K per kilogram of body weight per day to maintain adequate blood clotting factors. For a 3.5 kilogram or 7.7 pound newborn, this equates to 3.5 micrograms per day. Given that the average daily intake of breast milk in the first days is about 500 milliliters, the baby would receive approximately 1.7 micrograms of vitamin K per day, insufficient to meet their needs, and the baby's vitamin K needs increase as the baby gains weight. Considering babies double their birth weight within the first four to six months of life and the average baby peaks at about 900 to 1300 milliliters of breast milk per day after the first month of life, it would be impossible to keep up by solely relying on breast milk for vitamin K.

Speaker 1: 16:47

Even if mom takes a vitamin K supplement, it has limited impact. Even if mom takes a vitamin K supplement, it has limited impact. A study in the Journal of Pediatrics showed that while high-dose maternal vitamin K supplementation increased breast milk levels, it didn't raise infant plasma vitamin K levels to a protective range. So what about delayed cord clamping? Delayed cord clamping is beneficial for increasing a newborn's iron stores and improving hemoglobin levels. However, it does not significantly impact vitamin K levels. Research indicates that cord blood contains extremely low levels of vitamin K1, less than 0.05 micrograms per liter. So, while colostrum, breast milk and delayed cord clamping offer numerous health benefits, they do not supply enough vitamin K to protect against vitamin K deficiency bleeding. For now, the vitamin K injection remains the most reliable method to ensure newborns have adequate levels to prevent this potentially life-threatening condition.

Speaker 1: 17:50

Question three life-threatening condition. Question three are additives like preservatives and polysorbate 80 safe for baby? Let's address this common concern. Understanding the purpose and safety of these components can help in making an informed decision. First of all, if you're concerned about preservatives in the vitamin K shot, it's important to know that preservative-free versions are available. These formulations are designed to minimize additives while still providing the essential vitamin K your baby needs. Availability can vary by hospital, so it's a good idea to discuss this option with your healthcare provider ahead of time.

Speaker 1: 18:27

Another ingredient in the vitamin K shot that has come up as a cause for concern is polysorbate 80. It's a long, science-y sounding word that can feel kind of intimidating, but once you understand why it's there and how it works, it starts to feel a little less scary. So what is it? Polysorbate 80 is an ingredient that helps spread out the vitamin K in the injection, so your baby's body doesn't use it all up right away. Think of it like a slow-release system. It helps your baby have the vitamin K in the injection, so your baby's body doesn't use it all up right away. Think of it like a slow-release system. It helps your baby have enough vitamin K in their body over several weeks to months, eliminating the need for multiple doses. This is important because late-onset vitamin K deficiency bleeding can happen weeks or months after birth and this slow release helps protect your baby during that whole time. Polysorbate 80 is used in tiny amounts less than 0.1 milligrams in the whole injection. So what about safety?

Speaker 1: 19:22

Polysorbate 80 is not a heavy metal like mercury or lead. That's a common misconception. In fact, it's a water-soluble compound, which means your baby's body can break it down and get rid of it naturally. It doesn't hang around in the body, it doesn't build up in tissues, it doesn't stay stuck like some metals can. According to both the World Health Organization and the European Medicines Agency, polysorbate 80 is metabolized by enzymes and excreted. In other words, the body knows how to handle it. And just to give you some perspective on the amount, the World Health Organization says it's safe to get up to 25 milligrams per kilogram of body weight in foods and medicines. A 7-pound newborn, which is about 3.2 kilograms, would receive over 800 times less than that in the vitamin K shot. You might have seen scary headlines or studies in social media saying polysorbate 80 caused problems in animals. But here's the catch those studies use doses much higher than what's in the vitamin K shot, sometimes hundreds or thousands of times more. Sometimes hundreds or thousands of times more. So it's not really a fair comparison. To put it in perspective, even water is toxic to babies in unsafe amounts. So just to make it clear, a substance that would harm a baby in unsafe amounts is not necessarily inherently unsafe. It's just important to stick to the safe dosage amounts.

Speaker 1: 20:55

Question four Can I give my baby vitamin K orally instead. Okay, I hear this question a lot, so let's walk through it together. In places like the Netherlands and Japan, babies often get vitamin K drops by mouth instead of a shot. But and this is a big but it has to be given on a very specific schedule. For example, one study by Dr Cornelison and colleagues, published in the journal Pediatrics in 2012, looked at babies in the Netherlands who were given 1 mg of vitamin K by mouth every week for 3 months. They found that this weekly oral dose did help reduce the risk of late-onset vitamin K deficiency bleeding, but that only worked when parents gave the full dose every week on time.

Speaker 1: 21:42

The problem is in the US, we don't have a standardized plan for oral vitamin K. That means there's no one agreed-upon schedule, and the FDA hasn't approved any form for newborns. That's important, because the oral products you can buy online or in stores aren't always made the same as medicines that go through strict testing. You don't always know for sure how strong they are or how well your baby's body will absorb them. And we just talked about how important it is to give newborns the right amount of something, because even water in the wrong amount can be toxic to newborns. A 2022 article in the Journal of Neonatal Screening by Dr Takashi Ito and colleagues shared that fat-soluble vitamins like vitamin K can be harder for some babies to absorb orally, especially if they have a health issue that affects digestion, like biliary atresia. And if your baby doesn't absorb the vitamin well, it's less likely to protect them from dangerous bleeding.

Speaker 1: 22:39

Another big study done by the American Academy of Pediatrics in 2022 reviewed lots of research from around the world. The article was written by Dr Lars Olson and published in Pediatrics, and it showed that, while oral vitamin K can work in some cases, it's just not as reliable as the shot. The injection is absorbed right into the muscle and stays in the baby's system for months, while the oral form can wear off quickly or be missed altogether if a dose is skipped. And here's one more thing that often gets overlooked Giving your baby too much vitamin K by mouth isn't likely to cause harm with the correct form vitamin K1. But giving the wrong type, like vitamin K3, also called menadione can actually be dangerous. That form isn't used in babies anymore because in the past it caused problems like jaundice and damage to red blood cells.

Speaker 1: 23:33

This is another reason to make sure you're only using supplements recommended and monitored by your pediatrician. So, yes, there are parents who use oral vitamin K and, yes, it can reduce the risk of vitamin K deficiency bleeding if it's given properly. But you'll want to talk with your baby's doctor and have a very clear plan in place. This isn't something to DIY or guess your way through. And, again, there is no FDA-approved oral vitamin K for newborns in the US as of now. Here's the bottom line. If you're thinking of going the oral route, just know that it means being super consistent with the schedule, making sure your baby can absorb it and having guidance from a medical professional every step of the way. And just so you're considering all possibilities. Since there's no FDA-approved oral vitamin K protocol, it may be quite challenging to find a pediatrician who actually feels comfortable guiding you through the oral route. Since there isn't an FDA-approved oral form of vitamin K that has been deemed safe for newborns, your provider may not know how to safely guide you through this option. Remember, ultimately you're not just choosing between a shot or a drop. You're making a decision about how to keep your baby safe in those vulnerable early weeks of life, and that's a big deal.

Speaker 1: 24:52

Question five Isn't the injection giving my baby too much vitamin K? This is such an understandable question. Some parents look at the numbers and think wait a minute. If babies need only about 3.5 micrograms per liter of vitamin K to prevent bleeding, then why are we giving them a full milligram all at once? Isn't that overdoing it? Why are we giving them a full milligram all at once? Isn't that overdoing it? Let's talk about that. The number you're probably thinking of, 3.5 micrograms per liter, comes from studies like the one by Lane and Hathaway published in the Archives of Disease and Childhood in 1982. They looked at what vitamin K levels in the blood seem to protect babies from bleeding. But here's the thing the number is the target blood level, not the same as the dose you'd need to give to reach that level and keep it there over time.

Speaker 1: 25:39

So how does the shot work? Vitamin K is a fat-soluble vitamin, which means your baby's body doesn't just flush out the extra in their pee like it would with vitamin C. Instead, it gets stored mostly in the liver and released slowly as needed. That's how one dose can last for weeks or even months. And that brings up another great question I've heard If a newborn's liver is too immature to make vitamin K or clot properly, how can it be mature enough to store that one milligram dose from a shot? That's a really smart question and the answer is newborn livers are still developing, but they're absolutely capable of storing nutrients like vitamin K.

Speaker 1: 26:19

Several studies, including one by Shearer et al in Blood Reviews 2009, and another by Von Kreis in Thrombosis and Hemostasis in 1998, showed that after babies get the shot in 1998 showed that after babies get the shot, the vitamin K accumulates safely in the liver and is then released bit by bit to help the baby's blood clot normally over time. It's kind of like filling your baby's vitamin pantry. They're not ready to cook for themselves just yet, but they can store the groceries. This is also where polysorbate 80 comes in. It's not a preservative. It's an ingredient that helps the vitamin K dissolve and release gradually into your baby's bloodstream. Without it, the vitamin might get used up too quickly. The World Health Organization and the European Medicines Agency both confirm that polysorbate 80 is safe in the tiny amount used in the shot and plays a key role in helping the vitamin K work as it should. So the answer is no. It's not an overdose. It's a smart, science-backed storage strategy designed to keep your baby protected during the first months of life, when their bodies aren't quite ready to do it all on their own yet.

Speaker 1: 27:29

And I just want to say again it's okay to feel cautious. You're not supposed to know everything. This is your baby, your questions matter, and understanding why something is done can go a long way towards feeling at peace with whatever decision you make. Question six will the shot disrupt skin-to-skin bonding? This question comes up a lot and I totally get it. The moments right after birth are sacred. You've waited all this time to meet your baby and all you want to do is hold them close, hear their little noises and feel their skin against yours. That's what we call the golden hour, and it's not just sweet, it's backed by science. Skin-to-skin contact after birth has so many benefits. It helps regulate your baby's heart rate, temperature and breathing. It boosts bonding, encourages breastfeeding and even helps stabilize blood sugar. That's why hospitals and birth teams take it so seriously. So here's the good news Giving the vitamin K shot doesn't have to interrupt those precious moments.

Speaker 1: 28:26

In fact, when I'm working as a labor nurse, I almost always give the vitamin K shot while the baby is skin to skin on the mom's chest. Most nurses and providers I know, do the same, as long as the baby and the mom are both stable. We do other things during that time too, like checking vital signs, drying baby off and monitoring how they're transitioning to life outside the womb. The shot is just one tiny part of that gentle routine. The needle is small and the shot is quick, usually done in just a few seconds in the thigh muscle. Honestly, babies don't always even cry when I give them a shot, when they're skin to skin, with a warm chest, familiar voice and a gentle touch. Many babies don't even react much and if you're worried, you can always ask your care team to wait until the baby has started nursing or seems calm. It's up to you, but we optimally try to give it within the first hour of life.

Speaker 1: 29:15

A 2017 review published in Acta Pediatrica emphasized how important uninterrupted skin-to-skin is for newborns and stated that routine procedures like the vitamin K shot can often be done without interfering. It's all about how it's done, not just what's done. So if this is a concern for you, bring it up. Talk to your provider or your birth team ahead of time. Chances are they'll say absolutely, we can do that while your baby stays with you, because, at the end of the day, this isn't about one size fits all. It's about making sure that your baby's safety and your bonding experience go hand in hand.

Speaker 1: 29:50

Question seven Does the vitamin K shot increase the risk of childhood leukemia? This is one of those fears that just sticks with you, especially if you've heard it floating around online or in parenting circles. And I want to start here by saying if that question has been keeping you up at night or even just making you hesitate, it's okay. You're not alone and it's not a silly question. You're doing your job as a parent by asking hard things. So where did this fear come from?

Speaker 1: 30:17

Back in 1992, a small study published in the British Medical Journal by Golding and colleagues looked at 100 children with cancer and compared them to healthy children. They noticed a possible link between vitamin K injections and childhood leukemia. That was enough to raise concern, and rightly so. Anytime there's a suggestion of harm, especially when it comes to kids, we have to look closely. But here's the thing Science doesn't stop there. Since that early study, many larger and more rigorous studies have been done all around the world to see if that link holds up. And so far it hasn't, because a link doesn't necessarily mean it's the cause. A 2003 review published in the British Journal of Cancer looked at data from multiple studies and concluded that there was no evidence that the vitamin K injections increased the risk of leukemia or any other childhood cancers. Another large study from 2002 in pediatrics, led by Ross and colleagues, followed more than 2,000 children and also found no association between vitamin K injections and leukemia. And a 1998 study published in Cancer Epidemiology, biomarkers and Prevention that reviewed over 500,000 births in Sweden yes, half a million also found no link between the shot and cancer. That's a lot of babies and it's one of the strongest pieces of evidence we have. So while that original study of 100 babies raised a very important question and we should always keep asking questions when it comes to our children's health the science that followed gives us a lot of reassurance. The experts at the Centers for Disease Control, the American Academy of Pediatrics and the World Health Organization have all reviewed the data and agree the vitamin K shot is not linked to leukemia.

Speaker 1: 34:23

If you've been holding this fear close, I hope this helps you breathe a little easier. You're not wrong for worrying that's what parents do but I hope you feel comforted knowing that researchers and public health experts have taken this question seriously and that the answers we have are now clear and reassuring. Question eight but doesn't the shot hurt my baby? This is such a tender one and, honestly, it's one of the most human of all questions we've covered, because when you just met this tiny, soft, brand new person, the last thing you want to do is cause them pain, even if it's just for a second. So let me say this clearly it's okay to feel heartbroken about this. It doesn't make you dramatic. It doesn't make you dramatic, it doesn't make you weak, it makes you a parent and it shows how deeply you care. Yes, the vitamin K injection involves a small needle. It's given on the baby's thigh muscle, usually while they're skin to skin on your chest or snuggled close to you. And yes, they may cry, but the cry is typically brief, often just a few seconds, but I get it. It still breaks my heart every time one of my kids gets a shot.

Speaker 1: 35:31

Research suggests that babies experience pain differently than adults, and, while they can feel pain, studies like the one done in 1987 by Anand and Hickey in the New England Journal of Medicine remind us that the way pain is processed in newborns is still developing. They feel it, but their bodies and brains are built to recover quickly, especially when they're held, comforted and spoken to with love right after. In other words, the way your baby is held and comforted during and after the shot really matters. A 2015 Cochrane review looked at ways to reduce procedural pain in newborns and confirmed that being close to a parent, suckling or being given oral sugar water were all simple ways to help babies feel safer and soothed. And, honestly, your arms and your voice, those are better than medicine for so many things. I just want to be clear that I'm not advocating for sugar water in the first hour of life. I'm mentioning that because it was part of the studies on pain in newborns and it's a valuable tool when the baby is undergoing medical procedures, especially in the NICU, when the parent isn't always available for skin-to-skin. So, yes, it's okay to feel that lump in your throat when your baby gets an injection. I sure did and I still do. And it's also okay to make your decision knowing that this moment will be short and that your baby will be held and loved through it.

Speaker 1: 36:52

Question nine Isn't the vitamin K shot just another vaccine? If you've been hesitant about vaccines, or especially if you are against them? This question might be at the top of your mind and you know what that makes total sense. There's so much emotion and mistrust tied up in conversations about vaccines. Maybe you've had a bad experience with the medical system, maybe someone you trusted shared very scary information with you, or maybe you're just doing your best to protect your baby in a world that feels loud, overwhelming and full of conflicting advice. So let's gently talk about this one First.

Speaker 1: 37:33

The vitamin K shot is not a vaccine. Vaccines work by training the immune system to recognize and fight certain infections. The vitamin K shot doesn't do that. It doesn't interact with your baby's immune system at all. It's not trying to create antibodies or prepare the body to fight a future illness. Instead, it works like a vitamin supplement, just like we take vitamin D when we don't get enough sun or iron when we're anemic. Babies get vitamin K because they're born with very low levels of it, and that matters, because vitamin K is essential for blood clotting. Without enough of it, babies are at risk for the rare but serious vitamin K deficiency bleeding.

Speaker 1: 38:06

Now some folks worry about the ingredients in the shot preservatives, additives or the way it's made, and I get that. You're looking at the fine print because you care, but here's what we know. The main ingredient is vitamin K1, also known as phytonadione, a form of vitamin K that is safe and effective. The amount given in the shot, 1 mg, has been studied for decades and shown to be effective in preventing vitamin K deficiency bleeding without harming babies. Polysorba 80, an ingredient that sometimes raises concern, is not a preservative or a vaccine adjuvant. It simply helps the vitamin dissolve and absorb slowly, so one dose lasts several months. According to the European Medicines Agency and the World Health Organization, the tiny amount used in the vitamin K shot is well below any toxic threshold and is considered safe.

Speaker 1: 41:07

If you're worried about preservatives, preservative-free versions of the shot are available at many hospitals Just ask. And if you're wondering, but what if I don't trust the people doing the research, that's okay. It's valid to be cautious. That's part of protecting your child. But it's also important to know that vitamin K has been studied for over 50 years. Major studies like the one done by American pediatrician Dr Charles P Larson in the Journal of Pediatrics in 1990, and countless public health reviews since then, have all shown the same thing the shot works and it's safe. One of the reasons it's so hard to find solid evidence against the shot is because it's been so widely adopted and vitamin K deficiency bleeding cases dropped dramatically after its introduction in the 1960s. In fact, in countries where vitamin K isn't routinely given, vitamin K deficiency bleeding is still more common. So if your hesitation about vaccines is causing you to doubt the vitamin K shot too, I just want you to know it's okay to hold space for both caution and curiosity, it's okay to want to know more before you say yes, and it's okay to still choose it, even if you opt out of other things, because this isn't about doing what you're told. It's about making the choice that feels aligned with your values, your research and your love for your baby, and you deserve support in that process, not shame.

Speaker 1: 42:29

Question 10. Does the vitamin K shot contain heavy metals like mercury or aluminum? This is a super common worry, especially if you've been researching vaccines or supplements and have heard concerns about ingredients like thimerosal, a mercury-based preservative, or aluminum, sometimes used in vaccines as an adjuvant to help boost immune response. The good news the vitamin K shot does not contain mercury. It never has. It also does not contain aluminum. These ingredients just aren't part of the formulation.

Speaker 1: 43:00

The vitamin K shot is not a vaccine. It does not train the immune system or use adjuvants, so there's no need for aluminum. And thimerosal is a preservative used in multi-dose vaccines, though it has been phased out in almost all childhood vaccines in the US since 2001,. But it's not in vitamin K. So if that has been one of your hesitations, I want to reassure you. Those particular concerns don't apply here. Here's what the injection does include Vitamin K1, or phytonadione, the main ingredient, polysorbate 80, which helps the vitamin absorb over time, and a very small amount of preservative in some versions, but preservative free options are available at many hospitals. Just ask ahead of time if that's important to you. The Centers for Disease Control and Prevention, academy of Pediatrics and numerous studies have all confirmed that the ingredients in the vitamin K shot are safe and well-tolerated, even in tiny newborns. But the key takeaway this isn't about being pressured or scared. It's about being informed and knowing that this specific shot is not tied to the vaccine-related concerns you might have read about.

Speaker 1: 44:10

Here's a follow-up question what happens after the shot wears off? Where does the vitamin K come from then? That's such a good question and it shows your thinking beyond just the first few weeks, which is amazing. So here's how it works. The vitamin K shot is designed to protect your baby during those early months when they don't have enough vitamin K in their system and can't really get it on their own. But after a while usually around six months, that protection from the shot starts to wear off. So where does vitamin K come from after that?

Speaker 1: 44:40

Two main places. One their food. Once babies start eating solid foods like leafy greens, broccoli or even certain baby cereals, they start to get small amounts of vitamin K from their diet. Foods like spinach, kale and brussel sprouts are naturally high in vitamin K, and some baby foods are fortified with it too.

Speaker 1: 45:00

Two their gut bacteria. As babies grow, their gut starts to mature and good bacteria begin to build up. Some of those friendly gut bugs can actually make vitamin K inside the body. Isn't that cool, but this process takes time. Newborns aren't born with these bacteria and it can take months for their microbiome to develop enough to make a reliable amount of vitamin K. And don't forget if your baby got the shot at birth, they've also had vitamin K stored in their liver which the body slowly uses up during the first six months. That storage is what keeps their blood clotting safely while their gut and diet can catch up. By the time the shot wears off, your baby's own body has started to take over, with food, gut health and natural development working together to keep them protected. And, of course, if your baby ever has any health issues that affect absorption or liver function, that's something your pediatrician will help monitor. But for most healthy babies the system works really well.

Speaker 1: 45:57

Once everything matures, all right, let's take this info and put it all together. We've covered a lot, and if your head is spinning a little, you're not alone. When you're responsible for a brand new human, every decision can feel enormous. In this one, whether or not to give your baby the vitamin K shot is no exception. So let's review what we know in plain language.

Speaker 1: 46:17

First, the why. Babies are born with very little vitamin K in their bodies. It's not found in high amounts in cord blood, it's barely present in breast milk or pilostrum, and even formula doesn't offer enough to prevent what's known as vitamin K deficiency bleeding. Now, vitamin K deficiency bleeding is rare, but when it does happen, it's often sudden and severe, especially the late-onset kind that can occur weeks or even months after birth. It often shows up without warning and can lead to bleeding in the brain. According to studies like the one by Shearer et al in Blood Reviews 2009, and Von Kreis in Thrombosis and Hemostasis in 1998, about 20% of affected babies don't survive and around half of those who do survive have lasting complications. That's the risk we're trying to prevent.

Speaker 1: 47:06

So how does the shot work? The vitamin K injection is a one-time shot that gives your baby what they need to protect them for the first six months of life, before their gut bacteria are developed enough to start making the vitamin K on their own. Yes, it's a bigger dose than what babies are born with, but it's not too much. That dose has been studied and recommended by groups like the American Academy of Pediatrics, who reviewed decades of research to come to their position. The vitamin gets stored safely in the liver and, thanks to an ingredient called polysorbate 80, it's released slowly over time, maintaining safe levels without the need for repeat doses. And no, polysorbate 80 doesn't build up like heavy metals. It's water-soluble, which means it's broken down by the body and cleared out naturally.

Speaker 1: 47:51

Also important to know preservative-free versions of the shot are available at many hospitals. So if you're worried about ingredients, it's absolutely okay to ask. What about pain? The injection is tiny. As a nurse, I often give it while the baby is cuddled skin-to-skin with their parent. Sometimes they barely notice it at all, and if you're concerned about bonding, you can absolutely ask for it to be done in a way that keeps you and your baby close. Some parents wonder if it's too much if the shot exceeds safe blood levels like the 3.5 micrograms per liter target mentioned in earlier studies like Lane and Hathaway, but that number is more of a minimum protective blood level, not a cap. The dose in the shot was carefully chosen to keep your baby safely above that threshold for months, especially when other sources of vitamin K are so limited early on.

Speaker 1: 48:38

Now. Is there an oral vitamin K? Yes, in some countries, but there's no FDA-approved version here in the US and the over-the-counter options are unregulated, meaning we can't be sure the amount on the label is what is in the bottle. Some studies, like Cornelison et al in 2012 and Puckett and Ofringa in 2000, have shown oral vitamin K can work if you follow a strict and repeated dosing schedule. But that kind of consistency can be really hard for tired, overwhelmed new parents and if you miss a dose, the protection might not be there when your baby needs it the most.

Speaker 1: 49:15

And finally, this isn't about scaring you. It's about sharing the facts. This one little shot prevents something rare but devastating. It's been studied for decades, used around the world and is recommended by leading medical organizations like the American Academy of Pediatrics and the World Health Organization. But at the end of the day, you are the parent. This is your baby.

Speaker 1: 49:37

You deserve to ask questions, to wrestle with hard decisions and to choose what aligns with your values and your peace of mind. If that means saying yes to the shot, you're not failing your faith or instincts. And if you're still unsure, that's okay too. Keep asking questions, keep seeking truth, because that's what love does. You're doing a beautiful job, so what's the right choice? The truth is there's no-fits-all. Most experts, including the CDC and the American Academy of Pediatrics, recommend the vitamin K injection because it's safe, effective and has been used for decades. But I also believe informed parents make the best decisions, and your values, your birth setting and your access to follow-up care all matter. So if you've made it this far and you're still unsure about whether or not to give your baby the vitamin K shot, first of all, I just want to say that's okay Taking your time, asking questions and wanting to make the best decision for your baby is exactly what loving, intentional parenting looks like.

Speaker 1: 50:40

You don't have to rush this decision, you don't have to pretend you're not nervous and you don't have to decide alone. Let me share a tool that might help. It's called the brain model and it's something I teach all my birth coaching clients to use when they're facing challenging decisions. It's a way to walk yourself through the real questions, not just yes or no, but the why behind the choice. So let's try it together. The B in the brain model stands for what are the benefits?

Speaker 1: 51:05

What's the benefit of saying yes to the vitamin K shot? Well, the big one is that it helps prevent vitamin K deficiency bleeding, especially the late-onset kind. That can happen within weeks or months after birth, often without warning. Studies show that the shot is very effective at preventing this kind of bleeding, which can be serious or even life-threatening. R stands for what are the risks? The known risks are extremely low. The shot has been studied for decades and is considered safe by the American Academy of Pediatrics, the World Health Organization and many others. The injection might sting briefly, but babies settle quickly, especially when held skin to skin.

Speaker 1: 51:44

Some parents are concerned about ingredients like polysorbate 80, but, as we discussed earlier, it's present in very small amounts, doesn't accumulate and is cleared eventually by the body. A stands for what are the alternatives? There is an alternative oral vitamin K. In countries like the Netherlands and parts of Europe it's used with some success, but only when given on a strict schedule over weeks or months. Here in the US there's no FDA-approved oral version and the ones available over-the-counter aren't regulated, so you can't be sure what's really in them. If you go this route, it's best to do so under the care of a provider who understands oral vitamin K protocols and can help guide you.

Speaker 1: 52:26

I stands for what does your intuition say? This one is personal. Take a quiet moment. Picture yourself holding your baby. Tune into your gut, not your fear, not the noise on social media, but that deep inner voice that wants to do what's right for your family. What does it say? If you're leaning in a direction but still unsure, that's okay. Just noticing where your heart is pulling can help you find clarity.

Speaker 1: 52:53

N stands for what happens if you do nothing. If you skip the shot entirely, the risk of vitamin K deficiency bleeding remains, and that risk is higher for breastfed babies. If you're thinking about waiting a few days. Talk to your provider. Some hospitals allow a brief delay so that you can bond with your baby first, but you'll want to weigh that against the protection the shot offers. Late-onset vitamin K deficiency. Bleeding can happen weeks later, but early bleeding can occur in the first few days, especially if your baby is having trouble feeding.

Speaker 1: 53:24

And if you're still not getting the answers you need, try using your cuss words. This is a technique we use in nursing to speak up in a respectful but clear way. It stands for C I'm concerned, u I'm uncomfortable and S is this safe? So if you're feeling uneasy, try talking to your medical provider, saying something like I'm concerned because I'm hearing mixed things online. Can you help clarify? I'm uncomfortable with not fully understanding the ingredients. Can you walk me through it? Is this really safe for my baby? How do we know? It's a way to invite conversation, not confrontation. At the end of the day, you are the parent. This is your choice. My hope is that you walk away from this conversation feeling not pressured but prepared, not scared but supported. Whatever you choose, it's clear you're doing your best to show up with love, with care and with a heart wide open for your baby's future.

Speaker 1: 54:20

Okay, let's talk about the difference between when I'm wearing my nurse hat and when I'm wearing my coach hat, because they both matter and they guide me in very different but equally important ways. When I'm wearing my nurse hat, I look at the data, I look at the risks, I look at what I've seen firsthand, caring for hundreds, maybe thousands, of babies over the years, and based on all of that, I recommend the vitamin K shot. I gave it to my own children, and if I had to do it again, I absolutely would. In all my years of working in newborn care, I've never seen a single adverse reaction from the shot. What I have seen, though, is the peace of mind it gives parents, and how devastating vitamin K deficiency bleeding can be when it strikes unexpectedly.

Speaker 1: 55:02

If a parent is really unsure or firmly against the shot, my professional advice would be to talk to their provider about whether oral vitamin K is an option and to make sure they understand the dosing schedule completely. If you're still in the hospital, I'd recommend sitting down with the hospital pediatrician or neonatologist before making a final decision. But when I put on my coach hat, it's not about telling you what to do. It's about asking you what feels most aligned, what feels right for you and your baby and your values as a coach. I'd invite you to slow down, check in with your body and really explore all the emotions that might be coming up around this decision. We'd talk through the options again and I'd ask you to reflect how does this information sit with you? Where do you feel resistance? What part of your intuition is speaking up? I'd help you form thoughtful, non-confrontational questions for your provider, questions that help you get clear, complete answers instead of confusion or pressure. Then we'd work together to map out the path forward by figuring out your desired outcome, the facts and feelings around your current situation, the realistic options you are comfortable with and the way forward for you, because this isn't just about one shot. It's about how you show up as a parent, how you advocate for your baby and how you begin trusting your voice and your wisdom, starting now. And if you're still not sure, that's okay too. If you'd like someone to walk through it with you, without judgment, without pressure, just someone to help you find clarity, I'd love to help. You can schedule a free birth vision call with me at kellyhoffcom.

Speaker 1: 56:38

We can talk through this or any other decision you're facing as you prepare to welcome your baby. You're doing an amazing job. Just by listening, questioning and learning, you're already showing up for your baby in a powerful way. I know this can feel like a lot. So much of early parenting is navigating unknowns, but you don't have to do it alone. If you feel overwhelmed, that's okay. Ask questions, lean on your team and know that wanting to make the best choice for your baby is always a good place to start. Thanks for spending this time with me. If this episode helped you feel more informed or gave you new questions to ask your provider, I'd love to hear from you. You can write a review, share this episode with a friend or reach out on Instagram. Until next time, trust yourself, honor your intuition and keep showing up for your journey, one decision at a time.