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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

General Discussion of Oral Vitamin K instead of Injected Vitamin K

The reason for me is that poking and needling babies hurts them. The research on pain tolerance post-circumcision, I believe, can also be used for pain caused by needles and blood letting. The one intervention that I routinely do is heel prick for PKU and thyroid, and I work hard to make sure it is as painfree as possible, having baby nurse thru the procedure if possible. Virtually all our clients refuse Vit. K, unless in oral form, for this reason.

Oral Dose Journal Article

Journal of Pediatrics, vol. 127 #2, Aug., 1995, page 301
"Twenty-seven years of experience with oral vitamin K1
therapy in neonates" by Frank I. Clark, MD. JD. and
Elizabeth J. P. James, MD
From the Department of Pediatrics, Children's Hospital,
University of Missouri, Columbia.

A comment on Vit. K research: in the British Journal of Medicine, Aug. 8, 1992, article entitled "Childhood Cancer, intramuscular vitamin K and pethidine given during labour" -- found that intramuscular K is connected to increased childhood cancers, while oral K is not. Notes that it is the second of the only two studies done on this relationship between intramusc. K and cancer. I have heard that oral K is less effective in preventing hemorrhage, but don't have any research myself supporting that.

When this has been mentioned before on the list, some members have been quick to jump in and say that these studies are not to be believed. I personally think that since hemorrhagic disease of the newborn is so much less common than childhood cancers (as well as hyperbilirubinemia, another result of vit K injection) that vitamin K should probably not be used except perhaps in the event of a traumatic birth that may have caused injuries that could lead to hemorrhage. I first read a short blurb about these studies in Natural Health magazine....

"A couple of hours after a baby is born, most doctors provide an injection of vitamin K to reduce the risk of death from bleeding. However, two recent studies have found that infants receiving the injected form of vitamin K are about twice as likely to experience childhood cancer as those who are given the same dose orally."

"Since 1993, doctors in US hospitals have been required to give an intramuscular injection, rather than an oral dose, of vitamin K to newborns. Many scientists believe that this injection may be linked with phenol, a carcinogenic substance used in preparing vitamin K. The newborn is able to detoxify this substance when receiving it orally, but not when injected. While the drawback to oral vitamin K is that it requires repeated doses -- particularly for breast-fed babies (since breast milk is deficient in this vitamin) -- it appears worth the trouble." Natural Health, September-October 1995.

There was some weak research which suggested this might be so a few years ago. Every single study since has shown that IM vit K is perfectly safe and that vit K orally is not as effective.

Actually, there have been several studies since 1992 investigating the link between intramuscular (IM) vitamin K and childhood cancer, and all other studies found NO ASSOCIATION. There are more studies underway, but right now it looks like IM vitamin K is probably safe.

A single dose of oral vitamin K is not very effective, but a series of oral doses works well. Generally 1 or 2 milligrams are given by mouth on the day of birth, at week 2, week 4, and week 6.

Klebanoff, Read, Mills et al. New England Journal of Medicine vol 329, no. 13, 23 September 1993, pp 905-908. Based on a prospective study, abstract concluded: "We found no association between exposure to vitamin K and an increased risk of any childhood cancer or of all childhood cancers combined, although a slightly increased risk could not be ruled out. The benefit of neonatal vitamin K prophylaxis against hemorrhagic disease of the newborn have been well described. Unless other evidence supporting an association between vitamin K and cancer appears, there is no reason to abandon the routine administration of vitamin K to newborns".

See MIDIRS Midwifery Digest (Sep 1994) 4:3, pp 334 for the article 'Oral vitamin K prophylaxis and frequency of late vitamin K deficiency bleeding'. This report states "the report of late VKDB occurring despite three oral doses of 1 mg vitamin K, is of concern....." They also state that "the main difficulties with oral prophylaxis are poor absorption (especially in babies with cholestasis) and the lack of a licensed preparation for oral use."

Date: Thu, 25 Jul 1996 7:30:21 PDT

The reports in the British Medical Journal both found no link between the treatment and any form of childhood cancer.

A 1992 report frightened parents with evidence that the routinely administered vitamin injections could lead to leukemia.

But a group led by Dr Eve Roman of Britain's Leukemia Research Fund, and another led by Rudiger von Kries, paediatric epidemiologist at Munich's Ludwig-Maximilians-University, found no such link.

Kries's group wrote that they found ``substantial evidence that there is no association between parenteral (injected) vitamin K and childhood cancer.''