Newborn Vitamin K Shot Refusal Linked to Surge in Life-Threatening Bleeding Rates

Infant bleeding episodes caused by vitamin K deficiency surged by 347% between 2017 and 2025 as the percentage of newborns receiving the standard birth injection dropped from 97.7% to 95%, according to a longitudinal study published in JAMA Pediatrics.

Key Clinical Takeaways:

• Vitamin K deficiency bleeding increased 347% among infants over an eight-year tracking period.
• The proportion of newborns missing their routine birth injection grew from 2.3% to 5% between 2017 and 2025.
• Babies without the injection faced a 47% higher risk of any bleeding event and more than double the risk of brain bleeds during their first six months.

Researchers examined electronic health records for infants born between 2017 and 2025. The study, conducted by researchers at Virginia Commonwealth University, revealed that vitamin K deficiency rose 216% alongside the 347% surge in vitamin K deficiency bleeding, known as VKDB.

Lead study author Dr. Elizabeth Wolf, a pediatrician at Children’s Hospital of Richmond at VCU, noted the real-world consequences of declining prophylactic care.

“We knew from prior studies that vitamin K refusal had been increasing in the U.S., and we wanted to learn if there were any real-life consequences of this trend,” Wolf said in a university press release. “We found that the answer is undeniably yes, with the rates of VKD and VKDB multiplying over the course of our study.”

According to the Centers for Disease Control and Prevention, newborns have naturally low vitamin K levels because minimal amounts cross the placenta, breast milk contains low concentrations, and infant gastrointestinal tracts have not yet built up the bacteria required to produce it. The single intramuscular injection has been recommended as the standard of care for all newborns since the early 1960s to prevent severe clotting failures.

Without the prophylactic shot, infants face a heightened risk of bleeding into the skin, umbilicus, or gastrointestinal tract during their first week of life. After the first week, late-onset VKDB carries a 30% to 60% risk of intracranial hemorrhage, which can result in seizures, permanent brain damage, or death. Data from the research cohort showed that 7% of infants with vitamin K deficiency and 2% with VKDB developed intracranial or intracerebral bleeding.

Researchers tracked 5.2 million births and found that roughly 4.5% of infants had no documented record of receiving the injection. Infants without the documentation experienced 288 bleeding events per 10,000 births, compared to 186 events among those who received the prophylaxis. Controlling for gestational age, sex, and maternal characteristics, infants without the injection maintained a 47% elevated risk of bleeding overall and more than twice the risk of intracranial hemorrhage.

ABC News reported that infants who skip the injection face a significantly elevated risk of death during their birth hospitalization. Dr. David Hill, a hospitalist, pediatrician, and spokesperson for the American Academy of Pediatrics, emphasized the biological mechanism to ABC News. “Vitamin K is absolutely critical for our livers to make the clotting factors that help our blood clot,” Hill said, noting that physicians worry about life-threatening hemorrhages.

Researchers linked the downward trend in vitamin K uptake to broader societal shifts. “Similar to the recent measles outbreaks, we are seeing the real-world implications of growing mistrust of doctors and public health professionals,” Wolf stated. “We need clear messaging from all levels of public health about the benefits of vitamin K administration for newborns.”

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.