Declining Vitamin K Shots Put Infants at Risk for Dangerous Bleeding

Long before the two-month checkup, parents face one of the first health decisions for their baby just hours after their birth: whether to get a vitamin K injection, a routine recommendation that has been part of newborn care in the United States since 1961.

It’s a treatment with a long safety record and strong evidence behind it, but a growing number of parents are declining it. Tyler Reimschisel, MD, a pediatric neurologist at University Hospitals, explains more.

Why Do Newborns Need Vitamin K?

Vitamin K helps the body form the clotting factors that stop bleeding. Newborns arrive with very low vitamin K levels. Unlike older children and adults, who get vitamin K from leafy greens, dairy, eggs and meat, newborns don’t have the diet sources to supplement their levels. This can lead to a condition known as vitamin K deficiency bleeding (VKDB), which causes uncontrolled bleeding during routine procedures, such as circumcision in boys, as well as in organs like the intestines and the brain.

“An intracerebral hemorrhage, or brain bleed, can be a catastrophic event in a newborn, causing long-term or irreversible damage,” says Dr. Reimschisel. “The good news is it is largely preventable with a routine vitamin K injection.”

When Did Babies Start Getting the Vitamin K Shot?

The link between vitamin K deficiency and newborn bleeding was first made in the late 1800s. In 1930, the Danish biochemist Henrik Dam discovered that vitamin K deficiency caused unexpected bleeding in baby chicks, a discovery that earned him the Nobel Prize. Subsequent studies showed that giving vitamin K to newborns dramatically reduced their bleeding risk.

In 1961, the American Academy of Pediatrics recommended that all newborns receive the shot within six hours of birth. Thanks to this now-routine part of newborn care, VKDB is rare in the United States. The recommendation is also supported by the World Health Organization.

Why Are Some Parents Declining the Vitamin K Shot?

While the number of parents declining the shot remains low, data has shown an upward trend in recent years. A 2025 study from the Children’s Hospital of Philadelphia found that the number of newborns who didn’t receive the shot increased by 77 percent since 2017.

Parents who decline the shot most commonly want to minimize interventions for their newborn. Some have concerns rooted in misinformation, including a 1992 British study that suggested a possible link between the vitamin K shot and childhood leukemia. That study was investigated extensively and no evidence of a link was found.

Oral vitamin K is sometimes offered as an alternative for babies whose parents decline the injection. While it can provide some protection, it requires multiple doses over several weeks and is less immediately effective than a shot.

Dr. Reimschisel sees the hesitancy around vitamin K as part of a broader challenge families face in navigating health information today. “There is so much information out there now, and it can be genuinely difficult to know which sources are reliable and which aren’t,” he says. “I think this is an example of the need for parents to balance health information they access online with advice from their child’s healthcare professional.”

Is the Vitamin K Shot Safe?

The risks associated with the vitamin K shot are minimal, including localized pain and temporary inflammation at the injection site. Serious side effects are rare.

On the other hand, a baby’s risk of VKDB is low, but it’s not zero. “And it’s certainly much higher if you don’t receive vitamin K,” says Dr. Reimschisel.

There are often no early warning signs of VKDB, so by the time a parent realizes something is wrong, significant bleeding may have already occurred. When VKDB occurs before six months of age, it can have a mortality rate of up to 50 percent and a significant portion of infants have long-term brain damage. This can lead to seizures, cerebral palsy, cognitive impairment and motor disabilities, with consequences that follow a child for life.

“The risk of the treatment is exceptionally low,” adds Dr. Reimschisel. “You’re weighing that against the life-threatening or life-altering risks of bleeding in the brain.”

Talking to Your Healthcare Professional About the Vitamin K Shot

For parents who have questions or feel uncertain about the vitamin K shot, Dr. Reimschisel’s suggests raising those concerns directly with their doctor before their baby’s birth. Most doctors, he says, are more than willing to engage in real conversations about these early parenting decisions.

“We try to meet people where they are and listen to them,” he says. “The goal is to truly understand what a parent’s specific concern is, and address that directly.” Research supports this approach: Studies have found that when a pediatrician engages directly with hesitant parents, many reconsider their decision.

Vitamin K deficiency bleeding in babies remains rare today, precisely because the shot has been working for more than 60 years. For parents weighing the decision, that history and the safety of the injection is worth understanding before making a choice that could carry real consequences for their child.

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The experts at UH Rainbow Babies & Children’s Hospital provide comprehensive care for newborns and children at every stage, from preventive measures at birth to diagnosis and treatment of even the most complex neurological conditions.