Soon after birth, American babies are given a vitamin K shot to prevent a rare bleeding condition so severe it can be fatal or leave them with permanent brain damage. Yet the number of parents refusing the shot has jumped 77 percent in less than a decade.
Vitamin K deficiency bleeding can strike suddenly and without warning. In the most serious cases—late vitamin K deficiency bleeding, which can occur in babies between 2 and 24 weeks old—about 20 percent of cases are fatal. Among those who survive, two out of five may be left with lasting brain damage. Yet, between 2017 and 2024, among more than 5 million newborns analyzed, nearly 200,000 did not get the shot.
“In birth centers and out-of-hospital settings, I have seen a steady increase in parents refusing the vitamin K shot over the last decade,” Caitlin Goodwin, a doctor of nursing practice, certified nurse-midwife, and founder of Still Nurses, told The Epoch Times.
Why Newborns Are Given Vitamin K
“While vitamin K deficiency bleeding is rare, the reality is horrific,” Goodwin said, “Having managed care across the spectrum of birth environments, I can tell you that if it happens to your child, it is a 100 percent preventable tragedy.”
Babies are born with very low levels of vitamin K in their blood. Vitamin K does not pass easily from mother to baby through the placenta, is found at low levels in breast milk, and a newborn’s digestive tract lacks the bacteria needed to produce it. Because vitamin K helps blood clot, low levels put babies at risk for three types of bleeding deficiency: early—within 24 hours of birth, classic—within the first week, and late—between 2 and 24 weeks).
All three can cause life-threatening bleeding in the brain or digestive system. Signs include bruising, bleeding from the nose or umbilical cord, pale skin, and blood in the stool.
A single vitamin K injection in the thigh helps prevent bleeding by allowing the baby’s liver to make blood-clotting factors, according to the National Institutes of Health. A 2016 study published in the Journal of Midwifery & Women’s Health found that without the shot, one in 59 babies is at risk of developing vitamin K deficiency bleeding. With it, the risk drops to one in 100,000.
The shot has been a routine practice in the United States since the 1960s and has nearly eliminated vitamin K deficiency bleeding nationwide. Before it became standard, the consequences were stark. “One out of nine baby boys who had elective newborn circumcision without vitamin K had bleeding that wouldn’t stop,” Shannon Fitzgerald, a pharmacist and toxicologist, told The Epoch Times. In the early 1980s, some hospitals in England stopped giving vitamin K to all newborns—and cases of deficiency bleeding rose as a result.
Why Parents Are Saying ‘No’
Parents’ concerns are varied. Some cite worries about synthetic ingredients in the shot and their safety, whether a newborn really needs the injection, and a desire to have a more natural birth experience. Although the shot is an injectable vitamin, some parents consider it a vaccine, which may lead them to decline it.
Others believe the risks outweigh the benefits or worry about causing pain to their newborn or possible reactions after the injection, according to a 2020 American Academy of Pediatrics study.
Some point to a 1990 study that found an association between the vitamin K injection and childhood cancer. However, more recent and robust studies have found no such link.
Dr. Joel “Gator” Warsh, a functional pediatrician at Integrative Pediatrics and Medicine in California, and a contributor to The Epoch Times, said that the vitamin K shot has decades of safety data and is the most reliable way to prevent vitamin K deficiency bleeding.
“I understand why some parents hesitate—they want fewer interventions on day one, and I respect that instinct,” Warsh told The Epoch Times in an email. “But in this case, the benefit is very clear, and the downside is not as clear.”
The rise in vitamin K shot refusals may be a symptom of an overall growing mistrust in doctors and health agencies, and a pushback against pressure from experts and government recommendations.
Alison, a Wisconsin mother, declined vaccines for her newborn four years ago. If doctors had framed the vitamin K shot as a supplement to prevent dangerous bleeding rather than a vaccine, she might have been more open to it, she said, but she believes a healthy baby likely doesn’t need it.
Her skepticism and mistrust were reinforced by a difficult delivery experience that left her feeling rushed and unheard. Going forward, she prefers to research her options rather than accept every medical intervention offered.
According to Warsh, the reasons behind vitamin K hesitancy are multifactorial. “There’s definitely broader mistrust in institutions post-COVID, but I also see confusion from social media, conflation with vaccines, and a desire for ‘natural’ birth experiences driving some of it,” he said. “It’s less about vitamin K specifically and more about trust overall.”
If someone is considering declining the shot, Warsh wants them to at least understand the real risk they’re accepting and discuss alternatives thoughtfully rather than opting out reflexively.
What’s in the Vitamin K Shot?
The vitamin K shot is an injectable nutrient, not a vaccine. It does not stimulate the immune system to protect against infectious diseases like vaccines do.
There are two types: those with preservatives and those without. The Epoch Times reviewed two versions made by Pfizer and Cipla USA, but other companies, such as Merck and Amphastar Pharmaceuticals, also make vitamin K shots for newborns.
Preservative-Containing Vitamin K
According to the prescribing information, the preservative-containing version, made by Pfizer, contains synthetic vitamin K (phytonadione), a polyoxyethylated fatty acid derivative (an emulsifier that keeps the vitamin K in solution), dextrose (a common sugar used widely in medical settings), and benzyl alcohol as a preservative.
“Polyoxyethylated fatty acid derivative is an emulsifier used to dissolve the fat-soluble vitamin K1, and is used in small amounts in this formulation,” Fitzgerald said. “In very large doses [intravenous], it has rarely caused reactions, but in small amounts is considered generally safe.”
Dextrose is a common and safe substance often used in medical settings, and hydrochloric acid is used in trace amounts to adjust the pH, making the shot safer and more comfortable for injection, Fitzgerald added.
The prescribing information recommends using benzyl alcohol-free formulations in newborns and infants, if available, as potentially fatal reactions can occur in babies given excessive amounts of benzyl alcohol‑preserved drugs—though Fitzgerald notes this risk is mainly associated with premature, low-birthweight, or critically ill babies, and is avoided entirely with preservative-free versions.
Preservative-Free Vitamin K
The preservative-free version contains similar stabilizing and pH-adjusting ingredients, all of which, according to Fitzgerald, are commonly used in pharmaceuticals and, although inherently holding some risk, are considered generally safe at the single-dose amounts given to newborns.
Both versions may also contain trace amounts of aluminum as a manufacturing byproduct—not as an added ingredient. The risk of aluminum toxicity from a single, standard dose is extremely low, with buildup being a concern primarily for premature babies or those receiving long-term aluminum-containing treatments, Fitzgerald said.
Oral Vitamin K
Vitamin K can also be given by mouth. While oral versions are often used in Europe, there are no U.S. Food and Drug Administration-approved oral formulations available for children in the United States.
Studies show that when babies are given oral vitamin K, their risk of developing vitamin K deficiency is 2.8 per 100,000, compared with one per 100,000 in infants who receive the injectable form.
Oral vitamin K is a good option for parents who decline the shot, though it’s not as effective, Warsh noted.
Oral protocols also require strict multi-dose adherence over weeks—a significant margin for human error compared to the one-time injection at birth. The Netherlands, which had used an oral protocol since 1990, switched to recommending the injection after late deficiency bleeding cases continued to occur, particularly in breastfed babies with impaired fat absorption.
Natural Alternatives to the Vitamin K Shot?
Some parents look for other options to boost their baby’s vitamin K. While research has found that there are ways to potentially increase how much a baby gets, research is unclear on whether these methods actually prevent vitamin K deficiency bleeding.
A 2018 review found that taking vitamin K supplements during pregnancy can raise the mother’s vitamin K levels, but it does not lower the baby’s risk of bleeding. “While pregnant women can take vitamin K, it does not sufficiently cross the placenta to provide the infant with the stores needed to prevent late-onset vitamin K deficiency bleeding,” Goodwin said.
A 2015 study published in Nutrients found that both regular and supplemented infant formulas can protect against bleeding because they have more vitamin K than breast milk. However, because infants have very low vitamin K levels at birth, the American Academy of Pediatrics recommends that all babies get the vitamin K shot, whether they are breastfed or formula-fed.
Over-the-counter vitamin K drops are available in the United States as a dietary supplement. However, unlike prescription drugs, the FDA does not approve dietary supplements for safety or effectiveness before they enter the market. Since these products are not subject to a strict premarketing approval process, there’s no guarantee they contain vitamin K in the amounts stated on the label.
Additionally, over-the-counter drops are not equivalent to the standard intramuscular dose, Warsh said. Oral regimens require multiple properly dosed administrations and still provide less reliable protection against late vitamin K deficiency bleeding. If parents decline the shot, Warsh noted that any oral approach should be medically supervised—not do-it-yourself.
“There is no ‘natural’ replacement that matches the efficacy of the injection,” Goodwin said.
The vitamin K shot is widely considered the gold standard and most effective method for preventing all forms of vitamin K deficiency bleeding, Fitzgerald noted. “The benefits from administration of these injections far outweigh any risks.”
Doctors and public health experts need to have calm, non-dismissive conversations with parents who are hesitant to give their baby the vitamin K shot, Warsh said.
“Explain what vitamin K deficiency bleeding actually is, why newborns are uniquely at risk, and be transparent about risks and benefits,” he noted. “Listening first builds trust far better than pressure.”