The History Of Vitamin K Shots In Newborns

Vitamin K, routinely given to newborns in hospitals shortly after birth in the United States, is a controversial issue is some circles. While vitamin K does prevent hemorrhagic disease of the newborn, now more frequently called vitamin K deficiency bleeding, or VKDB, studies released in Great Britain, starting in 1990, indicated that the injection increased the risk of some types of childhood cancer. Currently, the vitamin K injection is endorsed as the standard of care in the United States for all newborns.

Discovery

Hemorrhagic disease of the newborn was first described in the "Archives of Pediatrics" by Charles Townsend in 1894. A 1913 article in the "Archives of Internal Medicine" by G. Whipple first discussed the potential causes of hemorrhagic disease of the newborn. Whipple theorized that low prothrombin levels could cause the condition. Prothrombin helps blood clot, preventing excessive bleeding. In 1937, an article published in the "American Journal of Medical Science" reported that newborns have low prothrombin levels compared to adults. In 1929, Henrik Dam from Denmark reported that a missing vitamin found in leafy green vegetables, which he named vitamin K for the German word "koagulation," could prevent HDN in chickens. In 1939, Dam isolated vitamin K from alfalfa. Research reported by Waddell and Gerry in the 1939 "Journal of Pediatrics" noted that oral vitamin K could prevent hemorrhagic disease in newborns.

Incidence

Several types of VKDB exist. One type occurs within the first 24 hours after delivery. The classic form of the disease appears between day two and day seven after birth. The late form occurs within two weeks to six months after birth. The incidence of the classic form of the disease ranges from 0.25 to 1.7 percent according to the American Academy of Pediatrics. The late form of the disease occurs in between 4.4 to 7.2 infants per 100,000 births, depending on the country of birth, the AAP reports.

Early Use

In the mid 1950s, several newborns who received 50 mg of vitamin K2, one of two forms of the vitamin, developed severe jaundice and hemolytic anemia. After these episodes, only vitamin K1 was used and doses were lowered. In 1961, the Committee on Nutrition of the American Academy of Pediatrics recommended giving vitamin K to all newborns as the standard of care.

Cancer Controversy

In 1990, a study published in the "British Journal of Medicine" by researchers from the Royal Hospital for Children in Great Britain raised concerns over the use of vitamin K as a risk factor for development of childhood leukemia. Further evaluation showed no correlation between the two, according to the AAP, which continues to recommend a single intramuscular dose of 0.5 to 1 mg of vitamin K shortly after delivery.