Key takeaways

  • Newborn infants do not have adequate vitamin K at birth. Doctors will typically recommend a vitamin K injection to reduce the risk of hemorrhagic disease, also called vitamin K deficiency bleeding (VKDB).
  • Parental refusal rates for the vitamin K shot have increased in the United States. This may be due to concerns over the necessity, side effects, and pain of the injection for the newborn.
  • Some parents may consider oral vitamin K as an alternative to the vitamin K shot. However, it’s important to note that this alternative is less effective.

A vitamin K shot at birth reduces the risk of hemorrhagic disease within the first six months of a newborn’s life. This risk exists because babies aren’t born with enough vitamin K, and don’t typically get enough until they start eating solid foods.

Vitamin K helps with blood clotting. However, some parents and caregivers may still have concerns about the necessity and side effects of the vitamin K injection for a newborn.

Vitamin K is an important nutrient because it helps with bodily functions such as blood clotting and bone metabolism.

Vitamin K doesn’t pass easily through the placenta to the fetus, so infants are born without enough vitamin K. After birth, the amount of vitamin K in breast milk or formula is not enough to lower the risk of bleeding early in the newborn period.

This puts them at risk of a rare health condition called hemorrhagic disease, in which they can’t stop bleeding. Bleeding can occur anywhere in the infant’s body.

When hemorrhagic disease occurs due to vitamin K deficiency, doctors may also call it vitamin K deficiency bleeding (VKDB). VKDB can occur hours, weeks, or months after birth.

To reduce the risk of VKDB, your maternity care team will recommend a vitamin K injection for the newborn baby. They administer a single dose of this injection into the infant’s thigh within six hours of birth.

The American Academy of Pediatrics (AAP) has recommended that infants receive a vitamin K shot at birth since 1961.

According to a 2025 study, the amount of newborns not receiving the vitamin K injection at birth in the United States rose from 2.92% in 2017 to 5.18% in 2024.

The study’s authors suggest parental refusal may be due to the following factors:

  • concerns over the necessity of the injection
  • concerns about the pain of the shot for the infant
  • concerns about potential adverse effects of the injection
  • public skepticism of pediatric medical interventions, which may be related to the COVID-19 pandemic

Some parents may have concerns that the ingredients in the vitamin K injection are unsafe, but the Centers for Disease Control and Prevention (CDC) confirms this is not the case.

The vitamin K shot is safe for infants, and doctors will work out the correct dose for an infant depending on if they are full-term or premature.

The most common side effects are temporary pain and bruising at the injection site. Allergic reactions to the vitamin K injection are rare.

Tips to comfort a baby during the vitamin K shot

If you’re concerned about the pain that the vitamin K injection will cause your newborn, the following tips can help you provide comfort:

  • ask to hold your baby while a doctor administers the shot
  • breastfeed during and immediately after the shot

It’s important to remember that the pain of the shot is short-lived, but the benefits of the injection are significant and can be lifesaving.

VKDB is a rare condition, but the CDC highlights that the condition is only rare because most newborns get the vitamin K shot.

Infants who don’t receive the vitamin K shot at birth are 81 times more likely to experience severe bleeding than those who have the injection.

VKDB can be severe and life threatening. According to the CDC, it leads to death in 1 in 5 cases. If bleeding occurs in the brain, it can cause brain damage. If the bleeding occurs elsewhere in the body, an infant may need blood transfusions or surgical interventions.

The risk of VKDB can last up to six months after a baby is born, and the condition can occur in infants who seem otherwise healthy with typical development.

Your doctor and maternity team can help you weigh up the benefits and risks of the vitamin K shot before your baby is born.

Since parental concerns about the vitamin K injection for newborns can center on the pain of the shot, some may wonder if there are alternative methods of administering vitamin K.

There is an oral alternative to the vitamin K shot. Instead of a single injected dose, the oral alternative tends to involve either:

  • an oral dose of 2 milligrams (mg) at birth, with repeat doses at 4 to 6 days and 4 to 6 weeks after birth
  • an oral dose at birth and weekly dosing

If an infant vomits or regurgitates the oral dose within an hour of receiving it, they may require an additional dose.

It’s important to note that oral administration of vitamin K is not as effective as the shot, as absorption rates may vary from one infant to another. Improper compliance with repeat doses can also lessen its effectiveness.

The AAP highlights concerns that oral vitamin K is less effective at preventing late-onset VKDB, and only recommends the injection.

Infants aren’t born with sufficient levels of vitamin K. At birth, doctors will typically recommend a vitamin K shot to help with blood clotting and reduce the risk of hemorrhagic disease.

Parental refusal rates of the vitamin K shot have been increasing slightly, which may be due to concerns about the injection’s side effects, pain, and necessity.

Although oral vitamin K may be an alternative to the shot, the vitamin K injection remains the most effective way to prevent vitamin K deficiency bleeding and its potentially severe health consequences.