1ST CITY CLINICAL HOSPITAL

Author of the article: neonatologist of the department for newborn children V.N. Sateeva

Until recently, maternity hospitals did not give injections of vitamin K to newborns, and neonatologists sounded the alarm. After all, just one injection reduces the risk of hemorrhagic disease, a formidable complication of the first weeks of life, tenfold. Why should you not refuse the injection and how is it done?

Why do newborns need vitamin K?

This is an essential vitamin for the blood coagulation system and blood vessels - in other words, it prevents bleeding. In utero, the baby receives vitamin K from the mother through the umbilical cord, and after birth - through milk. From 3-5 days of life, the vitamin begins to be synthesized by the child’s own intestinal microflora. But before this a dangerous “window” appears. By the second day of life, vitamin K reserves in the body are depleted, and “our own” vitamin K has not yet been produced. Colostrum in the first days is not enough to compensate for the deficiency. The vessels become fragile, the functioning of the blood coagulation system is disrupted, and bleeding may occur. This happens not only in the skin, but throughout the body - including where we don’t see it. We are talking about intracranial hemorrhages, pulmonary, gastrointestinal bleeding and other life-threatening conditions. Hemorrhagic disease occurs in 0.25-1.5% of newborns. But in countries where vitamin K is routinely prescribed, this figure is only 0.01%.

How is a vitamin K injection given?

One drug with vitamin K (Konakion) is registered in our maternity hospital. It is administered to all children in the first hours after birth (according to the Decree of the Ministry of Health of the Republic of Belarus dated April 2, 2020 No. 28 on the approval of the clinical protocol “Prevention of hemorrhagic disease in newborns”).

This is done with the consent of the mother. For newborns from risk groups, vitamin K is reintroduced (according to Resolution of the Ministry of Health of the Republic of Belarus No. 34 of April 18, 2022 “Providing medical care in neonatology”). The injection is given intramuscularly, in the front of the thigh.

Could there be complications?

Swelling and pain at the injection site are possible, especially if the technique of administering the drug is violated. There may be individual allergic reactions. But in practice in the maternity hospital, we have never encountered this.

What happens if you refuse the injection?

As mentioned above, the risk of bleeding in an infant increases hundreds of times. Moreover, it persists up to 12 weeks of life - this is the so-called late manifestation of hemorrhagic disease of the newborn.

The likelihood of the disease is higher if a woman took anticoagulants or large doses of broad-spectrum antibiotics during pregnancy; if the child was born by cesarean section, there was fetal hypoxia during labor or asphyxia of the newborn; if the baby was born prematurely, etc.

Unfortunately, many women refuse vitamin K injections due to fear and ignorance. But in practice, we see that children tolerate the injection very calmly.

A healthy baby is the main happiness in a woman’s life!