The vitamin K comes with many questions these days, and the clients I assist often are quite reluctant to give any kind of anything to their babies, therefore I get asked often what I think, even though what I think has no bearing on anything because it is not my pregnancy and not my baby, giving informed choices though is something I can help with. Although there are many views on this birth topic, I thought I would share an article I found comparing what is happening today when we have a baby, and what happened about 100 years ago when we had a baby.
A historical look at how Vitamin K became into routine use.
“How did humans survive before the introduction of vitamin K shot?” Pretty well actually. However, there was an epidemic of Newborn Hemorragic Disease (Vitamin K Deficiency Bleeding) in the US starting around the 1930s. At one point it reached almost one percent of babies. This was a huge departure from the earlier rates of under 1/1000 in term babies and a little higher in premies. No one new why, and did not seem particularly interested in the jump because the CURE was found! Give every baby a Vit K shot and NHD will just about disapear. So they did.
researchers questioned why it seemed limited to American Style obstetrics and the rise followed the introduction of this method around the world. Babies SHOULD be born with enough Vitamin K from their mothers to protect them in the first days while they began to accumulate their own. What changed?
We had three innovations:
1. mothers were given anesthetics which rapidly depleted their levels of Vitamin K
2. Births were conducted under ‘sterile’ conditions and biabies immediately washed with germicide, then wrapped into sterile clothing. The sterile handling continued through the hospital stay, with everyone gloved and masked, and in some regions even the mothers. The goal was to prevent babies from touching human skin (especially the mothers’).
3. Babies were under ‘gastric rest’. They were not given any food nor attempts at nursing for three days. (In some radical regions it was only 48 hours!) They might be given sterile water “if needed” at 12 or 24 hours, but they were not fed. Colostrum was thought to be a gastric irratant and worthless, and since the natural time of milk production is thee to five days, they assumed it was normal physiology for babies to “rest their stomachs”.
4. When babies were finally permitted to be fed, the mother’s nipples were first washed with germicide and dried. The mothers were not permitted to touch their babies — babies came with their hands tied under the wrappings or in mittens to prevent skin contact. Sterile procedures were throughout the week or more hospital stay and were to be followed as long as possible after going home.
this is what we know now.
1. Maternal levels of vitamin K affect fetal levels of vitamin K. Medications which reduce Maternal levels shoudl be avoided.
2. The baby is normally innoculated with bacteria during the birth process and especially in the first half hour after birth through skin to skin contact with the mother. These bacteria are essential to the manufacture of baby’s vitamin K. Washing after birth and use of sterile wrappings is detrimental.
3. colostrum is a source of vitamin K, AND it contains probiotic and prebiotic bacteria which rapidly colonize and begin the vitamin K process.
4. skin contact with the mother’s nipples is another primary source of necessary bacteria. Washing with a germicide is detrimental.
5. Colostrum and milk are food for the beneficial bacteria. Withholding feeds and sterile feeds prevent the innoculation AND the growth of those baby has actually acquired.
And what it all comes down to is: To promote rapid (normal) growth of the bacteria essential to vitamin k levels of newborn babies, the baby should not be washed after birth, should be kept in skin to skin contact, and early feeds should be encourged. The more quickly the baby has established a milk supply, the more quickly his normal gut bacteria will flourish and provide adequate vitamin K.
When these protocols are followed, newborn hemorrhagic disorder due to vitamin K deficiency blieeding becomes extremely rare; Estimates in regions where vitamin K is not provided but early nursing is normal range around one out of 5000 and below – in term babies. Two – or three – oral doses of vitamin K or one injection can bring this down to about one out of 25,000 (the effectiveness seems identical)
And this is why some mothers make the decision to decline vitamin K if they are not following 70 year old newborn routines. They should carefully assess their unique situation to see if their baby may be higher risk and should be made aware of warning signs of HDN and the dangers if treatment is delayed. And I do strongly encourage the use of oral vitamin K as a low-tech intervention, but ultimately, this is the parents choice.
There are many more articles on this subject, I provide my clients with as many as I can find. Contact me anytime. Enjoy your Day