Is a Vitamin K Shot Required for Circumcision?

Why Do Newborns Need a Vitamin K Shot for Circumcision?

A vitamin K shot shortly after birth in newborns has become commonplace to prevent a serious condition known as vitamin K deficiency bleeding or VKDB. Though rare, VKDB can be devastating, causing significant and life-threatening bleeding. When the bleeding occurs in the brain, the child’s life may be at risk, and the possibility of longer-term health problems and neurological deficits increases dramatically.

VKDB can be classified into early, which occurs within the first week after birth, and late, which presents between 2 and 12 weeks after birth. The late form of VKDB is typically more severe as this is when the bleeding is most likely to occur in the brain. VKDB can occur in children up to six months of age, but this is very rare.

The details of vitamin K in newborns

Vitamin K is crucial to forming blood clots, which in turn stops bleeding. Prothrombin, the protein that promotes clotting, and three other pro-clotting proteins depend on vitamin K. As an aside, Vitamin K also plays a significant role in producing healthy bone tissue, but this is less of a concern during the neonatal phase.

Newly born children have naturally low vitamin K levels stored in the liver because this nutrient does not cross the placental barrier as easily as other vitamins and minerals. Further, unlike adults, the neonatal gut does not have the appropriate function to produce or absorb vitamin K reliably until six months old. Lastly, breast milk is naturally very low in vitamin K, so babies that are breastfed or formula-fed may have a higher risk of vitamin K deficiency.

This combination of factors means it will take some time after birth for the child to build up vitamin K levels—this does not happen reliably until the child is six months old.

Are Vitamin K Shots Safe?

Vitamin K shots have been shown to be very safe and, as such, are a standard course of action in newborn care. As with any childcare decision, parents have the right to refuse a vitamin K shot or give their child oral vitamin K.

Vitamin K and Newborn Circumcision

Newborn circumcision is performed within the first ten days of the child’s life and often within the first 48 hours. As such, newborns who have not received their vitamin K shot are at a higher risk of bleeding during this time. Any surgical procedure or puncture of the skin will have a higher risk of uncontrolled bleeding and potentially cause devastating effects for the child. As a result, the newborn circumcision center does not perform circumcisions on babies without their vitamin K shot.

What About Oral Vitamin K?

Orally administered vitamin K has been studied and is significantly less effective against VKDB. Even after three oral vitamin K doses, research shows a ten times greater risk of bleeding versus just one vitamin K shot. This is because the infant’s intestines cannot reliably absorb vitamin K until the child is about six months old.

Learn more about newborn circumcision by scheduling an appointment with one of our newborn circumcision experts.