RFJ jr to lead Department of Health and Human Services

NYT:

As Parents Reject Vitamin K Shots, Some Babies Develop Devastating Bleeding
Doctors described treating brain and abdominal hemorrhages in infants who hadn’t received the routine injection. Several said the images of those patients were seared in their minds.


When the mother arrived with her newborn, blood oozing from the umbilical-cord stump, Dr. Jessica Kirk and a nurse were alone in a small pediatric emergency room in Florida.

After two decades in medicine, Dr. Kirk, a pediatric hospitalist now practicing in Fairhope, Ala., usually has an idea of possible diagnoses within moments of meeting a patient. But she hadn’t seen this before. As the nurse took vital signs, Dr. Kirk called her medical director.

“Oh no,” she recalled the director saying upon hearing the child’s name. The parents, the director said, had declined the vitamin K injection newborns routinely receive to help blood clot. Without it, infants are vulnerable to spontaneous bleeding.

This baby was hemorrhaging internally.

Within minutes, he was cold, pulse high, blood pressure low, Dr. Kirk recalled. She gave IV fluids, an emergency dose of vitamin K and a plasma transfusion, all while trying to arrange a transfer to a neonatal intensive care unit. The baby’s abdomen became firm from blood flooding into it. He started to fade out of consciousness.


It was 2021, and the number of parents refusing the vitamin K shot had begun to increase, quietly enough that encountering a baby who hadn’t received it still shocked Dr. Kirk. Now, many doctors say they see that regularly, and bleeding cases are accumulating.

A study of electronic medical recordsfound that 5.2 percent of babies in the U.S. went without the shot in 2024, up from 2.9 percent in 2017, meaning tens of thousands more unprotected babies. And more than 15 doctors told The New York Times they had observed a further increase in the past two years.

The resulting hemorrhages aren’t tracked nationally. But experts estimatethat as many as one in 60 untreated infants — 1.7 percent — will suffer a bleed in the first week of life, and another fraction of a percent within six months.

More than a dozen doctors around the country — including emergency physicians, neonatologists and pediatricians — told The Times they had treated brain or abdominal hemorrhages in infants who hadn’t received vitamin K, mostly in the past five years. They did not always know the outcomes, since some patients were transferred to other facilities. But at least 12 of these babies died, and at least 14 others had brain damage.

Some doctors described cases in broad terms to protect patient privacy, and some who provided more details asked that babies’ sex or exact age not be published.


Dr. Meghan Martin, a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital in St. Petersburg, Fla., said she and her colleagues now treated a hemorrhaging infant every month or two on average.


“It’s not unusual anymore,” Dr. Martin said.


Several doctors described vitamin K deficiency bleeding cases as so horrific that they were seared in their minds, though they treat sick children every day.

Dr. Donna Schoonover, a pediatric hospitalist in Washington, said she would never forget one image: an eye popping out of its socket from the blood pooling in an infant’s skull.


A Routine Injection
Infants are naturally deficient in vitamin K because it doesn’t cross the placenta well, and breast milk contains little. Formula can contain more — but newborns’ digestive systems can’t fully absorb it, said Dr. Leela Sarathy, the medical director of newborn nursery services at Mass General Brigham for Children.

The risk of bleeding from vitamin K deficiency is highest in the first week but persists at a lower level for months. One injection within six hours of birth nearly eliminates it. (Unrelated factors can also cause bleeding.)

The American Academy of Pediatrics recommended the shot in 1961, and vitamin K deficiency bleeding became very rare in the United States. “We learned about it, but it was something that happened mostly in other countries,” said Dr. Judy Felgenhauer, the medical director of the pediatric hematology and oncology program at Providence Sacred Heart Children’s Hospital in Spokane, Wash.

The injection is very safe. But in the 2010s, doctors started to notice more Americans turning it down for their children. While the vitamin K shot is not a vaccine, rejection of it rose alongside vaccine rejection, among many of the same parents.

Misinformation online has contributed, said Dr. Stephanie DeLeon, the associate chief medical officer at Oklahoma Children’s Hospital OU Health.


Some Facebook groups and other forums for expectant parents are full of inaccurate claims and parents expressing anguished indecision, unsure what to believe and terrified of harming their children.

Though the C.D.C. still recommends vitamin K, Health Secretary Robert F. Kennedy Jr. and other Trump administration officials have amplified distrust of standard medical guidance in many areas. And Children’s Health Defense — an organization Mr. Kennedy previously led — has suggested vitamin K shots could be dangerous.