The 2-month-old baby arrived at the hospital with the type of bleeding in and around his brain that was so unusual Miami neurosurgeon Heather McCrea had only read about it in textbooks.
The pooling blood indicated that the baby had a severe vitamin K deficiency – something usually prevented by a shot at birth. But his parents, like a growing number of Americans skeptical of injections, had declined to get the shot for their baby.
“This is not something I really saw during training,” McCrea said. The baby survived, thanks to a large dose of vitamin K that stabilized him enough for surgery.
It was such an unusual experience, McCrea asked colleagues if they were seeing similar things. Many told her, to their surprise, they were.
For nearly 65 years, babies in the US have received a dose of vitamin K within hours of their birth. The injections aren’t a vaccine, but a supplemental dose of a vitamin found in leafy green vegetables that allows blood to clot. Newborns can’t produce much on their own. The injection helps prevent them from developing severe vitamin K deficiency bleeding. The chances they will do so are slim – less than 1 in 14,000 – but it’s fatal for about 20% of babies.
The shot has been so successful and widely used the Centers for Disease Control and Prevention doesn’t track vitamin K deficiency bleeding cases because for a long time there were virtually none.
Doctors now say that’s changing as more parents refuse the shot. A December study found that 5.2% of US families turned down the shot in 2024, up from 2.9% in 2017. Researchers have long linked the refusal of the shots to bleeding-related deaths in infants. And there have been instances of children becoming permanently impaired in Tennessee and Pennsylvania.
“It used to be a vanishingly rare occurrence that a parent would come in and turn down vitamin K,” said David Hill, a vitamin K researcher and pediatrician in Seattle. And when they did, “We’d look at each other like, ‘Oh my God. Why in the world not?’”
Vitamin K shots have been swept up in the broader backlash against vaccines, which has been inflamed by top US health officials, including Health and Human Services Secretary Robert F. Kennedy Jr. The current overarching public health message is that parents should trust their own instincts over doctors’ advice. While the focus is immunizations, that thinking is now being applied to all kinds of health-care decisions for kids.
Skepticism around vitamin K shots – made by Pfizer Inc. and generic drug manufacturers – isn’t hard to find online. Influencers like Candace Owens tell parents they put kids at risk of cancer and contain toxic chemicals. Such messages fan growing fears among US parents about what they’re putting in their children’s bodies – even if it’s something as simple as a vitamin.
Hill, who sees 15 to 20 newborns a day, says parents now want to skip vitamin K shots “all the time.” There’s a broader resistance to anything that’s injected, vaccine or not.
Families that decline the shots are also more likely to pass on other standard medical care for their babies, according to a study from the American Academy of Pediatrics. More people are opting out of giving birth in a hospital altogether, without the full suite of newborn treatments that are normally available.
Kate Barnard, a 29-year-old doula and content creator in Baltimore, said she first had concerns about the vitamin K shot when she was pregnant with her third child in 2022. One of her pregnant clients said she planned to skip it. Barnard looked into the injection and learned it has a black box warning, the US Food and Drug Administration’s most serious safety alert for drugs and treatments.
The label warns of rare and dangerous allergic reactions, and even fatalities, though there has only been one recorded case of this happening to a baby. That was enough to scare Barnard. When she did more of her own research online, she found a 1990 British study that suggested possible links between vitamin K shots and childhood leukemia and that a preservative in some injections, benzyl alcohol, can be toxic to newborns in certain doses.
A representative for Pfizer pointed to the product’s label that states the safety and effectiveness of the shot has been established in infants. The American Academy of Pediatrics and other health groups say after further extensive study about the link between the shot and cancer, vitamin K injections have been proven safe. There’s no credible evidence the shot “has any effect other than saving countless lives,” said Ivan Hand, a pediatrician and lead author of the AAP’s policy statement on vitamin K shots.
Barnard said she ultimately fell deep in the “rabbit hole” of online discussion about injections, but wasn’t confident enough in her knowledge to reject doctors’ advice for her third child, who got the shot. She became more suspicious as she heard physicians online dismiss concerns about the injections, she said. “They come off very rude and just like, ‘I’m a doctor so I know more.’”
When she had her fourth child last year, Barnard opted out of vitamin K shots – and all other routine vaccines – for him. Instead, she got vitamin K drops off Amazon, which doctors have found to be less effective but better than nothing.
Barnard said that she knows vitamin K deficiency bleeding is real and dangerous, but that she wishes the US tracked it better and that she was treated more respectfully when making her own health-care choices.
“Telling a parent what to do does not work,” said Anna Morad, a doctor who runs the newborn nursery at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville. She says she’s learned what’s more effective is “recognizing that they’re the expert in their child.”
When parents still don’t want vitamin K after hearing of the benefits, Morad makes a note in the baby’s chart. The chances that the child will start to dangerously bleed within six months are low. But if it happens there will be no warning signs, and she wants to help the next doctor know what to do.
Hill said if vitamin K shot status isn’t mentioned as part of a child’s medical history, he’ll now ask about it. That background was useful to Hill recently, when he saw a toddler whose parents had opted out of the injection. The boy was “born perfect,” but on the second day of his life his brain started bleeding. He survived but is now permanently disabled.
“I breathe a sigh of relief every time I review a chart and see that the baby has got vitamin K,” Hill said.
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