What’s your approach to anti-vitamin K parents?

[pedspedspeds18]

Skip that Newborn Vitamin K Shot | The Healthy Home Economist

Found an interesting (read: infuriating) article earlier this week. Just thought I would get everyone’s opinion/approach to this issue.

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[SurfingDoctor]

Skip that Newborn Vitamin K Shot | The Healthy Home Economist

Found an interesting (read: infuriating) article earlier this week. Just thought I would get everyone’s opinion/approach to this issue.

My approach: “Your baby may get a brain hemorrhage and die without Vitamin K, but you don’t want it? Okay...”

 

[oldbearprofessor]

I suggest giving them accurate information. The article you quote mis-states the conclusions an old Cochrane review (Prophylactic vitamin K for vitamin K deficiency bleeding in neonates | Cochrane)

More recently there are quite a few publications related to cases and case series of CNS hemorrhage when vitamin K is not given. Read them and quote them. Although oral vitamin K MAY be useful as an alternative, there is no ideal form of that in the US and it must be given more than once with obvious f/u issues. In practical terms, this is not really feasible in the US.

There are, I believe, some videos on-line of families who had a child with a brain hemorrhage after not receiving the vitamin K. They can be referenced as well for evening viewing for the families

Finally you can ask them what they are concerned about. If it's the alleged connection with cancer, that is readily refuted.

If none of that works, there isn't much you can do but count on luck/providence/whatever to protect that baby as this will be a baby that never gets needed preventive care in all probability, not just one who doesn't get vit K at birth.

 

[Dr. Wexler]

I counsel them on risk and benefits, like everything else.

Although oral vitamin K MAY be useful as an alternative, there is no ideal form of that in the US and it must be given more than once with obvious f/u issues. In practical terms, this is not really feasible in the US.

As OBP alludes to, in my opinion the harder discussions are when the family wants to do oral vitamin K. There was an ethics point and counterpoint in Pediatrics about the topic in the past few years. My takeaway was that it is not ethical to offer oral vit K as an option. If families want to do it, they are on their own. I will not be involved.

 

[NurWollen]

Sarah Pope aka "Healthy Home Economist" is one of the worst of the worst when it comes to anti-vax, anti-K, anti-anything-that-is-actually-evidence-based. Boils my blood reading anything she puts out.

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[BabyDoc86]

"Your son can't have a circ unless he gets Vit K." Parents care more about their kid's penis than his brain.

 

[mvenus929]

"Your son can't have a circ unless he gets Vit K." Parents care more about their kid's penis than his brain.

Eh. Most of the parents I’ve had that adamantly refused Vit K also didn’t want a circ. Or had a girl, so it didn’t matter. There are some parents who refuse it because they read something somewhere saying it caused autism (or whatever), and they’re usually pretty easy to convince to get it once you explain that it prevents brain bleeds.

 

[PTPoeny]

In residency the incidence of vitamin K refusers went to zero for a while after we had a local baby die after a brain bleed... I think people really don't believe the bad things happen unless they have heard or read about them before coming in to the doctor's office.

 

[KaapstadMK]

"Your son can't have a circ unless he gets Vit K." Parents care more about their kid's penis than his brain.

Definitely true. My OB preceptor talked a good number of parents into it in the OR this way