Aside from weighing your newborn, in the first few hours after birth your baby will receive an antibiotic eye ointment and a Vitamin K injection. These two events are very important to the health of your baby.
But why is this being done exactly?
Let’s start with Vitamin K.
For blood to clot properly it needs Vitamin K. This vitamin is made in the gut by bacteria. Since the baby’s bowels are sterile at birth it actually takes several weeks to build up bacteria to make a Vitamin K supply. Very small amounts are passed from mom to baby by the placenta and breastfeeding.
Babies with low Vitamin K are at risk of bleeding spontaneously. This is referred to as Vitamin K deficient bleeding (VKDB) (previously called hemorrhagic disease of the newborn). What this means is that the baby can bleed into several different organs such as the brain (which can be similar to having a stroke), kidneys, or gut and can even lead to death. Sometimes you can see bleeding, bruising or even signs that the infant is not well, but sometimes there are no symptoms at all.
Since the early 1960’s, the Vitamin K injection has been given to all newborns in Canada. Some people wonder why an oral dose cannot be given instead of the injection. Oral doses are less effective than a single injection of Vitamin K in preventing late-onset (between 2 weeks-2 months) VKDB [1-5].Even repeat doses do not result in the same effect as the injection [6, 7]. The Vitamin K injection (into the infant’s thigh muscle) reduces the chance of bleeding to almost zero. There are no known side effects to the Vitamin K. From the injection, there is a risk of bleeding which can easily be controlled with pressure as well as a risk of infection; however, proper cleaning of the injection site virtually eliminates this risk.
The next medication your baby receives is a dose of antibiotic eye ointment to prevent against common infections of the eyes as per Health Canada guidelines and several other organization recommendations [8-10].
Erythromycin ointment (or a suitable alternative) can protect against bacteria from the vagina including gonorrhea and chlamydia [11, 12]. Often Mother’s do not even know they have these infections as they have no symptoms and pass it on to their newborn during delivery. These infections can cause ulcers to the eye and even permanent blindness. This medication is required as per the Canadian Health Protection Act (i.e. law) [13]. If refused, it is reported to the public health department.
The ointment is put into the babies eyes within an hour after birth. It can cause their vision to be a bit blurry but otherwise does not cause any discomfort. Occasionally a baby may have some redness to the eye or very mild swelling so do not be alarmed. If this does occur, ensure that you show a physician to verify whether this is a minor side effect of the ointment rather than an infection.
Waiting closer to the 1hr period post birth allows that initial attachment period to progress naturally between mom and baby. This includes allowing the first breastfeeding session and skin to skin contact to help establish bonding. The baby’s quiet alert period then ends with a sleep period in which Mom can soothe her baby post injection and the blurring from the eye ointment would not be an issue. However, all parents can decide when the best time to give these medications are after birth. Don’t worry if you forget, your medical staff will ensure they are done and welcome any questions you may have!
- Six years’ experience of prophylactic oral vitamin K. Wariyar U, Hilton S, Pagan J, Tin W, Hey E. Arch Dis Child Fetal Neonatal Ed. 2000;82(1):F64.
- Can 3 oral 2 mg doses of vitamin K effectively prevent late vitamin K deficiency bleeding? von Kries R, Hachmeister A, Göbel U. Eur J Pediatr. 1999;158 Suppl 3:S183.
- Prevention of vitamin K deficiency bleeding in newborns. Zipursky A. Br J Haematol. 1999;104(3):430.
- Prevention of vitamin K deficiency bleeding: efficacy of different multiple oral dose schedules of vitamin K. Cornelissen M, von Kries R, Loughnan P, Schubiger G. Eur J Pediatr. 1997;156(2):126.
- Controversies concerning vitamin K and the newborn. American Academy of Pediatrics Committee on Fetus and Newborn.
- American Academy of Pediatrics Committee on Fetus and Newborn. Pediatrics. 2003;112(1 Pt 1):191.
- Canadian Pediatric Society Position Statement: Routine administration of vitamin K to newborns, Paediatr Child Health 1997;2(6):429-31. Reaffirmed: Jan 30 2012 2.
- Canadian Paediatric Society, Infectious Diseases and Immunization Committee. Recommendations for the prevention of neonatal ophthalmia. ID02-03. Paediatr Child Health 2002;7(7):480-3.
- Canadian Pharmacists Association. Compendium of Pharmaceutical and Specialties, online version (e-CPS); 2011.
- Health Canada. Family-Centered Maternity and Newborn Care: National Guidelines. Minister of Public Works and Government Services, Ottawa 2000.
- AMERICAN ACADEMY OF PEDIATRICS: Policy Statement: Controversies Concerning Vitamin K and the Newborn. Pediatrics. 2003 112(1pt1):191-192. Reaffirmed May 2009
- Canadian Task Force of the Periodic Health Examination. Prophylaxis for gonococcal and chlamydial opthalmia neonatorum. CMAJ 1992;147(10):1449-53.
- Health Promotion and Protection Act, 1990). Communicable Diseases – General, R.R.O. 1990, Reg. 557.