Study Finds Vitamin K Refusals for Newborns Rising in U.S., Doubling Bleeding Risk

A new study in JAMA, based on more than 5.2 million health records, reports that the share of newborns who do not receive a vitamin K injection at birth has more than doubled between 2017 and 2025, rising from 3.1% to 6.8%. The increase was especially steep between 2024 and 2025, when the rate climbed from 5.6% to 6.8%.

Dr. Kristan Scott, lead author of the study and assistant professor of pediatrics at Children's Healthcare of Atlanta, said the findings confirm that more infants are missing the protective shot and therefore face greater bleeding risk. The analysis also showed that infants who did not receive vitamin K had a 47% higher likelihood of any bleeding event in the first six months of life, and the risk of brain bleeding more than doubled compared with those who were vaccinated. Mortality during the birth hospitalization was also more than twice as high among the unvaccinated group.

The vitamin K injection, a single intramuscular dose given shortly after birth, has been standard U.S. practice since the early 1960s to prevent vitamin K deficiency bleeding (VKDB), a condition that can cause severe internal bleeding, including brain hemorrhages. The Centers for Disease Control and Prevention notes that about half of late-onset VKDB cases involve brain bleeds, which can lead to permanent damage, and that one in five affected infants dies.

Pediatricians are observing the trend in refusals firsthand. Dr. Thomas Patterson, a pediatrician in Idaho, said that refusals that were once “sporadic and rare” have become common, recounting a recent shift where half of the babies in his unit left the hospital without the injection.

Physicians attribute the rise to misinformation and parental concerns about the FDA’s black-box warning, which applies to high-dose intravenous vitamin K in adults, not the low-dose intramuscular form given to newborns. Some parents also mistakenly equate the injection with a vaccine. Dr. David Hill, spokesperson for the American Academy of Pediatrics, emphasized that the shot is a vitamin, not a vaccine, and is essential for clotting factor production.

Experts advise parents to discuss any concerns with trusted healthcare providers. Dr. Heather Burris, a CHOP neonatologist and study co-author, likened the injection to wearing a seatbelt: it markedly reduces the chance of serious injury in the event of a bleed.

The study’s authors caution that the growing refusal rate could reverse decades of progress in preventing life-threatening bleeding in newborns.