Vitamin K Refusal in Newborns Is Rising - and Leaves Infants 81 Times More Likely to Bleed

Vitamin K deficiency bleeding is rare. That rarity is almost entirely a product of a routine intervention introduced decades ago: a single injection of vitamin K, given right after birth, that prevents the condition in the vast majority of cases. The shot is not a vaccine. It is a supplement that compensates for a biological reality - newborns are born with very low levels of vitamin K, which the body requires for blood to clot properly.

When that supplement is refused, the consequences can be severe. A preliminary systematic review presented at the American Academy of Neurology's 78th Annual Meeting found that babies who do not receive vitamin K at birth are 81 times more likely to develop vitamin K deficiency bleeding - a condition that can cause an intracerebral hemorrhage, a type of stroke in which a blood vessel ruptures inside the brain. Approximately 14% of the babies in case series reports of vitamin K deficiency bleeding died. About 40% sustained long-term neurological disabilities including cognitive impairment, seizures, or motor deficits. Around 63% had brain bleeds.

A Small But Growing Trend

The overall refusal rate in the United States remains below 1% at most hospitals, and the review does not document a dramatic surge. But the direction of the trend is consistently upward across the datasets examined.

In Minnesota, refusal rates rose from 0.9% in 2015 to 1.6% in 2019 - nearly double in four years. In California, Connecticut, and Iowa, refusal rates ranged from 0.2% to 1.3% in 2018 and 2019. More than half of hospital staff in those states reported perceiving increases in refusal rates. Internationally, refusal rates ranged from 1% to 3% in Canada, New Zealand, and Scotland, and exceeded 30% at some birthing centers.

The review covered 25 studies and examined two decades of global data on vitamin K refusal rates, incidence of vitamin K deficiency bleeding, clinical outcomes, parental reasons for refusal, and potential links to vaccine refusal. Study author Dr. Kate Semidey of Florida International University in Miami noted the findings point to an urgent need for prenatal counseling to ensure parents understand the risks involved in refusing the supplement.

What Parents Cite - and What the Data Show

The reasons parents give for refusing vitamin K typically include concerns about pain from the injection, concerns about preservatives in the formulation, and exposure to inaccurate information suggesting the supplement is unnecessary or harmful. None of these concerns are supported by the evidence base for vitamin K safety, which spans decades of clinical use across millions of newborns.

The review also found a notable pattern: parents who refused vitamin K were far more likely to decline other recommended newborn interventions. In the United States, parents who refused vitamin K were 90 times more likely to also refuse both the hepatitis B vaccine and eye medicine intended to prevent potentially blinding neonatal infections. In Canada, parents who refused vitamin K were 15 times more likely to leave their child unvaccinated by 15 months old. In New Zealand, the figure was 14 times more likely. The pattern suggests vitamin K refusal functions as a marker of broader healthcare hesitancy rather than a concern specific to this particular supplement.

Scope and Limitations

The review synthesized existing published research rather than following individual infants prospectively. That design means it cannot establish the exact risk to any specific baby, and the studies included used varying definitions, time periods, and geographic settings. Case series on vitamin K deficiency bleeding tend to capture the most severe cases, which may overrepresent the worst outcomes relative to what would occur in a broader population of unvaccinated infants.

The findings are scheduled for presentation at the American Academy of Neurology Annual Meeting in Chicago in April 2026. The review has not yet been published in a peer-reviewed journal, and the data should be read as preliminary pending full publication and peer review.

The core clinical picture, however, is not contested: vitamin K deficiency bleeding is preventable, the prevention works, and when it is skipped, the consequences can be devastating and permanent. The findings from this review quantify those stakes in a way that may help clinicians communicate the issue more effectively to hesitant parents before birth.