Refusal of Vitamin K by Parents of Newborns: A Survey of the Better Outcomes Through Research for Newborns Network

Acad Pediatr. May-Jun 2017;17(4):368-373. doi: 10.1016/j.acap.2016.10.012. Epub 2017 Mar 9.


Objective: To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals.

Methods: An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries.

Results: Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K.

Conclusions: Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness.

Keywords: BORN network; vitamin K refusal.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antifibrinolytic Agents / therapeutic use*
  • Humans
  • Infant, Newborn
  • Nurseries, Hospital
  • Parents*
  • Surveys and Questionnaires
  • Treatment Refusal*
  • United States
  • Vitamin K / therapeutic use*
  • Vitamin K Deficiency Bleeding / prevention & control*


  • Antifibrinolytic Agents
  • Vitamin K