U.S. Infant Bleeding Episodes Jump as Vitamin K Refusals Rise, Two Studies Find

According to two studies published in JAMA and JAMA Pediatrics, U.S. infant bleeding episodes have increased as the share of newborns receiving vitamin K injections fell from 97.7% to 95% between 2017 and 2025. The decline, which a Department of Health and Human Services spokesperson attributed to falling public trust in healthcare institutions, occurred despite recommendations from the CDC and American Academy of Pediatrics that all babies receive the shot at birth.

The research, led by Dr. Heather H. Burris of Children’s Hospital of Philadelphia, documented a nationwide decline in vitamin K administration paired with an increase in bleeding risks, according to the study published in JAMA Pediatrics. A second study in JAMA found that the share of newborns receiving the injection fell from 97.7% to 95% between 2017 and 2025.

The studies determined that about 60% of infants diagnosed with vitamin K deficiency and 81% of those diagnosed with vitamin K deficiency bleeding had not received the shot, according to the findings.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend all babies receive a vitamin K injection at birth to prevent vitamin K deficiency bleeding, which can cause bruising, particularly around the head and face, or bleeding from the nose, umbilical cord, or brain.

A Department of Health and Human Services spokesperson said the injection should be administered within six hours of birth. The spokesperson attributed the declining uptake to falling public trust in healthcare institutions, particularly during the COVID-19 pandemic amid “heavy-handed mandates and inconsistent messaging.”

Dr. Elizabeth Wolf, a pediatrician at Children’s Hospital of Richmond at Virginia Commonwealth University, said researchers need to understand why parents refuse vitamin K and how to improve uptake.

Dr. Joel Warsh, a California pediatrician not involved in the studies, said the growing lack of trust in medicine extends beyond vaccines to interventions like newborn vitamin K. Warsh recommended honest conversations with parents about risks and benefits.

Vitamin K deficiency bleeding in infants can cause symptoms including pale skin or gums, yellowish eyes, bloody stool, vomiting, irritability, seizures, or excessive sleepiness, according to the research.

Both studies used Epic Systems Corporation’s Cosmos platform, which contains records from more than 2,000 hospitals and 49,000 clinics across all 50 states. Both excluded infants born at less than 35 weeks gestation.

The Burris-led study noted that bleeding risk rose faster among infants who did not receive vitamin K, though the reasons for the trend were unclear, according to the research.

The Burris-led study received funding from the National Institutes of Health. One researcher on that study received grants from Pfizer, which manufactures a vitamin K shot. The other study received funding from the Children’s Hospital Foundation, associated with Children’s Hospital of Richmond, and reported no conflicts of interest.

The findings come as healthcare providers continue to address parental concerns about routine newborn interventions. The American Academy of Pediatrics has maintained its recommendation for universal vitamin K administration since the 1960s, when routine use of the injection became standard practice following evidence that it prevented a rare but potentially fatal bleeding condition in newborns.