Newborn checks: What's the deal with the eye gel and the Vitamin K shot?

Eye gel and Vitamin-K: What’s the deal?

In the first couple of hours after your baby is born, there are a few simple checks that will happen. Baby will be assessed using the APGAR scale, then they will be weighed, measured, and your care provider will offer to apply an antibiotic eye gel called erythromycin and give your baby an injection of Vitamin-K.  Until recently, this has been considered standard procedure but as times change, people are starting to ask if these two treatments are necessary.

What is Erythromycin?

Erythromicin is a medicated eye ointment that has been used to help prevent neonatal opthalmia ( in essence “pink eye”) which can be caused by the transmission of certain sexually transmitted infections (STIs) such as chlamydia and gonorrhea.  The reality is that the gel is not very effective at preventing or treating infection and that increasingly midwives and OBGYNs would be just as happy to stop administering the gel altogether.

 Erythromycin eye gel has been a standard newborn treatment for decades, but the times might be changing.

Erythromycin eye gel has been a standard newborn treatment for decades, but the times might be changing.

What if you don’t want to use the gel?

By law, in the province of Ontario, midwives and OBGYNs are required to apply erythromycin gel to your baby’s eyes after birth which can leave you and your health care providers in a tricky situation if you would like to decline the treatment. What we are seeing now in Peterborough is health care providers who are willing to work with parents in declining this treatment. It is still a bit of a “mixed bag” so talking to your midwife or OB during one of your prenatal visits is always a good idea. Make your preference known so that you can feel out your care provider’s stance on the issue and have your choice recorded in your charts. It is ultimately your choice, but depending on your healthcare provider, you may have to dig your heels in a bit!

What is Vitamin K?

Vitamin K is a fat soluble vitamin that helps with blood coagulation (it helps to stop bleeding).  Although we are born with “adequate” levels of vitamin K, they often dip and are at their lowest levels by  2 or 3 days after birth, especially if the baby if exclusively breastfed. This happens because we do not produce vitamin K independently and even if a mother has strong levels of Vitamin K, it does not transfer well through the umbilical blood and breast milk is quite low in Vitamin K (infant formula, on the other hand is comparatively high).

Why is Vitamin K important?

If a baby develops vitamin K deficiency (or is born deficient) spontaneous internal bleeding can happen and though it is uncommon, can be fatal.  Vitamin K injections have been shown to be very effective in preventing deficiency and bleeding. There is an option to give your baby vitamin K as a drop taken orally, but it seems that the injection is more effective and longer lasting.

 Vitamin-K shots are optional but generally considered another standard newborn check or treatment in the first hours after birth.

Vitamin-K shots are optional but generally considered another standard newborn check or treatment in the first hours after birth.

What if you don’t want your baby to have this shot?

Whether or not you give your baby the vitamin-K injection is completely up to you in Ontario. Unlike erythromycin, there is no specific law about this medication. As always, talking to your care provider prenatally is helpful so that your choices about this injection are noted to avoid any confusion after birth but whatever your choice, you should have no problems simply telling your nurses, midwives, or OGBYN “Yes” or “No” when they do their newborn checks.   

Do your research and stand by your choice!

When it comes right down to it, it is your baby and your choice.  Times (and rules) change so just like every other choice you have to make as you move through pregnancy, birth, and life with your newborn read, ask questions, and make the choices that are best for your family.