The birth of a baby is an exciting and happy time for parents. For a healthy start, babies should receive the following newborn medications on the first day of life: vitamin K injection, hepatitis B immunization and erythromycin eye ointment. Each of these are recommended by the American Academy of Pediatrics as they are important for the health and wellbeing of newborns. Each will be briefly discussed below with helpful links to additional resources provided.
Vitamin K is a nutrient that is very important to prevent bleeding. Infants generally do not receive sufficient vitamin K during development in the womb nor with the initial feeds after birth. Due to this, there is a risk of vitamin K deficiency bleeding. When this occurs some babies will have serious bleeding of the brain which can cause permanent disability and even be life-threatening. While a rare occurrence, this does happen and is often undetectable before the damage is done. A one-time vitamin K injection shortly after birth is extremely safe and sufficient to greatly reduce the chance of serious bleeding in the newborn period. While oral vitamin K liquid is available online and in some stores, it is not recommended as the product content is minimally regulated and it is much less effective due to unpredictable absorption from the infant's immature gastrointestinal tract. For additional information on Vitamin K from the American Academy of Pediatrics, please see Why Your Newborn Needs a Vitamin K Shot - HealthyChildren.org
Hepatitis B is an infection caused by a virus which can lead to failure of the liver as well as cancer. While mothers are usually tested for evidence of hepatitis B infection during pregnancy, some infants contract this virus during the newborn period even when their mother did not show evidence of infection. The hepatitis B vaccine is a very safe way to provide a high degree of life-long protection. Due to the devastating nature of hepatitis B illness in children as well as the safety and efficacy of the vaccination, it is important to start the hepatitis B vaccine series shortly after birth. For additional information on hepatitis B from the American Academy of Pediatrics, please see: Hepatitis B Vaccine: What You Need to Know - HealthyChildren.org
Infants are susceptible to a vision-threatening eye infection known as Neisseria gonococcal conjunctivitis. The bacterium which causes this infection is also one that mothers are often screened for early in pregnancy. Despite this, some infants contract this eye infection every year who had mothers that tested negative. Fortunately, erythromycin eye ointment is a mild and very safe, one-time treatment that can greatly reduce the chance of this preventable form of eye injury. For more information on the erythromycin eye ointment from the American Academy of Pediatrics, please see: Erythromycin Ointment - HealthyChildren.org
Of late, there has been an unfortunate decline in infants receiving the three newborn medications. Much of this has resulted from misunderstanding. Some parents have declined to provide these medications because of concerns about safety. Truly, these newborn medications are extremely safe. In fact, most parents would be quite comfortable providing a chewable vitamin for a child or administering antibiotic eyedrops for a toddler with pinkeye. The newborn medications are quite similar yet administered in a way that is effective for the newborn.
Another misunderstanding springs out of a parental desire to provide a more 'natural' experience for their newborn with the belief that this approach is more health promoting. This back-to-basics push is understandable given our society's heightened dependency on technology. Certainly, providing infants with breast milk and toddlers with a minimal-media environment, ample outdoor play and a diet rich in fresh vegetables and fruits is undoubtedly both natural and healthy. Yet, declining the newborn medications is something quite different. The avoidance of serious infection and life-threatening bleeding is a worthy endeavor which promotes infant well-being and serves as a foundation for a natural and healthy experience in life.
As a parent you are the decision-maker for your infant. Your baby depends on you for everything, which is an awesome honor as well as a huge responsibility. If you have any questions or are feeling hesitant about the newborn medications, we hope that you will take the time to talk with your baby's pediatric team. It is both our desire as well as our responsibility to share with you the most accurate information so that you can make the best, informed decisions for your baby.
Sincerely,
Pediatric Hospital Medicine