Vitamin K injection?

[~Saram~]

Just wanting some info about when this injection is usually given and what the limits are ie. does it have to be at birth or can it be a few hours later etc. DS had the oral vit K but we have decided to do the inject this time as DS had very bad jaundice and I have heard that this could have been helped by the Vt K. TIA

[christy]

As far as I was aware at our hospital they give it at birth. I had the oral vit K instead. Did you know as well to help with preventing jaundice that if you leave the cord pulsating the baby gets all the important haemoglobin. Kelly's posted articles about it on here...Cutting the Umbilical Cord

[~Saram~]

Yes thansk def doing that this time. Had it in our last birth plan but I am pretty sure they clamped it straight away as they sneakily gave me the syntocin inj despite me not asking for it!

[visitor1]

DD had the injection about 3-4 hours later after her birth.

[~Saram~]

Thanks

[christy]

Saram... I'm actually going to look it up again, because I was "talking" with someone who said that she had read it was the opposite, that the more platelets the more chance of jaundice.... So I'm going to have a read through some information about that for you, don't want to be giving you bad advice May have a midwife around here check on me too

[christy]

Although this article is about very low-birth weight babies, it's interesting because of the relationship between delayed cord clamping and protection from IVH (Intraventricular Hemorrhage) and LOS (Late-Onset Sepsis). This is the closest information we have about the protective effect of delayed cord clamping against HDN for term babies.

Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial.
Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W.
Pediatrics. 2006 Apr;117(4):1235-42.

RESULTS: Seventy-two mother/infant pairs were randomized. Infants in the ICC and DCC groups weighed 1151 and 1175 g, and mean gestational ages were 28.2 and 28.3 weeks, respectively. Analyses revealed no difference in maternal and infant demographic, clinical, and safety variables. There were no differences in the incidence of our primary outcomes (BPD and suspected NEC). However, significant differences were found between the ICC and DCC groups in the rates of IVH and LOS. Two of the 23 male infants in the DCC group had IVH versus 8 of the 19 in the ICC group. No cases of sepsis occurred in the 23 boys in the DCC group, whereas 6 of the 19 boys in the ICC group had confirmed sepsis. There was a trend toward higher initial hematocrit in the infants in the DCC group. CONCLUSIONS: Delayed cord clamping seems to protect VLBW infants from IVH and LOS, especially for male infants.

Here's the Reuter's version:

Thursday, April 6, 2006

By Clementine Wallace

NEW YORK (Reuters Health) - Waiting 30 to 45 seconds before clamping the umbilical cord of very low birth weight infants -- those weighing less than 1500 grams -- seems to protect them against bleeding in the brain and the development of blood infections later on, researchers report.

The strategy seems to benefit boys especially.

"While countries in Europe tend to wait before clamping these children's umbilical cord, the current practice in the United States is to clamp it immediately after delivery," Judith Mercer told Reuters Health. "There hasn't been a lot of research done in this country on delayed cord clamping, and most studies were limited by small samples."

Evidence is accumulating to suggest that, for very low birth weight infants, delaying cord clamping and lowering the newborn below the mother's level significantly increase the amount of blood flowing from the placenta to the newborn, according to Mercer, from the University of Rhode Island in Kingston.

In their article in the medical journal Pediatrics, she and her colleagues note that waiting 30 to 45 seconds results in an 8 percent to 24 percent increase in the baby's blood volume.

"Immediate cord clamping may deprive these infants of essential blood volume, which might result in hypotension (low blood pressure) and in a poor perfusion of the tissues," Mercer explained.

Her group's study involved 72 pregnant women who gave birth to infants before the 32nd week of gestation. The women underwent either immediate cord clamping at 5 to 10 seconds after the birth, or delayed cord clamping 30 to 45 seconds after delivery.

The researchers saw differences between the two groups in rates of brain bleeds in the babies, and in their risk of late-onset sepsis.

These differences were significant from a statistical standpoint in male infants, but not in females. Specifically, 2 of the 23 male infants in the delayed-clamping group had intraventricular hemorrhage compared to 8 of the 19 in the immediate-clamping group. No case of sepsis occurred among the first group, whereas 6 cases occurred among the others.

The researchers say the strategy is a simple way to improve outcomes of very preterm infants.

SOURCE: Pediatrics, April 2006.

This was something posted by Kelly in a thread here: Pros & cons of Vitamin K

[Fi]

Hamish's Vit K was done about 12 hrs after his birth I think. I'm not sure really, I remember it was the morning shift midwife that did it, so thats somewhere between 7am and 3pm, and he was born at 3am. It was definitly not done straight away.
Hamish was jaundiced enough to warrant a 3rd visit from the dom midwife service. Apparently he was graded as a K2-3. I have no idea if thats bad. His cord was left to pulsate.

[~Saram~]

Thanks Christy for that article and everyone else for their input. Spoke to the midwife today and she is happy to wait a while before giving the vit k, just couldn't think of anything worse that being born then jabbed with a needle. I have asked that it be given when the bub is BF as I remember this always helped DS with his vaccinations. thanks again