Questions re: Vitamin K, Hep B and Heel tests

Hi,

I'm starting to do my research about infant immunisations and screening tests, and have a few questions that I'm hoping others might be able to answer.

DH and I are approaching the issue of vaccination with an open mind. I object to my child receiving a vaccination without us having made an informed decision, so we're researching individual vaccines and making a "Yes," "No," or "Maybe later" decision on each of them. At this stage we don't consider ourselves "objectors" or "pro-vaccine;" we're basing it on individual merit of each vaccine.

So far, it's likely that we'll say "no" to our baby receiving the Hep B vaccine at birth. That's about as far as we've got...I've only read about Hep B and Vitamin K, so I'll have more questions about the other vaccines as I get to them.

My questions so far....

1. *Do we need to complete a Conscientious Objector form if we intend on saying No to the Hep B vaccine at birth? Do I need to do this before the birth, or is it okay just to say "No" at the birth (and in our Birth Plan, etc)? Likewise, is saying No to the Vitamin K dose at birth considered a conscientious objection, or just a routine "No." Ie. Will the midwives at the hospital accept our decision or do we need a CO form for this?

2. Do we need to complete a Conscientious Objector form if we intend to say no to some vaccines and yes to others?

3. (If yes to either of the above) Do both DH and I need to sign the CO form, and do we both need to attend an appointment with our GP to sign this form? (This isn't a problem, we'll be making a joint decision, but I just need to know whether DH needs to come to the appointment).

4. I've been reading about the Vitamin K injection/oral dose and am a bit conflicted...I'd be interested in hearing some personal stories about why others said yes or no to the Vitamin K dose at birth, and if the answer was yes, whether and why you chose the injection or the oral dose.

5. If you said no to the Vitamin K dose, did you supplement your own diet in order that Baby received extra Vitamin K through your breastmilk?

6. And one more (for today)...am I alone in being a bit apprehensive about the Heel Test done on my baby (where the baby's heel is jabbed a few days after birth to test for rare genetic deformities). Have others refused this test, and why/why not?

Thanks in advance. It would be nice if someone just gave me a crystal ball but these decisions (and the research) is difficult!

Seph

I have done some research on newborn screening (the heel ***** test). What are your concerns with testing? I may be able to answer questions you might have.

Personally, i am looking into the same issues with vaccinating etc, so will be interested to see replies.

Hi Kate,

I understand the heel test is quite ouchy and that blood is squeezed out of the heel. Do you know if there are less invasive tests? Less painful ones? I'm not sure the benefits outweigh the pain to bub.

1. *Do we need to complete a Conscientious Objector form if we intend on saying No to the Hep B vaccine at birth? Do I need to do this before the birth, or is it okay just to say "No" at the birth (and in our Birth Plan, etc)? Likewise, is saying No to the Vitamin K dose at birth considered a conscientious objection, or just a routine "No." Ie. Will the midwives at the hospital accept our decision or do we need a CO form for this?

When you book in at the hospital they will talk you through it and give you a few leaflets. You will also have to sign saying that you agree for your child to have the vaccination. I can't remember though if you could sign for a 'no' option but you wont need an actual CO form for it.

2. Do we need to complete a Conscientious Objector form if we intend to say no to some vaccines and yes to others?

It will probably be easier to do this so you don't have an issue with the ones you don't get.

3. (If yes to either of the above) Do both DH and I need to sign the CO form, and do we both need to attend an appointment with our GP to sign this form? (This isn't a problem, we'll be making a joint decision, but I just need to know whether DH needs to come to the appointment).

No, you don't both have to sign it. DH did not sign the one for DS2. I went to my GP and got one, but you can download it. Not sure if a MCHN can sign off on it (GP needs to sign too as well as the parents) So your DH wont need to go to the appt.

4. I've been reading about the Vitamin K injection/oral dose and am a bit conflicted...I'd be interested in hearing some personal stories about why others said yes or no to the Vitamin K dose at birth, and if the answer was yes, whether and why you chose the injection or the oral dose.

I think that the main reason for the oral dose is so that a newborn baby doesn't have to have a needle kwim? More of a gentle option. You can also choose to delay it for a few days too. You will need to check that your hospital/birthcentre even has the oral dose as some do not carry it in stock. My hospital did not have the oral dose.


5. If you said no to the Vitamin K dose, did you supplement your own diet in order that Baby received extra Vitamin K through your breastmilk?

6. And one more (for today)...am I alone in being a bit apprehensive about the Heel Test done on my baby (where the baby's heel is jabbed a few days after birth to test for rare genetic deformities). Have others refused this test, and why/why not?

I think the PKU test is helpful because if there is an issue with your baby not having the enzyme needed to use phenylalanine (an amino acid) they will require a special diet to prevent further health issues. If you don't have it done at birth, it can be done via a urine test if bubs is over 6wks. I do not know if that test would be as accurate as the blood test though.

I've never known anyone to say no to the heel test - honestly, my two girls didn't even seem effected by it, just had a bit of a jolt when it was done, but continued on feeding. My midwife warmed up the area though first.

We got the vitamin K shot for DS and DD1 because they were c-sections. Generally seen as a more traumatic birth for bubs - whereas I didn't get it for DD2.

I haven't ever gotten them vacced at birth for hep b -i didn't see the point. They weren't going to come into contact with anyone with it for the first two months of their lives and we weren't taking them overseas. I've never had to fill in a CO form for that one - I think that one really is optional.

Trillian answered just as I would so I won't say any more. Good luck with your decisions my love. :hug:

In relation to your 5th question which I couldn't answer myself, I did a bit of googling and found this taken from Midwifery Today Vitamin K in Colostrum and Breastmilk now it doesn't say if those mothers supplemented vitK themselves or not and the sample was only quite small, so its not really an effective study, but it does give you a bit of an idea about vitk in breastmilk.

Persephone I cant comment on the CO form questions, I'm not up on what is required or necessary.

Like Mel, when DS was born by emergency c-section we consented to the injection of Vitamin K as its a more traumatic birth for bubs. Had we had a normal vaginal birth we would have declined based on our own research and discussions prior to birth.

I'm not aware of anyone who has declined the heel test either. Generally it screens for a lot of conditions, and therefore can provide treatment options quickly if anything was found. No, its not a nice concept having that tiny little brand new heel jabbed, bit DS didn't really fuss at all and we thought the benefits outweighed the concern.

We declined Hep B at birth as we didn't consider that DS would be at risk in his first two months of life (which he wasn't). We just declined and our middie noted it in his book.

Good luck, hope that is somewhat helpful for you.

We didn't have the hep B at birth - and we didn't sign the CO form, but I'm not sure if we had to or not - we weren't told either way.

We chose the oral vit k - I didn't believe she really needed it at all, but felt it was better to be safe than sorry. The oral vit k was very easy, and no drama to her. Much nicer than a needle IMO! My midwife gave me a wonderful book that basically said if you breastfed from birth you wouldn't need the vit k as colostrum is super high in it. Wish I could remember the name of that book!

All the best with your decisions - good on you for researching everything thoroughly :)

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Hi Kate,
I understand the heel test is quite ouchy and that blood is squeezed out of the heel. Do you know if there are less invasive tests? Less painful ones? I'm not sure the benefits outweigh the pain to bub.

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I haven't heard of any less invasive tests. They used to do a urine (wet nappy) test for PKU but it didn't detect all affected kids. Some bubs sleep through the collection and don't react, whilst others have a harder time with the blood collection.

Some people prefer for the nurse to take their bub away for testing, but then it just helps the parents cos they don't see if bub gets upset. Warming the foot up before the test is done can help the blood flow easier.

It is only a small number of bubs who will be identified as having one of the conditions they test for, BUT having that info and starting treatment early can make enormous difference in the life of that child.

They now test for more than 30 conditions, but due to the advances in technology they still only need the same blood as when they used to test for just 3 or 4 conditions.

HTH,

Kate

Another alternative would be to feed your baby while they do it.

I actually don't like the feeding while doing the test Trill. I worry about the association between the hell***** and the breast so soon after birth... That's just my wierd take on it though.

Good on you for researching all of this. That's exactly what every parent should do. Immunisation is so tricky isn't it, so I won't offer advice there as we are on the fence with that one!

I do worry though, when parents decline tests that look for very serious illnesses. Of course it is your choice, but saying no to testing (such as the heel pr*k) can have a HUGE effect on bub so please research this well.
I have to say I bf my 2 babies while they did the test, and they barely cried. Actually, bathing them as newborns resulted in them becoming a million more times distressed than the heel pr*k!

All the best with your choices

Hi Persephone,

My birth centre (Angliss), had a form regarding the Hep B, and I ticked a box saying we were going to delay the shot. I was also asked at hospital and I also had it in my birth plan, but no CO form was required.

I did Oral Vitamin K, as thought it was a little less traumatic then a needle, and had no issues, the first dose was done at the hospital, the second dose by the visiting MCHN and then the third by the MCHN at her office - I did need to hold on to the 3rd dose in the fridge for a while. From recollection there was something about less nasties in the oral dose then the injection, but these are just vague recollections - yuo'd have to google. And, again, vaguely, that there is a risk that less Vit K is getting in with the oral dose then via the injection.

Also, if it you choose Oral Vit K as you think it will be less traumatic, Eleanor hated the Oral vitamin K, where as one injection would have been over and done with :D.


Hope that helps, but it may have just muddies the waters a bit!

Thanks Ladies, you're such a help.

I'm feeling pretty adamant now about saying no to the Hep B injection at birth, haven't decided at which point we'll introduce the Hep B vaccine...that's another thread.

And I'm thinking that the Vitamin K decision will be made after the birth, and depending on how the birth goes. And I'm thinking if it's a "yes" then it'll be the oral dose.

And...the Heel Test...augh, I really hate the idea of my baby being in pain as a result of a decision that we've made, but I think I might just bite my own lip and shed a tear myself, and know that we're doing for bub's best interests.

I think the immunisation decisions are hard because for the first time ever I'm having to make decisions for someone else, without their input, and them being completely dependent on me. I'm finding this very confronting! I'm also finding it hard knowing that my baby will trust in me implicitly to make the right decision, and I don't know which decision is the right one! :wall:

Thanks again girls, much appreciated.