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The Vitamin K Shot vs Vitamin K Drops: Pros and Cons

Vitamin K is an important part of newborn care. It can be lifesaving. But vitamin K shots aren’t the only option. In this blog post, learn about the pros and cons of the vitamin K shot and vitamin K drops. Plus, find out what my recommendation is.

bottles of drops

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Immediately after birth, your baby will likely experience a few procedures and other routines. Depending on where you give birth, this may include a bath, getting eye ointment, and receiving a few shots.

Each of these routine procedures have pros and cons that you should be informed about before deciding whether or not to accept them.

Today I want to talk about one of these procedures – administering vitamin K.

Why Is Vitamin K Important?

Vitamin K is important for both babies and adults because it plays a role in blood clotting. When you get a cut, you only bleed for a little while because your blood naturally thickens (“clots”) to stop the bleeding and keep you safe.

Babies are not born with sufficient vitamin K levels. And they do not reach high enough levels of vitamin K until they are about 6 months old. 

Vitamin K comes from food we eat and is produced by healthy gut bacteria. Breastmilk doesn’t contain much vitamin K at all and formula contains hardly more than that. And it takes 3-6 months for babies to have enough gut bacteria to produce sufficient amounts of vitamin K.

Usually, even low levels of vitamin K are enough to help blood clot. But if vitamin K levels are too low, the body may start to bleed spontaneously – without apparent cause.

This rare but dangerous situation is called “vitamin K deficiency bleeding.”

What is Vitamin K Deficiency Bleeding?

Vitamin K deficiency bleeding (VKDB) is when vitamin K levels in a baby’s body are so low that bleeding occurs without injury. Usually that bleeding is internal, in the intestines or in the brain.

It sounds really scary. And it can be. Keep in mind that it is rare, even without any supplementation. And the good news is, if a newborn receives vitamin K at birth, the chances of that baby experiencing VKDB are almost zero.

There are 3 types of VKDB:

  • Early (happens in the first 24 hours after birth)
  • Classical (happens after a day but within a week of birth)
  • Late (happens between 1 week and 6 months)

The 3 types of deficiency are similar but have slightly different risk factors. Early VKDB is usually seen in babies of mothers who were taking specific medications that interfere with vitamin K.

The causes of classical and late VKDB are unknown but are associated with exclusive breastfeeding (more on that later). Babies with undetected gallbladder disease, cystic fibrosis, chronic diarrhea, or antibiotic use are at higher risk of late VKDB.

It is important for parents to be informed about the possibility of VKDB because, often, symptoms don’t show up until it’s too late. And while VKDB can be treated, it can cause lifelong complications, like brain injury and paralysis.

So let’s talk about what can be done to avoid VKDB.

Vitamin K: Shot or Drops

Most often, especially here in the US, vitamin K is given to newborns within 6 hours of birth through a shot in their leg. This vitamin K shot has been used for decades and is generally safe.

Alternatively, vitamin K can be given to babies orally (by mouth) right after birth and in the weeks following. Oral versions of vitamin K are more popular in Europe. The dosage of the oral version is lower so it has to be taken multiple times to equal the shot.

Vitamin K drops are also safe and effective.

If that was everything you needed to know, I’d stop there. But vitamin K for newborns has become a bit of a controversial topic. So I want to provide you with more information so you can make a truly informed choice for your baby.

Before I dive into the pros and cons of both the vitamin K shot and vitamin K drops, let’s be clear about what the research says.

To quote a study from 2021, “while data from older studies suggest that [the vitamin K shot] may be more effective than…oral doses of vitamin K…the more recent data…does not seem to support a significant difference between the [shot] and the oral route.”

In simpler terms, the shot and the drops are nearly equal in effectiveness.*

*THAT SAID, and this is a very important caveat, the oral version is only effective when taken multiple times, as directed.

With that clear, let’s take a look at the pros and cons of the vitamin k shot at birth and the pros and cons of vitamin k drops at birth and in the following weeks.

Pros and Cons of the Vitamin K Shot at Birth

The vitamin K shot is by far the most common way of giving vitamin K to newborns. It has some definite pros and some real cons.

Pros of the Vitamin K Shot

First and foremost, the vitamin K shot is very effective. When given within 6 hours of birth, the risk of late VKDB (the most dangerous) after a vitamin K shot is 0 to 0.4 infants per 100,000. That’s less than 1 for every 100,000 babies born. 

Second, the vitamin K shot is a one-and-done thing. Your baby will get the shot after birth and then you don’t have to think about it anymore. It’s thought that the vitamin K from the shot is stored in the muscle and slowly released over time. That would explain how it helps prevent early, classical, and late VKDB.

Third, vitamin K from a shot is usually better absorbed than the oral version. Babies can’t spit it up and it goes directly into their bloodstream.

Cons of the Vitamin K Shot

Like all shots, the vitamin K shot at birth is painful for babies. It can also cause slight bruising at the site of the shot. 

One of the main concerns that parents have about the shot is what else it contains. All shots contain preservatives and other ingredients that can seem questionable. Generally, the amount of any ingredient in a shot is so tiny that it has almost no effect on the child.

That said, concerns about ingredients aren’t invalid. If you are worried about what the shot is putting into your baby’s body, you have another option: the oral version.

Pros and Cons of Vitamin K Drops

Vitamin K drops are more common in Europe than in the US, but some parents in the US choose this route for their children.

Pros of Vitamin K Drops

Of course, the first benefit of vitamin K drops is that they are effective. The risk of VKDB after full dosage over time of vitamin K drops is 0 to 0.9 infants per 100,000. Comparing this to the shot, the “relative risk” seems big – 0.9 is nearly twice 0.4 – but the “absolute risk” is still tiny – less than one.

As I mentioned above, one benefit of using drops instead of a shot is that they don’t contain the same preservatives or additives as shots. They do have added ingredients but the ingredient list is usually shorter and is all naturally-derived ingredients.

Another big positive of drops is that they don’t cause any pain.

Because they don’t cause pain or require a doctor to administer them, drops are also a gentler option for newborns in their first hours of life.

Cons of Vitamin K Drops

The biggest and most problematic downside to vitamin K drops is that parents or care providers have to remember to give each dosage on the appropriate days. If later amounts are forgotten, the vitamin K won’t be nearly as effective.

Similarly, babies can spit up the vitamin k drops which would also make them ineffective. This can be remedied by giving another dosage if the first is spit up.

Vitamin K drops are often not absorbed as well as the shot. They are better absorbed, however, when given during a feeding. 

Finally, in the US, vitamin K drops are not licensed or regulated as a recommended alternative, like they are in other countries.

Exclusive Breastfeeding and Vitamin K

Breastfeeding may seem totally unrelated to the subject of vitamin K, but it’s not.

Exclusive breastfeeding is the best form of nutrition for young babies. Interestingly, it is also a risk factor for VKDB.

Even if a mother has sufficient levels of vitamin K, very little of that vitamin K is transferred to her baby through breast milk. While this is normal, it does mean that exclusively breastfed babies have lower levels of vitamin K than formula-fed babies do. (Formula usually has vitamin K added.)

I bring this up only to make sure you are truly informed. You don’t need to be afraid that breastfeeding is somehow bad for your baby. Quite the opposite, actually. But now that you know, you won’t be afraid if someone brings this point up.

And it’s an additional reason to not decline vitamin K altogether but to choose either the shot or the drops.

Summary and Recommendation

The #1 thing I want you to understand after reading this blog post is that giving vitamin K is an important part of taking care of your newborn. Though vitamin K deficiency bleeding (VKDB) is rare, it can be dangerous so it is best if we parents do all we can to prevent it.

You can choose between the vitamin K shot and vitamin K drops for your baby. Both have benefits and both have risks.

In the US, it is common for care providers (and people online) to ignore the option of vitamin K drops because it is not a licensed form of vitamin K in this country. While that does present challenges (such as the possibility of inconsistent amounts of vitamin K), it does not make drops a bad or invalid option.

My Recommendation

I chose vitamin K drops with my first daughter. We set an alarm to remind us and were careful to give her the right amount every week. We felt like that was a good and safe option for her.

And that would be my recommendation to you. Unless you truly feel like you will be unable to give the drops consistently as needed, I recommend you choose drops over the shot.

That will allow for a much gentler transition for your baby to life outside the womb (especially if you also choose not to get the Hep B shot). It also avoids the possibility of putting unnatural ingredients into your baby’s body. 

That said, the vitamin K shot is still a good option. It will protect your baby and the pain will be momentary.

Both options reduce the risk of late VKDB to nearly zero. And at the same time, neither option is a guarantee. Even babies who have received the shot have developed VKDB.

So with this information, follow your gut, seek inspiration, and make the choice you feel is best for your baby.

Until next time,



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