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Acad Pediatr. 2017 May - Jun;17(4):368-373. doi: 10.1016/j.acap.2016.10.012. Epub 2017 Mar 9.

Refusal of Vitamin K by Parents of Newborns: A Survey of the Better Outcomes Through Research for Newborns Network.

Author information

1
Department of Pediatrics, Yale University, New Haven, Conn. Electronic address: Jaspreet.Loyal@yale.edu.
2
Department of Pediatrics, University of Washington, Seattle.
3
Department of Pediatrics, Oregon Health & Science University, Portland.
4
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
5
Academic Pediatric Association, McClean, Va.
6
Department of Pediatrics, Yale University, New Haven, Conn.

Abstract

OBJECTIVE:

To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals.

METHODS:

An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries.

RESULTS:

Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K.

CONCLUSIONS:

Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness.

KEYWORDS:

BORN network; vitamin K refusal

PMID:
28277269
PMCID:
PMC5928503
DOI:
10.1016/j.acap.2016.10.012
[Indexed for MEDLINE]
Free PMC Article

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