Rates of life-threatening bleeding in U.S. infants have risen sharply since 2017 as parents increasingly refuse routine vitamin K injections, according to two major studies published on November 5, 2026. The findings, which appeared in JAMA and JAMA Pediatrics, provide the first large-scale evidence connecting declining vitamin K prophylaxis to a surge in preventable infant hemorrhages.
Vitamin Deficiency and Bleeding Cases Rise Amid Pediatric Recommendations
For over 60 years, the American Academy of Pediatrics has recommended a single intramuscular vitamin K dose at birth to prevent vitamin K deficiency bleeding (VKDB). Because newborns have poor placental transfer of the nutrient and low levels in breast milk, the shot is considered a cornerstone of neonatal care. The nutrient is essential for activating specialized proteins that allow for normal blood clotting.
During the same period, the rate of vitamin K deficiency increased by 216%, while cases of vitamin K-deficient bleeding rose by 347%. Of those diagnosed with these conditions, approximately 7% and 2% had intracranial or intracerebral hemorrhage, respectively.
A separate study of 5.2 million infants, led by Kristan Scott, MD, MSHP, of the Children’s Hospital of Philadelphia, found that the refusal rate doubled, rising from 3.1% in 2017 to 6.8% in 2025. Infants who did not receive the shot faced a 47% higher risk of bleeding within their first six months of life (288.0 vs 185.9 per 10,000; adjusted RR 1.47, 95% CI 1.43-1.51). In addition, these same babies experienced more than double the likelihood of intracranial hemorrhage (33.0 vs 13.2 per 10,000; adjusted RR 2.43, 95% CI 2.26-2.62) and mortality involving concurrent bleeding during their initial hospital stay after birth (2.9 vs 1.1 per 10,000; adjusted RR 2.69, 95% CI 2.09-3.47).
What we’re really worried about is serious life-threatening bleeding … And often, by the time we figure out that bleeding is happening, it’s really too late to stop the worst consequences of it.
Dr. David Hill, a hospitalist
Clinical Observations of Preventable Trauma
Dr. Thomas Patterson, an Idaho pediatrician, noted that prior to 2022, refusals were sporadic. Cathleen Ballance, M.D., MPH, a pediatric hospitalist and Vice Chair of Quality & Safety, noted the gravity of the shift, while Katharine Clouser, M.D., pediatric hospitalist and Vice Chair of Clinical Affairs at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, described the trend as a devastating but entirely preventable public health issue.
There has been a significant uptick for me … One day [this year], I had 10 babies and five of them went out of the hospital without vitamin K.
Dr. Thomas Patterson, a pediatrician
Steven Woolf, a professor of family medicine and population health at Virginia Commonwealth University who also co-authored the JAMA Pediatrics research, observed that such a rise in complications has not been seen for generations. The researchers also collaborated with Darya Shokouhi Niaki, Pharm.D., of the VCU School of Public Health’s Department of Biostatistics.
Experts stress that the vitamin K shot is not a vaccine, but a necessary supplement for blood clotting. Despite this, parental skepticism regarding newborn interventions has accelerated. Researchers noted that the peak of these bleeding events in 2025 coincided with eroding trust in public health following the COVID-19 pandemic and rising vaccine hesitancy. Because the U.S. Centers for Disease Control and Prevention (CDC) does not track rates of vitamin K refusals or bleeding, these studies provide critical, previously unavailable insights.
Risks of Intracranial Hemorrhage
The consequences of skipping the injection can be permanent. In the study published in JAMA, researchers documented that for infants who have late VKDB—occurring between 2 weeks and 6 months of age—about half experience brain bleeds, which can lead to permanent brain damage. Laura Kair, MD, MAS, of the University of California Davis School of Medicine, and her colleagues noted in an editorial that while the underlying causes for these trends remain uncertain, the increase in bleeding rates was significantly faster among those who did not receive the vitamin K.
Medical professionals emphasize that this is a straightforward, safe, and effective preventative measure. Jade A. Cobern, MD, MPH, a physician board-certified in pediatrics and general preventive medicine, highlighted that it is a simple pinprick that serves as a vital safeguard.
Following these findings, some lawmakers have called on the CDC to begin tracking vitamin K compliance and associated bleeding deaths to provide more transparent public health data. Parents concerned about these risks are encouraged to consult with their pediatricians or qualified medical professionals to discuss the benefits of vitamin K administration for their newborns and to address any questions regarding standard-of-care treatments.
Earlier coverage: Infant Dies in Wisconsin Measles Outbreak, First State Death Since 1990
