A public health analyst recently contacted the Network for information about Oregon’s and other states’ statutes and codes addressing administration of vitamin K to newborns. According to the Centers for Disease Control and Prevention, infants who do not receive the vitamin K shot are 81 times more likely to develop Vitamin K Deficiency Bleeding (VKDB) than infants who do get the shot. VKDB can include life-threatening intracranial bleeding.
The Network provided the requestor with specific information on Oregon’s law regarding administration of vitamin K for newborns, and also provided an overview of laws in a few other states of note.
Oregon law requires administration of vitamin K to newborns within 24 hours of birth, by injection or orally. (See Or. Rev. Stat. §§ 433.303; 433.306(1)). The physician or midwife attending a mother at the birth of the child is responsible for ensuring the newborn receives vitamin K. (See Or. Rev. Stat. § 433.306(1)). The statute provides that administration of vitamin K may not be refused because of parents’ ability to pay (see Or. Rev. Stat. § 433.306(3)), and it allows for religious exemptions (see Or. Rev. Stat. § 433.306(2)).
Oregon’s regulations further prescribe appropriate forms and doses of vitamin K and provide procedures for obtaining a religious exemption. (See Or. Admin. Code § 333-021-0800). The regulations also clarify applicability of the requirement across practice settings and providers. (See Or. Admin. Code § 333-021-0800(4) (requiring administration of vitamin K by medical, osteopathic, naturopathic, and chiropractic physicians as well as by midwives); 333-520-0060(5) (requirements for hospital maternity services); 333-076-0670(17) (requirements for birthing centers); 332-025-0022(3)(d)(I) and (4) (practice standards for midwives).
Oregon law is fairly comprehensive compared to many other states. In addition, Oregon appears to be the only state with a broad statutory (rather than regulatory) provision requiring administration of vitamin K regardless of delivery setting or provider; however, some states have broad regulations or have relevant statutes more limited in scope.
New York regulations state that it is the duty of a physician, midwife, nurse, or other licensed medical professional attending a newborn to assure administration of a single intramuscular dose of vitamin K1 oxide within 6 hours of birth. (See 10 N.Y. Comp. Codes R. & Regs. tit. 10 § 12.3; access this provision from the table of contents.) In addition, within the regulations setting minimum standards for hospitals, administration of Vitamin K is included as a required element for immediate care of a newborn. (See N.Y. Comp. Codes R. & Regs. tit. 10 § 405.21 (e)(4)(v)(b)).
Illinois includes vitamin K requirements in hospital licensure requirements as well as in the regulatory code for birth centers. Specifically, administration of a single parenteral dose of vitamin K-1 shortly after birth, but usually within one hour of delivery, is included among the practices and procedures for care of mothers and infants required of all obstetric departments (see 77 Ill. Adm. Code 250.1830(g)(8)), and a similar requirement must be included among the written policies and procedures of a birth center (see 77 Ill. Adm. Code 265.1900(a)(3)).
Virginia hospital licensure regulations require adoption of policies and procedures for care of newborns, which shall include provision of a single parenteral dose of vitamin K-1 after delivery (see 12 Va. Admin. Code § 5-410-444(J); (K)(6)).
Massachusetts hospital licensure regulations state that each maternal and newborn service shall develop and implement policies and procedures for patient care, including vitamin K administration to newborns (see 105 Mass. Code Regs. 130.616(D)(12); access this provision from the table of contents).