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Our Birth Plan

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Our Newborn Care Decisions

A quick reference for our birth team & hospital staff

← Full Birth Plan
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Decision 1 · Vitamin K

Vitamin K Prophylaxis

✓ Our choice: ORAL Vitamin K drops — declining the injection

Why we chose this

We prefer the oral route and want to avoid the injection unless our baby is in a higher-risk category. We understand the trade-off and we are committing to the full multi-dose schedule, which is what makes oral protection work.

Evidence behind this

What we know (and accept)

  • Vitamin K prevents Vitamin K Deficiency Bleeding (VKDB). Late VKDB (weeks 3–8) is the dangerous form — more than half of cases involve bleeding in the brain.
  • The injection brings late-VKDB risk close to zero (about 0–0.4 per 100,000) in a single dose.
  • A fully completed 2 mg oral regimen is nearly as protective (about 0–0.9 per 100,000). But that only holds if every dose is given and absorbed — older 1 mg or incomplete regimens are clearly worse, and most oral "failures" happened when doses were missed. We accept this and have a reminder system in place.
  • A dose may not absorb if baby has an empty stomach or spits up shortly after — we will re-dose per our product's instructions if that happens.

Our oral dosing plan

Most evidence-based schedule (German/Swiss 2 mg regimen — both this and the Danish weekly option below get late-VKDB under 1 in 100,000):

Product:

DoseWhenDate givenDone
Dose 1 — 2 mgAt birth, with first feeding
Dose 2 — 2 mgDay 4–6
Dose 3 — 2 mgWeek 4–6

Danish weekly alternative: 2 mg at birth, then 1 mg every week for 3 months (good for exclusively breastfed babies). US reality check: there is no FDA-approved infant oral vitamin K in the US — available options are unregulated supplements with variable dosing, so confirm the exact product and schedule with our provider.

⚠ We WILL accept the injection if any of these apply

  • Baby is premature or low birth weight.
  • Any liver / gallbladder / cholestasis concern, or signs of malabsorption (e.g., chronic diarrhea).
  • Instrumental or traumatic delivery, bruising, or planned surgery (including circumcision).
  • Mom took warfarin or seizure medication in pregnancy (early-VKDB risk).
  • Baby is on repeated antibiotics or isn't feeding well enough to keep doses down.
  • We cannot reliably complete the full oral schedule.
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Decision 2 · Eye Prophylaxis

Erythromycin Eye Ointment

✓ Our choice: DECLINING — unless clinically indicated

Why we chose this

The ointment exists mainly to prevent gonococcal eye infection (ophthalmia neonatorum). It does not reliably prevent chlamydial or other bacterial eye infections, and the at-birth dose can briefly blur baby's vision during our first bonding hour. With a low-risk screening picture, declining is reasonable — the AAP itself stopped recommending universal use in 2018.

Evidence behind this

Our risk context

Mom's gonorrhea & chlamydia screening in pregnancy:   Date/notes:

If screening is negative, we are in a low-risk relationship, and we have fast access to care, the risk of declining is very low.

⚠ This becomes "obvious" — we WANT it (or treatment) if

  • Mom's STI screening was positive, incomplete, or unknown.
  • Prolonged rupture of membranes or any sign of maternal infection during labor.
  • Baby develops eye redness, swelling, or discharge — treat right away. (Note: an active infection needs systemic antibiotics, not just ointment.)
  • Any new exposure risk we're unsure about.

Heads-up for us

Some states mandate eye prophylaxis and may require a signed refusal/waiver. Ask our provider what's needed in our hospital ahead of time.

Honest facts at a glance

So we're making these calls with eyes open.

Not medical advice. This is a personal decision summary to discuss with our midwife/OB and pediatrician, grounded in Evidence Based Birth’s reviews on the vitamin K shot and erythromycin eye ointment. Guidance, products, and state laws change — confirm specifics (especially the exact oral vitamin K regimen and any required refusal forms) with our provider before the birth.