What is vitamin K?
Vitamin K is a group of fat-soluble compounds involved in blood clotting, bone metabolism and cardiovascular health.  Newborn babies have almost no vitamin K at birth since it does not cross the placenta efficiently and isn't produced until baby starts digesting food.
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What are the concerns about baby having low vitamin K?
Low vitamin K levels in babies can lead to vitamin K deficiency bleeding (VKDB). VKDB is a rare but serious bleeding disorder that can occur in infants within the first 6 months of life.  There are three types of VKDB.

• Early VKDB occurs within the first 24 hours of life and is usually caused by medications such as blood thinners the mother took during pregnancy. Early VKDB affects .025%  to 1.5%  of newborns.
• Classic VKDB occurs between days one to seven after birth and is typically characterized by bruising or bleeding from the umbilical site. Classic VKDB occurs in approximately 0.44% of newborns.
• Late VKDB is the most concerning type and occurs between two and 12 weeks of age. Late VKDB is often linked to high rates of infant deaths caused by internal bleeding. Late VKDB occurs in about 4 to 7 babies out of every 100,000 who do not receive any Vitamin K at birth.

Can I increase the amount of vitamin K my baby is born with by changing my diet or taking a vitamin K supplement?
In studies, researchers have found that the concentration of vitamin K in cord blood was significantly lower than the concentration in maternal blood, indicating that vitamin K does not cross the placenta efficiently. This result was the same whether Mom included vitamin K rich foods in her diet or took a vitamin K supplement. The evidence indicates maternal diet or supplementing with vitamin K in pregnancy doesn't increase vitamin K levels in newborns.
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Why are babies born with low vitamin K?
We don't know, but there is some indication that newborns may have a slightly different clotting mechanism than is found in adults. However, if a newborn does have bleeding or bruising, it is wise to be cautious and give them vitamin K.

What is the treatment for VKDB and how effective is it?
The recommended treatment for VKDB is to give the baby a vitamin K injection. When a a baby with VKDB receives a shot of vitamin K, this will usually slow or stop the bleeding within 20-30 minutes. However, if bleeding happens in the brain, the baby may already have brain damage by the time the shot is given.
The vitamin K injection is highly effective at preventing classical and late VKDB, and basically eliminates all cases of late VKDB. Most babies who have VKDB will recover, especially if they receive treatment quickly. 

What about giving baby oral vitamin K drops?
Oral vitamin K is effective in preventing VKDB, but it is not as effective as the injectable form. The 3-dose regimen of 2 mg oral vitamin K lowers the risk of classical and late VKDB to under 1 per 100,000, but is  still not as effective as the injection, which has incidence rates even closer to zero.

Do you require vitamin K for baby in your practice?
I trust my clients to make the best decision for their babies, and I will fully support whatever decision they make. If I see bruising or other issues that I think may merit getting a Vitamin K shot, I will share that with my clients.

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What is amniotic fluid?
Amniotic fluid is a water-like substance that surrounds and protects baby during pregnancy as baby grows inside the amniotic sac which is filled with amniotic fluid.

What is amniotic fluid comprised of?
The composition of amniotic fluid changes from early to late gestation. In the first weeks of pregnancy, amniotic fluid comes from both baby and mom and includes water, maternal fluids, and fluid from the amniotic cavity. Around 20 weeks, amniotic fluid is largely produced by baby's urine and lung secretions.​

What does amniotic fluid do?

• ​ Amniotic fluid helps to protect baby from injury by providing cushioning  from bumps and jolts. 
• Amniotic fluid helps to prevent the umbilical cord from getting compressed, which could cut off baby's oxygen supply.
• Baby practices breathing and swallowing amniotic fluid. This helps to develop the lungs and digestive system.
• Amniotic fluid helps to regulate baby's body temperature by keeping it at a constant level.
•  Amniotic fluid contains antibodies that help to protect baby from infection.

What is oligohydramnios and polyhadramnios?
Oligohydramnios is too little amniotic fluid. Polyhydramnios is too much amniotic fluid.  Both of these situations can lead to complications for Mom and baby. As a midwife I evaluate how much amniotic fluid is in the amniotic sac everytime I palpate baby.  If I have questions or concerns, I will recommend an ultrasound to assess just how much amniotic fluid there is.

What about meconium in amniotic fluid?
​Meconium is the first bowel movement of a newborn baby, and it is normally passed after birth. However, if a baby passes meconium before birth, it can be a sign of fetal distress. Meconium can cause problems if the baby breathes it in, which can lead to a condition called Meconium Aspiration Syndrome. Meconium Aspiration Syndrome can cause breathing problems, pneumonia, and other serious health problems.  Meconium Aspiration Syndrome is pretty uncommon. Data shows 15% to 27% of term and post term babies have meconium in the amniotic fluid.  Of those babies, Meconium Aspiration Syndrome occurs 2% to 10% 

Fun facts about amniotic fluid:

• Amniotic fluid has a pH of 7 to 7.5
• Amniotic fluid appears around 12 days or pregnancy when the amniotic sac forms