The terrifying result of refusing newborn Vitamin K

Olive 1

I’ve written in the past that bitter grief is often an unselfish motivator:

Consider organizations like Mothers Against Drunk Driving, started by parents who suffered the ultimate loss, to ensure that other parents would not have to endure the death of a child. Consider the various laws named after children who were abducted and murdered, championed by parents who wanted to make sure that no other family’s life would be shattered by crushing grief…

Where is the organization to ensure that no other mother has to endure the preventable death of a child at homebirth or because the mother refused recommended obstetric or newborn care guideline?

There is no such organization.

Why? Because the mothers who have a child who was injured or died as a result of homebirth or of refusal of routine interventions often collude with the providers who encouraged them.

Thankfully, that is not the case for Stefani Leavitt. She has unselfishly shared the story of the terrifying result of failing to give the recommended Vitamin K injection to her newborn daughter.

You can read the entire story across three blog posts:

The First 24 Hours
Getting Out of the Woods
Why It Happened: The Truth About Vitamin K Deficiency Bleeding

Leavitt has the inner strength to be brutally honest, even with herself:

This may be the hardest part of Olive’s story that I will write. The part where I admit that what happened to her was nearly 100% preventable. And yet it happened.

It happened because she didn’t receive her dose of Vitamin K when she was born.

I spent the first few days that she was in the hospital blaming myself. I ran through the situation in my mind, trying to understand why I would say “No” to something that would keep my daughter from being in this much pain. In Olive’s situation, unfortunately, it was largely accidental. That didn’t stop me from feeling guilty, however, and only recently did I accept that although this happened to Olive, it doesn’t have to happen to another person’s baby.

What happened to Olive?

It all started on Valentine’s Day.

Olive had struggled to eat the night before, so she and I had been up all night…

When we woke up [from a nap], Olive could barely open her eyes – the only word I could think of was “lethargic,” and since that never coincides with anything good, I immediately called the doctor… The doctor told us to go to the ER immediately …

At the hospital:

By this point, Olive was breathing and her heart was beating, but she was otherwise non-responsive…

The pediatric intensivist, Dr. M., came and asked me if we had given our daughter a Vitamin K shot at birth, and I just stared at him and said I had no idea. He said they needed to bring her in for a CT scan, but every time they tried to place an IV (which she needed before she went for the scan), the vein would blow. She was bleeding from every spot that she had gotten poked that night, including the LP point on her spine.

Finally they were able to perform the head CT.

The next thing I knew I was sitting in a room with Eric and our Bishop from church, and seeing the doctor wheel in a computer with pictures on the screen… Just by looking, you could tell it wasn’t good. Where the left side of her brain was supposed to be, there was a huge (16 mm, to be exact) mass of blood, pushing her entire brain off center.

Dr. M. explain that a clot had developed which was placing immense pressure on Olive’s brain. Not only that, but there was bleeding on the back of the right side of her brain as well. The water pockets that are within the brain were completely destroyed, and the tissue on the left side of the brain looked mostly damaged. He said that the lack of Vitamin K in Olive’s system resulted in her body’s inability to clot. Anything as small as putting her down in her bed could have caused this bleed. Since she couldn’t clot, the bleeding didn’t stop. There had been one other case of this that the doctor had seen – I asked what had happened then, and was told that the baby hadn’t lived.

The treatment? Correcting her clotting deficiency with Vitamin K and brain surgery to remove the blood clot.

After the brain surgery:

I walked into the hospital room to find Olive hooked up to a plethora of machines, with even more wires running from her. She had a gauze turban around her swollen head, and a breathing tube running from her throat. As hard as it was to see her like that, I was full of so much gratitude that she was alive and I was comforted by the sudden knowledge I had that she was going to be okay – I just didn’t know how.

The surgery had been successful:

Where there was once a huge mass of blood, her brain had moved back into place. The neurologist who spoke with us, Dr. R., explained that there had been a significant stroke on the left side of her brain, but it was on the surface, rather than in the central gray matter. On the right side, there was a pocket of blood in the cerebellum, but this was expected to absorb into the brain. Overall, Dr. R. said that he felt “cautiously optimistic.” ..

The next days were marked by milestones, which all seemed like little miracles.

Towards the end of the third day, Olive was taken off of sedation and opened her eyes for the first time in days.

From the blog C'est Si Bon

From the blog C’est Si Bon

Olive continued to improve.

From the blog C'est Si Bon.

From the blog C’est Si Bon.

Overall, Olive’s progress has been remarkable.

Olive is nothing short of a miracle. After seeing her condition the first night and seeing her now, only two weeks later, I am still in a state of disbelief. Countless doctors and nurses told me what amazing progress she was making. She took to nursing again like a champ. She is moving both sides of her body, with very little difference in strength. And since her surgery, we have all been able to see her beautiful smile.

There will still be struggles from here, I’m sure. We are uncertain of what Olive’s future will bring, or what challenges this brain injury will cause. But despite all of that, I am so grateful for the blessing that she has been to our life thus far …

But none of this had to happen at all. Stefani writes:

… [T]he Vitamin K shot should not be optional.

When a baby is born, they have a limited amount of Vitamin K in their system, and while some begin to produce it on their own, others struggle with a severe Vitamin K deficiency. If these babies receive a shot of Vitamin K at birth, this isn’t a problem and they will eventually begin to produce the Vitamin K on their own in order to avoid any deficiency bleeding. In a case like Olive’s, however, the severe lack of Vitamin K results in an inability to clot, which can cause deadly bleeds in a baby’s brain and gastrointestinal system.

In children that receive the Vitamin K shot at birth, the chance of developing this disease is relatively nonexistent. When the shot is not given, however, the risk of having late stage (from 2 weeks to 2 months old) deficiency bleeding is 81 times greater.

The sad thing is that while it is extremely rare, recent years have seen children suffering from VKBD more and more often. Four cases were reported at a hospital in Tennessee in 2013 – one resulted in severe gastrointestinal bleeding and the other three in severe intracranial bleeding. In the hospital where Olive was treated, there was one other recent, which resulted in the child’s death.

Stefani speaks from experience:

I can’t change what happened to Olive, but I can try to prevent it from happening to another baby.

Please share Olive’s story. Please tell the mothers you know about the importance of Vitamin K. Please let them know that the risks of rejecting the shot may not be as rare as they think.

Kudos to Stefani for turning her family’s pain into vital advice for other families. She will never know how many lives she may have saved.

304 Responses to “The terrifying result of refusing newborn Vitamin K”

  1. Yvette
    August 24, 2015 at 3:21 am #

    “In children that receive the Vitamin K shot at birth, the chance of
    developing this disease is relatively nonexistent. When the shot is not
    given, however, the risk of having late stage (from 2 weeks to 2 months
    old) deficiency bleeding is 81 times greater”…
    This risk information is not at all helpful without estimates of the absolute rates of deficiency bleeding…’81 times’ an ‘amost non-existent’ risk isn’t much of a risk at all, even though it sounds like a serious increase when presented in relative terms as done here. These kinds of biases in risk communication not only cause unhelpful mistrust once uncovered, but ultimately leave the less critical or scientifically-untrained lay person uninformed for making a quality healthcare decision.

  2. Ash
    August 18, 2014 at 1:39 pm #

    Gosai, S., Broadbent, R. S., Barker, D. P., Jackson, P. M. and Wheeler,
    B. J. (2014), Medical and midwifery attitudes towards vitamin K
    prophylaxis in New Zealand neonates. Journal of Paediatrics and Child
    Health, 50: 536–539. doi: 10.1111/jpc.12490

    Physicians and midwives in New Zealand were invited to participate in this survey. In total, 189 doctors and midwives were approached, with 107 responses received, giving an overall response rate of 56.6%: doctors 87.2% (41/47) and midwives 46.5% (66/142)

    Participants were asked how important it was that
    infants receive a dose of vitamin K: 100% (41/41) of doctors and 71.0%
    (44/62) of midwives thought it was very important or important, while
    29.0% (18/62) of midwives were neutral. When asked which babies should receive vitamin K prophylaxis, 100% (41/41) of doctors and 54.7% (35/64)of midwives said that all babies should receive it. Of the remaining midwives, 45.3% (29/64) said that only babies ‘at risk’ should receive prophylaxis, with common clarifying comments being prematurity,
    instrumental/surgical delivery and bleeding disorder.

    When asked ‘If you were to have a child/another child, would you give
    vitamin K to your baby?’, 100% (40/40) of doctors and 74.2% (46/62) of
    midwives would. The remaining 25.8% (16/62) of midwives would not give vitamin K or were unsure.

    • Young CC Prof
      August 18, 2014 at 1:54 pm #

      That’s pretty scary.

      Midwives are supposed to help women and babies, and the real ones need to strike back against this nonsense.

    • Theoneandonly
      October 10, 2014 at 4:11 pm #

      I just had dinner with my SIL and BIL last night – they have a week old newborn.
      They didn’t get Vitamin K for her – their midwife didn’t get it for any if her own children, and said pretty much exactly above, that because it was a straightforward, non instrument birth, and is a ‘low risk’ for bleeding disorders that they don’t need to get it.
      These are 2 highly educated loving parents, and they have taken this midwifes word without question. I am so angry that NZ midwives are allowed to let personal preference dictate the medical advice given to new parents – and that our system puts them in such a position of power with no checks that they are actually giving informed consent.

  3. Box of Salt
    April 4, 2014 at 8:47 pm #

    I came across this very information article written by a pediatrician through a post on another website, and I am crossposting here on the most recent posts:

    I hope anyone who lands here to argue reads and thinks about it.

    • Box of Salt
      April 4, 2014 at 8:49 pm #

      Since the whole link does not show up, the title of the article is
      “Playing Newborn Intracranial Roulette: Parental Refusal of Vitamin K Injection”
      Apologies for the typo: information should read informative

  4. onandoff
    March 18, 2014 at 11:43 pm #

    MDC takes on vitamin K.

  5. Laura
    March 16, 2014 at 8:14 pm #

    I just copy and pasted Olive’s picture and part of her story for information for my nursing school classmates about vitamin K. I am a credentialed teacher who has gone back to nursing school and I will always have a passion for education. So, her story and her picture have at least educated 10 nursing students who are currently doing their rotations in labor and delivery, maternity and the newborn nursing. AND giving vit k shots, without a doubt. Thank you to Olive’s mom for posting her picture and this story because in a small way it is educating in future nurses and parents.

    • guest
      March 17, 2014 at 9:45 am #

      Do Judah too! (link in the comment just below this). And they can see what happens when the outcome isn’t as good at Olive’s.

  6. guest
    March 15, 2014 at 1:21 pm #

    Very much on topic: I read Olive’s mom’s blog and then the comments underneath. I see a comment from an anti-Vitamin K person, linked to a Healthy Home Economist article encouraging moms to skip the Vitamin K shot. I read those comments. In all of that there is a link to ANOTHER blog post on forgiveness from ANOTHER mom, written March 14, and apparently inspired by Olive’s mom.
    She had a lovely home birth in Florida in 2011, declined Vitamin K from her midwife as she had for her first five children. Five weeks later, her infant was having seizures from two brain bleeds. She says some doctors have told her it was the absence of Vitamin K, but others say there’s no way to know. She has spent a great deal of time in self recrimination, trying to reassure herself that she made her decision out of love. And this is the thing – all these people who spew medical advice without a license seem so smug about it. And don’t seem to realize that there are real consequences to real people who love their children above all.

    • OBPI Mama
      March 15, 2014 at 10:22 pm #

      Ugh… healthy home economist. I scrolled through her blog posts and I want to go throw up now. I sympathize with Judah’s mom and told her that… we can become so led astray by people who are so convincing and who tell us things we want to hear! It all “makes sense” when we don’t understand the science (or try not to or believe it’s all a conspiracy). Hindsight makes us want to go slap ourselves. Sigh. And all we want to do is help prevent others from making the same decisions, but it seems futile sometimes… not one of my friends has chosen hospital birth since my son’s story and a few others we all know who had tragic outcomes. Will they change their minds about Vit. K??? I doubt it as well. Maybe more middle of the road people would?

  7. Ash
    March 13, 2014 at 11:15 am #

    OT: Someone on Jezebel said that in order to use the Birthing Center at Mt Sinai/St Lukes Hospital (NYC), one has to take mandatory “Introduction to the Birthing Center’ and “Early Discharge from the Birthing Center” that costs $400 total. The birthing center is separate from the “regular” L&D suites which don’t require this charge. $400 extra and no epidural anesthesia is available in the birthing center? Blah. I guess the nice thing about the L&D wards in my city is that they all have private rooms.

    • LMS1953
      March 13, 2014 at 11:42 am #

      Is that scam charge covered by NY state Medicaid.? Or are birthing centers in NYC just for the elite?

      • Ash
        March 13, 2014 at 12:00 pm #

        NY elite, the hoi polloi who don’t pay $400 out of pocket for the classes are not allowed to use the birthing center.

        • LMS1953
          March 13, 2014 at 12:09 pm #

          Massa sez dem folks gots ta go through the kitchen do’.

          • March 13, 2014 at 12:52 pm #

            Risky joke. Funny though 🙂

    • LMS1953
      March 13, 2014 at 12:29 pm #

      Is the Birthing Center off campus or is it nearby the L&D unit? There is a good chance this discrimination could be considered Medicaid fraud depending on what billing numbers are used. But better New Yorkers spend their time protesting the Koch brothers donating $100 million for a Women’s Hospital than confront rank elitism.

      • Ash
        March 13, 2014 at 12:43 pm #

        It is on campus…seems like it’s one floor away from the L&D unit.

        • LMS1953
          March 13, 2014 at 12:59 pm #

          Shortly after WWII, a mechanism called Hill-Burton funding became available. Communities would get funding for a hospital in exchange for providing for “indigent care”. When health care costs skyrocketed circa 1980’s, the indigent care burden caused many Hill-Burton hospitals to declare bankruptcy. Anyway, the blueprints were very cookie cutter. If you remember that peculiar green colored tile on the walls of an old hospital, that was likely a Hill-Burton hospital. They had two sets of blueprints, one for the North and one for the South. In the South, there were mirrored wards for racial segregation. Nowadays a similar accommodation is made for social status.

    • The Computer Ate My Nym
      March 13, 2014 at 1:24 pm #

      I delivered in St Luke’s and started in the birthing center. I remember a rather pointless class in non-pharmacologic pain relief being required, but it didn’t cost anything. I guess things change in 10 years…

    • Lena
      March 13, 2014 at 3:26 pm #

      Eh, I’m a big fan of (legally!) parting rich fools from their money, and since the vast majority of people who go for these types of birthing centers have more money than sense, I’m totally cool with this.

      • LMS1953
        March 13, 2014 at 4:12 pm #

        You really need to read the articles. To accommodate one on one nursing for the concierge clients they had to pull a nurse from steerage. That left one nurse with EIGHTEEN BABIES. They are contracted to be no more than 1:7. The nurses may well go out on strike over this. One medical resident had to stay in the ER for THREE DAYS with herniated discs until an attending intervened on her behalf to get her a room. The fancy rooms are very large and square footage is at a premium on Manhattan. They could easily quadruple the occupancy with the space used for luxury suites.

        There was also a great observation made by a doctor. He gets stuck with Medicare rates (say $1200 for a hysterectomy for uterine cancer) while Mrs Gotrocks pays $1600 out of pocket without blinking an eye for each night in a luxury suite. I think if a patient opts out of Medicare coverage for her room charges, then she has means tested herself out of the program and she can pay the doctors top dollar for their services too.

  8. LMS1953
    March 13, 2014 at 9:57 am #

    As regards the NY Times “All the propaganda that is fit to print” blog cited earlier:

    Delivery at 37 or 38 weeks was widely considered benign — but it is not. Infant mortality is at least 50 percent higher for babies at 37 or 38 weeks than at 39 or 40 (at 41 weeks the rate rises again). These babies are also more likely to suffer breathing, feeding and developmental problems.

    Citation please. Again, is it infant mortality or newborn mortality? Let me see if I’ve gotten this straight. A purported 50% increase in “infant death rate” due to “elective” deliveries before 39w0d causes several states to deny payment for the delivery. With no evidence of safety, crunchy states have legislated that the services of CPMs be covered by Medicaid and private insurance. When irrefutable statistical analysis shows that home birth with a CPM has a FOUR HUNDRED AND FIFTY PERCENT increase in the newborn death rate what do we hear from these state legislatures and the NY Pravda/Times ………….crickets chirping.

    • The Bofa on the Sofa
      March 13, 2014 at 9:58 am #

      Yep, where are the “the absolute risk is low” crowd in response to that?

      BTW, how does the mortality rate at 42 weeks compare?

      • LMS1953
        March 13, 2014 at 10:20 am #

        Indeed. Actually, I would be willing to bet that the stillbirth + newborn death rate for 41w0d to 41w6d is AT LEAST 50% higher than the rate for 38w0d to 38w6d.

    • Young CC Prof
      March 13, 2014 at 10:13 am #

      I might actually believe 50% higher infant mortality, but only if the people doing the study are idiots who didn’t control for, well, anything.

      Race and therefore socioeconomic status, for example: Black women tend to deliver earlier, and they have a LOT of spontaneous 37-38 week babies. Also, if the early delivery was due to an induction or prelabor section, did the authors properly control for the reason the early delivery was done? (Like my cousin who was induced at 38 weeks so her baby could be born with a neonatal heart surgeon standing by?)

      I’d want to see a significant increase in early neonatal mortality NOT related to congenital defects or external causes, preferably among spontaneous births only, before I decided 37 week deliveries kill.

    • Karma Kidney Stone
      March 13, 2014 at 11:38 am #

      The increase in neonatal mortality for late preterm babies is basically negligible. I believe the CDC has pretty good charts showing the neonatal death rates and gestational age.

      • LMS1953
        March 13, 2014 at 11:51 am #

        Exactly – which is why I think the author of the NY Pravda article picked the 50% figure out of her caudal vault – especially as it might pertain to elective 38w0d to 38w6d deliveries

    • LMS1953
      March 13, 2014 at 12:19 pm #

      The article said something about the millions upon millions of dollars being saved from NICU admits of 37w0d-38w6d elective deliveries that are no longer allowed. So, what is the rate of NICU admission from planned home birth? I bet it dwarfs that of the other cohort. I know the risk of a 5 minute APGAR is 12 fold higher with HB – which would be a strong indication for an NICU admit if the CPM would recognize that. So, if cost savings are the goal, why does the state not also refuse Medicaid payment for HM?

      • rh1985
        March 14, 2014 at 2:04 pm #

        I wish I could have just scheduled my elective CS for 38 weeks instead of having an emergency one at 39w0d for pre-eclampsia which resulted in me having to be on the magnesium sulfate drip the first night (that medicine is nasty stuff) after throwing up almost everything I ate the last couple of days I was pregnant.

        And it probably would have been cheaper too. My baby was fully developed when delivered and I don’t think a few days earlier would have meant she wasn’t.

        • Amelia Turnage Presnall
          July 10, 2014 at 8:29 pm #

          I wish I could have had scheduled c-sections too. I also had emergencies. And magnesium recovery. Blood. Platelets. Lasix. Being threatened with a cvl by the anesthesiologist if he couldn’t find another vein, while BEATING the back of my hand. My eldest child was born at 30w0d due to severe HELLP Syndrome. I didn’t meet him until he was 48 hours old. Because the wonderful labor staff & my ob were trying to keep me alive and out of the ICU. They were successful. Today, I have a 6 foot tall 15 year old that most commonly utters something to the effect of being hungry. Again?!?! We went on to have 2 more c-sections also due to pre-eclampsia/HELLP Syndrome. Not nearly as dramatic. But still emergent. I am 1000% grateful for modern obstetrics. I would have died 150 years ago.

  9. Mel
    March 13, 2014 at 8:47 am #

    Did anyone else notice that when Olive’s mom wanted to transfer to the hospital for pain management the mdwife said that it would take TWO HOURS for transfer and medication to occur?

    I’m strangely relieved that Olive’s health problems started in the postpartum period since a labor emergency would have killed her.

    • Ash
      March 13, 2014 at 9:03 am #

      And yet ” I loved the experience that I had there and to this day, I hold no hard
      feelings against the wonderful midwives that were present when she was
      born.” Had I been in this situation, I would have been PISSED, and not calling the midwives “wonderful”

      • Guesteleh
        March 13, 2014 at 1:07 pm #

        She may get angry once she’s had time to process what happened. Also, I hate to be a downer, but it’s too soon to know how this will affect her baby. There could be learning delays down the road that aren’t apparent yet.

    • LMS1953
      March 13, 2014 at 9:04 am #

      I suppose that the calculus was 10 to 20 minutes for ambulance transfer to the hospital. Then 20 minutes to get put into the EMR and get labels and ID tags and sign all the permits. Then 30 minutes to get the blood drawn for CBC, platelets, PT,PTT and have the results come back. Then 10 minutes to track down the anesthesiologist/CRNA and then 20 minutes to place the epidural, inject it and have it take effect. Patients should be INFORMED of that institutional inertia as relates to birthing center – hospital transfer for pain management and many patients may reasonably choose the hospital, especially if they also realize they and their babies will be kicked out 5 hours post partum even if it is the middle of the night and mom is woozy from hypovolemia,

      • Trixie
        March 13, 2014 at 9:18 am #

        If you choose the rare accredited birth center whose CNMs have hospital privileges and electronic patient records integrated into the hospital’s system, it probably speeds it up a bit. But that’s rare.

        • The Bofa on the Sofa
          March 13, 2014 at 9:46 am #

          The first thing that is required for efficient transfer is going to be a preadmission. Get all of that hassle out of the way.

          Our hospital always had us do preadmission paperwork so that if we came in in labor, it would be a quick trip to L&D. “Here’s your bracelet – GO!”

          If a BC were to tell me that they were affiliated with a hospital, I would be expecting this. OK, that means that if we go to the hospital, I slide right in, right? Without having to go through a full admission process?

          If not, then what’s the point? How is it different from showing up at the door on my own?

        • LMS1953
          March 13, 2014 at 12:45 pm #

          Do Birthing Centers fall under EMTALA law? That law requires communication between facilities before a transfer can be arranged. Provider has to call an accepting provider. Unit director/administrator has to call the accepting director/administrator. Then you have to fill out an attestation that an ambulance is needed. I have had all that bureaucracy take up to an hour from first phone call to the ambulance leaving. And EMTALA violations can come with a significant fine.

          • Trixie
            March 13, 2014 at 1:34 pm #

            The accredited birth center that I’m thinking of has a transport agreement in place with the hospital a few blocks away. For example in an emergency they will send a resuscitation team in an ambulance from the hospital. The CNMs have the ability to admit patients, and the hospital OB group is, like for real, their backup, and supervises their cases at regular meetings. Beyond that I’m not sure of the administrative specifics, but I know that admission is streamlined quite a bit.

      • The Computer Ate My Nym
        March 13, 2014 at 9:35 am #

        So much for “the hospital’s only 10 minutes away if anything happens.”

        • yugaya
          March 13, 2014 at 7:57 pm #

          I am starting to believe that in America everyone lives ten minutes from a hospital. 🙂

      • guest
        March 13, 2014 at 12:03 pm #

        If she really did give birth at Spokane Birth Center, my google maps says it is 2.9 minutes/7 miles to get to Sacred Heart, which is the best hospital in town. (That would have to be with no traffic, though, since it is straight through downtown). If she went the other direction, to Holy Family, that’s 2.1 miles/six minutes. I am willing to bet that two hours is not what they told the parents when they asked what wold happen if they transferred. And I’ll bet two hours is not what the parents told their skeptical friends and family.

        • The Bofa on the Sofa
          March 13, 2014 at 12:18 pm #

          2.9 minutes/7 miles

          Like, by helicopter!!!!! 🙂

  10. SuperGDZ
    March 13, 2014 at 4:24 am #

    “A few weeks before her birth, we went over the routine shots that infants are given in the hospital, and decided whether or not Olive would receive them. For most of these I knew my answer, but since I knew nothing about the Vitamin K shot, I decided to do my research and then decide at the birth what I would do.”

    But why? Why the need to research yourself what has obviously already been researched by people with actual qualifications? It’s appalling that birth centres and midwives (and vitamin salesmen, and naturopaths, and, and, and…) have succeeded in creating a lucrative little niche for themselves by engineering mistrust in “conventional” medicine.

    • LMS1953
      March 13, 2014 at 8:48 am #

      GDZ, you make a terrific point. HIV used to be regulated by states as “opt-in” or “opt-out”. Opt-in states require that a specific consent be signed before the HIV test can be obtained. The CDC conducted research and EVIDENCE BASED MEDICINE showed that the opt-out approach is much better – at last count I think 44 states are opt-out. In practice, that means that a provider can obtain the standard tests without a belabored consent. It is probably a good idea to provide the patient a list but the onus is on her to specifically request that the HIV test not be done. (I have never had a patient refuse it). The same with routine newborn care that is typically required by STATE LAW. The patient should be provided with a list of what is done WITHOUT the CNM/CPM editorializing her opinion “you don’t want your baby to get that awful Vit K shot do you? You are eating plenty of kale, aren’t you? That shot is just for babies who are at risk of being dropped or are being formula fed by negligent mothers. So, think about it, do your research and you can sign the refusal required by state law when you come in to the birthing center”.

      • LisaJ
        March 13, 2014 at 9:10 am #

        Funny thing is, formula would have prevented the problem. It’s breast milk that’s deficient in Vitamin K. Yes, breast milk, that liquid gold that is “designed” for your baby.

        • Trixie
          March 13, 2014 at 9:15 am #

          Correct me if I’m wrong, but I was under the impression that while breastfed babies are more likely to develop this problem, formula doesn’t exactly prevent it, because the amount of vitamin K in formula isn’t all that huge, and newborns don’t absorb it orally all that well.

          • The Bofa on the Sofa
            March 13, 2014 at 9:48 am #

            If breastfed babies are more likely to develop the problem, then how is formula not preventing it?

          • Young CC Prof
            March 13, 2014 at 9:52 am #

            Well, the shot reduces HDN from like 1.7% to super-rare. I would imagine formula-feeding cuts the risk somewhat, but nowhere near as far.

          • The Bofa on the Sofa
            March 13, 2014 at 9:57 am #

            OK, so “prevent it” in a absolute sense? I just put it in comparison, compared to breastfeeding, formula is preventative. Sure, it’s not as good of a preventative as the shot, I agree.

            Tripped up by my probabilistic world view, where there are no absolutes, just degrees along the continuum…

            (IOW, it’s not “Does it prevent HDN?” but “How well does it prevent HDN?”)

          • SNM1
            March 13, 2014 at 3:56 pm #

            Studies have been done on oral vitamin k as opposed to the injections and they found that oral is poorly absorbed and therefore does not prevent bleeding. Given this knowledge I wouldn’t think that the vitamin K in formula would decrease risk because of poor oral absorption so I don’t think you would see much, if any, difference if you were to study incidences of hemorrhage in breastfed vs formula fed newborns who hadn’t received the injection. I can somewhat understand the hesitancy to give the hep B injection to a newborn (and given the relative immaturity of their immune systems I wonder about the actual benefit of doing it right after birth over waiting a month or two if they are born to a mother without Hep B) but have never understood those who choose not to give Vitamin K given that there is very little risk of harm and lots of proof that it decreases risk of hemorrhage.

          • SNM1
            March 13, 2014 at 3:57 pm #

            Would not decrease risks not would! Sorry for the error!!

          • Trixie
            March 13, 2014 at 1:38 pm #

            Yeah, poorly phrased on my part, but my point was that formula alone is not considered prophylactic treatment for vitamin K deficiency. Both FF and BF babies need the shot.

  11. Monique Davis
    March 13, 2014 at 12:57 am #

    Ponders why Olive is such an adorable name, but not Apple, Pecan, or Tomatillo.

    • realitycheque
      March 13, 2014 at 7:53 am #

      Pistachio and Turnip just don’t quite have the same appeal.

      I love the name Olive because it reminds me of Abigail Breslin in Little Miss Sunshine.

      • March 13, 2014 at 9:38 am #

        Makes me think of Olive Oyl, but hey, different strokes…

      • LMS1953
        March 13, 2014 at 10:06 am #

        Chive, Leek and Chili would be good boys names. Capers would make a good middle name, Pimento not so much.

        • Laura
          March 13, 2014 at 11:17 am #

          I actually think Pimento has a nice ring to it!

      • Laura
        March 13, 2014 at 11:16 am #

        Hilarious! Your screen name aptly fits you! (And loved Little Miss Sunshine, too.)

  12. Lisa from NY
    March 13, 2014 at 12:09 am #

    OT: Can you drink diet soda when you are pregnant? Does it destroy the baby’s brain?

    • realitycheque
      March 13, 2014 at 7:54 am #

      Why would it? Is someone claiming this? Is their reasoning something along the lines of “chemicals are bad (but only the ones that sound science-y)”.

      • The Bofa on the Sofa
        March 13, 2014 at 9:53 am #

        aspartame is bad…

        Too much caffeine is probably not a good idea, but compared to something like coffee, Coke doesn’t have a lot. Two liters of Diet Coke vs say two Starbucks coffees? Of course, 2 L is a lot.

        • corax
          March 13, 2014 at 4:32 pm #

          Bofa, are you a chemistry professor? Or am I confusing you with some other fast little article?

          I would like to know why you say aspartame is bad – I have migraine and on the few occasions I’ve consumed aspartame, I’ve gotten a fierce headache, but I’ve been told that it’s all in my head …

          • March 13, 2014 at 9:24 pm #

            Hah! All in your head (ache)

    • yentavegan
      March 13, 2014 at 8:02 am #

      Heroine is off limits. Diet soda is not heroine. It lacks nutrition but seriously, …

      • fiftyfifty1
        March 13, 2014 at 8:47 am #

        Heroin is actually not that bad during pregnancy. Your baby will be born needing to be withdrawn, but it doesn’t cause birth defects.

        • Guesteleh
          March 13, 2014 at 1:09 pm #

          Most people don’t realize that alcohol is far worse for fetuses than either cocaine or heroin. A friend of mine adopted a meth baby whose grown up fine with no delays or behavioral issues.

    • Amy M
      March 13, 2014 at 8:04 am #

      It might if you injected it intra-cranially.

    • Houston Mom
      March 13, 2014 at 8:22 am #

      Anecdote: I had occasional diet sodas while pregnant. My son is a happy, healthy 22 month old. He’s already telling lies which supposedly is a sign of advanced cognitive skills in a toddler.

    • anh
      March 13, 2014 at 8:50 am #

      my child is comprised of 50% diet coke and 50% lamb gyros. #fact

  13. Lynn
    March 12, 2014 at 9:51 pm #

    What a beautiful baby.

  14. yentavegan
    March 12, 2014 at 9:15 pm #

    I am in awe of Olivia’s mom for bravely sharing her story. What I honed in on though was the reality of the substandard care given to a mom and newborn in a free standing birth center.

  15. Jen
    March 12, 2014 at 7:50 pm #

    I know I’ve posted about this in the past but I think it’s worth repeating. Right now, I’m hanging out with my 5-year-old son who is alive for three reasons 1) the Vitamin K shot given at birth that protected him from the risk of a late VKDB caused by biliary atresia diagnosed 9 weeks after his birth 2) his Kasai portoenterostomy that gave him decent bile drainage for a few years and 3) his liver transplant. He’s a freaking miracle of modern medicine. Yay science!

  16. Captain Obvious
    March 12, 2014 at 7:09 pm #

    Heck, I am just going to eat more healthy foods at term. And I am sure I can avoid that shot as long as my birth isn’t too traumatic. Because i researched the internet about such things so i can tell which babies might have an issue with vitamin K deficiency. Besides, God made infants vitamin K deficient, there must be a reason 😉

    • Jessica S.
      March 12, 2014 at 7:15 pm #

      Maybe if I eat lots of Special K cereal? That sounds like it makes sense!

      • March 12, 2014 at 7:17 pm #

        Once again…

        • prolifefeminist
          March 12, 2014 at 8:20 pm #

          COLON BLOW!!!!!

          One of my favorites EVER (right up there with “Oops, I crapped my pants”…which is…rather fitting).

          • March 13, 2014 at 1:05 pm #

            Don’t forget the Woomba! And Mom Jeans! Really, I wish we could get Tina Fey, Amy Pohler and Maya Rudolph to speak out about CPMS. They’ve already done some great parodies…
   (link won’t work on mobile)

      • The Bofa on the Sofa
        March 12, 2014 at 8:06 pm #

        And listen to a lot of Louis CK

        Special K, Vitamin K, Louis CK, what’s the difference?

      • Durango
        March 12, 2014 at 11:42 pm #

        I’m going to eat a lot of bananas (potassium = k). I had a nursing student-to-be tell me that potassium was vitamin K. Eek!

        • The Bofa on the Sofa
          March 13, 2014 at 7:38 am #

          She didn’t quite remember her chemistry class right.

    • Lisa from NY
      March 13, 2014 at 12:03 am #

      It’s because the mother didn’t think positive.

      (Trust me, I wish life was that simple.)

    • Jesse Stone
      August 16, 2019 at 9:26 pm #

      How about Vitamin D? Since God designs perfect babies then why breast milk lacks of Vitamin D? There must be something wrong, right? Why these so called natural moms are so willing to give their babies Vitamin D? Non sense.

  17. realitycheque
    March 12, 2014 at 7:05 pm #

    Posts like these come over me like a black cloud of shame. Amongst other foolish and ignorant choices I made surrounding my son’s birth and neonatal care, refusing the Vitamin K shot is one of them.

    My MW claimed that Vit-K injections were to prevent bleeds from the baby being “knocked or dropped”, and that if we were planning on staying at home and in bed for the first couple of weeks, it wouldn’t be a problem. She said that the way to avoid low Vit-K was to eat lots of Vit-K rich foods during pregnancy and while BFing, and that deficiency was “only really a problem for formula fed babies”, which I now know to be a bald-faced lie. There was not a single mention of HDN. I didn’t even know it existed until years after the fact. Similarly, I refused the Hep B injections (now up to date) after she explained that it was, “Obscene that a newborn should be given a shot for a sexually transmitted disease”.

    My pregnancy had been a tumultuous time, and with my thoughts consumed by personal circumstances, my critical thinking skills were effectively non-existent. I subsequently placed a great deal of faith in my midwife’s recommendations, considering her to be the “expert”. It seemed senseless to question her advice, after all, why would such a nice lady do anything to put my baby at risk? It isn’t lost on me how incredibly fortunate we are that nothing bad happened, either during the birth or afterwards, and that the only difference between myself and the mothers whose babies died, or ended up with permanent brain damage is luck – sheer luck. Why am I sitting here receiving cuddles from a happy, healthy 2-year old, while other mothers have empty arms? I’m eternally grateful that my son is healthy, but there’s almost a sense of “survivors guilt” that comes with seeing other women who made the EXACT same choices as I did ending up with broken hearts.

    Even though we were fortunate enough to avoid complications, the guilt lingers, and there is a pang of shame whenever a HCP asks the question, “Which hospital was your son born at?”. I wish I never again had to be asked that question again and expose my foolish, ignorant and irresponsible choice.

    I’m so glad Olive appears to have avoided any permanent damage. The HB, anti-vax and anti-medicine communities have a lot to answer for. It breaks my heart to know that as the NCB ideology continues to spread, more and more babies and parents will suffer tragic and preventable outcomes.

    • March 12, 2014 at 7:09 pm #

      You are being really hard on yourself. I think its criminal that vulnerable women are at the mercy of charlatans like lay midwives and their ilk. You needed support and a competent care provider, its something every pregnant woman deserves. Take care.

      • realitycheque
        March 13, 2014 at 7:31 am #

        Thank you. I try not to beat myself up about it, although the guilt and general facepalm of it all does get to me some days, particularly when seeing stories like that of Olive or little Gavin Michael.

        You’re absolutely right about the midwives. The most frightening part is that my MW wasn’t even considered “fringe”. She was a CNM equivalent and has quite a good reputation amongst the HB community as far as I can tell. One MW I spoke to claimed that she would consider it a “privilege” to have my MW attend her birth.

        If the so-called “best” midwives are lying (or just ignorant) about Vitamin K, and referring to breech and twins as a “variation of normal”, what hope is there for the rest of them? What hope is there for the parents, or the babies for that matter? I have to wonder how many parents she dealt the same advice to, and how many babies have suffered as a result… I’d like to think none, but knowing that she had at least 1 death at a twin birth only a few months before my son’s, I find it hard to believe.

        • yentavegan
          March 13, 2014 at 7:58 am #

          I carry with me the shame of cowardice and “sheepishness” The Alpha mother in a parenting group I attended spouted all this anti-hospital pro homebirth propaganda. I did assimilate many of her tropes into my breast-feeding support meetings. Since coming to the SkepticalOb I have separated myself from that foolish mindset. I only hope my words of support for those past behaviors has not hurt some innocent mother and baby.

    • Danielle
      March 13, 2014 at 5:46 am #

      Don’t beat yourself up too much. The problem is that you SHOULD be able to trust your provider to get at least basic facts correct, particularly when making recommendations on points of routine care. If she’s telling you about the vitamin K shot, she should at least have it straight as to what it prevents. Are you supposed to be double checking every single tiny fact you are told? If the answer is yes, the provider is irresponsible. It’s possible to figure this out, but Google will take you to all kinds of sites spouting the same nonsense, so it’s a smoke and mirrors experience for people.

      What irks me in these stories that information that is so incorrect or incomplete is being given, that people feel like they’ve been “very well informed” by their (very confident and caring) providers, but they have not been. It is a big problem.

      • realitycheque
        March 13, 2014 at 7:48 am #

        “The problem is that you SHOULD be able to trust your provider to get at
        least basic facts correct, particularly when making recommendations on
        points of routine care. If she’s telling you about the vitamin K shot,
        she should at least have it straight as to what it prevents. Are you
        supposed to be double checking every single tiny fact you are told?”

        Yes, absolutely. This is what REAL health care should look like. It shouldn’t be unreasonable to expect that we pay someone to provide us with competent, evidence based care; to leave their personal ideologies out of it and do what is (scientifically proven to be) right for the patient, regardless of if they “hate” you for it. If we can’t trust our HCPs to do this, then what is the point of having them in the first place?

        Biological essentialism aside, I can’t even begin to fathom how women can call themselves feminists while subscribing to the victim-blaming ideology we so frequently see doled out by NCBers. “Baby died? Midwife withheld critical information/lied? Deliberately hid her professional history to avoid future clients finding out about preventable deaths? The parents should have known better! They should have done their research!”

        How is this even a thing? How are there people out there who see the actions of these midwives, and instead of saying, “Woah, not cool. Your lies/negligence/incompetence led to a preventable death/injury. You should be punished, and not be allowed to attend any more births” think, “Hey, midwife’s negligence led to tragic outcome, let’s raise money for her and completely dump the parents in the middle of a tragedy”.

        It’s sick beyond words.

  18. rh1985
    March 12, 2014 at 6:55 pm #

    Such a cute baby – hope she makes a full recovery. And I hope the mom sharing her story raises awareness so future babies don’t have to suffer.

  19. Efty
    March 12, 2014 at 6:02 pm #

    If it was forgotten then the midwives are responsible for what followed.

  20. Ash
    March 12, 2014 at 5:36 pm #

    Hey Dr. T, NYTimes has an article about reducing early elective deliveries in the USA. I hope you will respond on the NYTimes website 🙂

    • Amy Tuteur, MD
      March 12, 2014 at 6:08 pm #

      My comment has already been posted.

      • LMS1953
        March 12, 2014 at 8:28 pm #

        I have never read a more convoluted and confusing statement of the 39 week rule. It was a Rikki Lake redux.

        • rh1985
          March 12, 2014 at 8:34 pm #

          I hate how they always point out that due to miscalculated due dates, the 37 weeker could actually be a 35 week preemie – well then isn’t the opposite true – the baby thought to be 40 weeks could be 42 weeks and at a much higher risk of stillbirth?

          • Ceridwen
            March 13, 2014 at 1:34 am #

            It’s much less common for the due date to be off in that direction. Women often ovulate later than expected. Sometimes much later. It’s less common to ovulate early and it’s impossible to ovulate more than about a week earlier than standard calculation methods expect. Being off in that direction (thinking the pregnancy is less far along than it actually is) by more than a few days requires something pretty exceptional having happened.

            With a early ultrasound there’s much less confusion over the dating but they are not standard practice in many places.

          • Young CC Prof
            March 13, 2014 at 3:40 am #

            My mother now thinks both happened to her, but she had long irregular cycles her entire reproductive life. I was born (spontaneously) a few days after my due date, but looked, according to the doctor, 38 or 39 weeks. And she was “late” for a while before the pregnancy tests turned positive with me. My brother arrived on his due date, 9 ounces bigger than me, and the pediatrician declared him post-mature.

            Of course, that whole argument ignores the fact that many women actually DO know their due date with close precision, either because they were using assisted reproductive technology or natural family planning, or because they did have an early ultrasound. More can identify a “minimum” due date because they used a pregnancy test very very early.

            I wonder what percentage of pregnant women in the USA right now can be quite sure of their due dates to within a week or less. Probably a lot.

          • SuperGDZ
            March 13, 2014 at 4:04 am #

            Isn’t that extremely unlikely if ultrasound is performed in the first trimester?

          • rh1985
            March 13, 2014 at 8:41 pm #

            There’s still the possibility of a small margin of error of up to a week I think. My due date would have been several days later if based on my first trimester ultrasounds (i had at 5, 6, 7, 8, 9 weeks at the IVF clinic). Because the date of egg retrieval and fertilization was known exactly, I was given a due date of 38 weeks after egg retrieval/ovulation.

          • Mac Sherbert
            March 14, 2014 at 6:57 pm #

            And what about babies conceived using fertility treatments…There was no possibility of miscalculations with my last baby. We knew exactly! The baby always measured a week ahead and was born big, but there was no way we were ever going to change the date.

          • rh1985
            March 14, 2014 at 11:21 pm #

            Yep – my IVF baby would have been due a few days later if my due date were based on first trimester ultrasounds, but we stuck with the date that was 38 weeks after ovulation/egg retrieval. She caught up and ended up being born a very average weight.

  21. AnotherGuest
    March 12, 2014 at 5:35 pm #

    Thank you for sharing this story. A doula once told me that she thought babies must surely make enough vitamin K in nature, so she couldn’t see why the vitamin K shot was needed. Hearing things like that just exhausts me now. I wish the beautiful baby and family a full recovery.

  22. Cold Steel
    March 12, 2014 at 2:57 pm #

    My favorite part of the birth story was how her postpartum hemorrhage was treated only with 2 liters of IV saline. She probably went home with a crit of 20.

    • Ash
      March 12, 2014 at 3:33 pm #

      Ahh, here’s the thing. If this truly is Spokane Midwives, per a HBC website, “State law mandates that patients must leave the birth center within 5hours after giving birth, even in the middle of the night. If mother or baby requires care after 5 hours, patients must transfer to a hospital for that care.” I suspect this may have led to the decision to discharge her from the birth center so soon.

      Also, at the birth center MWs cannot attend VBAC, breech, or multiples but they can in the client’s home.

      • anh
        March 12, 2014 at 3:35 pm #

        I pondered giving birth in a birth center staffed by CNMs and what made me change my mind was that you had to leave within a few hours of the birth. As a first time mom this terrified because I knew I’d have zero idea of what I was doing at this point.

        It seems somewhat contradictory to me. It’s all about taking care of the mom and the baby, but they kick your butt out a few hours after giving birth??? how does that work?

        • Bombshellrisa
          March 12, 2014 at 6:00 pm #

          Ah, that is where all those pamphlets at the front desk for postpartum doulas come in. They figure you can afford to hire a doula or you will have friends and family ready to surround you with care casseroles

          • Jessica S.
            March 12, 2014 at 7:20 pm #

            What a racket! It seems far less confusing – and if you are insured, cheaper – to just be at a hospital. And that’s without mentioning safety!

        • prolifefeminist
          March 12, 2014 at 8:26 pm #

          Leaving right after like that is what turned me off to birth centers too. Aside from the safety issues, who wants to go through an exhausting birth and snuggle into bed with their new baby, only to be woken up and kicked out a few hours later? From a mental standpoint, you barely even have time to adjust to baby being there before you’re kicked back to your home. I wouldn’t like that at all. I actually really, really enjoyed my hospital stays – they were always very happy times, and I was treated really well and got plenty of rest. I personally would hate to miss that!

          • Laura
            March 13, 2014 at 11:27 am #

            Along those lines, I had some really great hospital stays – ones that including putting my baby in the nursery so I could sleep! After having more kids (I had 6 in total) I knew what I was going home to and always insisted my husband go home to sleep in his own bed and take care of our other kids. I didn’t have other people stay with me in the hospital so I really appreciated the nurses taking my baby, giving them a bottle or whatever, and sleeping after my deliveries. I then went on to successfully breast feed exclusively and bond with my babies quite well, thank you very much! It galls when I hear people brag about how the hospital nursery is now empty because they have rooming in now and how wonderful that is. Maybe for some moms, but not for me.

        • Busbus
          March 13, 2014 at 2:41 am #

          But it’s not about taking care of the mom and baby. The whole NCB cult is based on bragging how tough you are as a new mother – how you could take the pain of labor without medication, how you could breastfeed even through the biggest pain and hurdles, how you didn’t need anybody and how you were up and running right away. Nothing about NCB is about taking care of the mother (and the baby’s safety is often sacrificed as well). Real compassionate care would include an open discussion of pain management instead of cheering you on that “you can take it” and making you feel like a failure if you can’t.

    • araikwao
      March 12, 2014 at 4:29 pm #

      And *most* of the time, they will get away with that. Until some inconsiderate, uneducated/not trusting birth enough mother won’t stop bleeding. I hope it never happens..

    • March 13, 2014 at 4:08 am #

      And a Hgb of 6. But nowadays everyone thinks twice before transfusions.

  23. Cold Steel
    March 12, 2014 at 2:55 pm #

    Why didn’t the baby get the shot? From the story it doesn’t sound like the mother was misinformedly opposed to the injection, it sounds like at the birth center at which she delivered it wasn’t even on offer. Does anyone know if a non-CNM midwife has the prescribing power in Washington to even offer it?

    • Renee
      March 12, 2014 at 3:20 pm #

      She IS a CNM and an APRN. She FORGOT the shot.

      • Danielle
        March 12, 2014 at 3:24 pm #

        Which is sad and scary. Mom blames herself, but with all that is happening during and just after birth, how many people have a checklist in their heads that reads: “Double-check that the baby has been given shot X. Double-check the the baby’s hearing has been checked. Double-check …”

        Most people just assume the hospital or birth center is going to tell them what is recommended.

        • Amy M
          March 12, 2014 at 3:37 pm #

          As they should….

        • thankfulmom
          March 12, 2014 at 3:59 pm #

          So can a birth center be sued for this? Or is the building and CNM uninsured? Don’t they have written check-lists to check off? I believe they didn’t have enough staff to attend to both mom and baby after the delivery.

          • The Computer Ate My Nym
            March 12, 2014 at 4:48 pm #

            Well, if nothing else, they have a building that could be confiscated to pay off a malpractice suit…

          • Ash
            March 13, 2014 at 8:09 am #

            If this was Spokane Midwives, the website indicates that there are two staff members there (1 CNM, 1 non RN midwife). I imagine the postpartum situation must have been crazy, considering they had to discharge her within 5 hrs after delivery, and only 2 ppl would be attending at most.

        • The Bofa on the Sofa
          March 12, 2014 at 4:14 pm #

          Well, you can figure what happened. Mom started hemorrhaging, shit’s hitting the fan, not enough staff around and routine baby care is forgotten.

          Under the circumstances, it would be understandable. The problem is that those shouldn’t be the circumstances in the first place. A hospital is adequately equipped to have someone caring for the baby even if there is an emergency with the mother. That’s how it is done properly to prevent errors.

          • The Computer Ate My Nym
            March 12, 2014 at 4:47 pm #

            Forgetting the shot is understandable. Especially with the hemorrhage. (Though, as you point out, there should have been more people around to make sure someone is always looking after the baby even when things go badly for the mother and vice versa.) But even aside from that problem, didn’t anyone document the birth? And notice that the vitamin K wasn’t given? Maybe call the mother and say, “Hey, sorry, but we forgot to give your baby a routine shot. Please bring her in for it.”

          • Amazed
            March 12, 2014 at 5:42 pm #

            They probably celebrated the fact that mom forgot about it. It saved the baby from an unnatural intervention, after all!

          • Ra
            March 12, 2014 at 5:12 pm #

            Yes. This exactly. In the hospital, if mom is hemorrhaging then there are other nurses to care for the baby. In the system I’m familiar with, mom and baby have completely different nurses in L&D. The baby nurse doesn’t have anything to do with mom, so she can focus just on baby. If the hemorrhage is really bad and dad is unable to attend to the baby, baby goes to the nursery for a bit for care until mom is taken care of.

      • Mishimoo
        March 12, 2014 at 8:12 pm #

        I really don’t understand how, to be honest. My CNM readied the shot, asked permission even though I’d already signed the paperwork, and administered it while bub was having his first feed. The student was keeping an eye on my bloodloss and it took what felt like less than a minute for the CNM to explain, consent, and administer, so she could get back to doing other things.

    • Rochester mama
      March 12, 2014 at 5:35 pm #

      The way I read it they told her it was optional but never really explained what the shot was or what it prevented and she never said “yes” during prenatal visits and then they never asked again at the birth. So since she never opted in they didn’t do it.

  24. batmom
    March 12, 2014 at 2:30 pm #

    Olive is adorable. I’m glad she has come through the surgery well, and I’m glad her mother is sharing her story. It’s not easy to admit to a mistake with such devastating consequences, and extremely brave and compassionate to do so in the hope of preventing the same thing from happening to other parents.

  25. wookie130
    March 12, 2014 at 2:22 pm #

    What a beautiful baby, and thank goodness she’s alive after all of that. I pray for her recovery, and I am sorry she will have to live with a brain injury. In the midst of all of the denial, butt-covering, and foolishness that exists in the woo, we should be grateful that there are parents such as Stefani who can come forward, tell the truth about a situation, and perhaps prevent it from happening to someone else’s child.

  26. March 12, 2014 at 1:57 pm #

    I’m surprised that no one hasn’t noticed that instrument of the Devil — that Olive is sucking on a pacifier (dummy). that’s sure to stunt her growth and warp her personality and who knows what else.

    • Jocelyn
      March 12, 2014 at 2:27 pm #

      My daughter has that same pacifier. 😉

    • Petanque
      March 12, 2014 at 9:49 pm #

      Don’t worry, it’s balanced by the fact she isn’t hatted!

  27. Dr Kitty
    March 12, 2014 at 1:50 pm #

    Slightly OT: isn’t Olive just the cutest?
    Such a sweet baby.

    • The Computer Ate My Nym
      March 12, 2014 at 1:51 pm #

      Olive is totally cute.

      • Amazed
        March 12, 2014 at 6:46 pm #

        She’s such a sweetie. I am so happy that she made it. Her mom was very brave to come out in public like this. No doubt she’ll be “educated” about the dangers of the shot any minute now.

    • The Bofa on the Sofa
      March 12, 2014 at 2:38 pm #

      Actually, it really struck me because when I started reading, I was expecting the worst. Imagine my delight to see those gorgeous, shining eyes at the bottom of the post!

      How adorable!

      • Laural
        March 13, 2014 at 12:49 am #

        Me too. Almost didn’t read further when I saw the title photo. What a beautiful, delightful baby. God bless, sweet Olive.

    • Danielle
      March 12, 2014 at 5:17 pm #

      That was my thought too while reading it.

      Also, Olive is such a great name!

    • Jessica S.
      March 12, 2014 at 7:25 pm #

      Oh, those eyes! Very adorable. We’re naming our little girl Olivia, with Olive as a nickname.

    • Mishimoo
      March 12, 2014 at 8:36 pm #

      She’s adorable! I hope she makes a full recovery.

  28. Dr Kitty
    March 12, 2014 at 1:30 pm #

    What are the odds this outcome will be captured by MANA, or reported in the stats about Birth Centres?

    If your clients have a very high rate of refusing Vit K, I would think you should at least attempt to collect data on rates of VKDB and the outcomes of the babies who suffer it.
    It is a very simple matter of clinical governance.
    A phone call around baby’s first birthday, asking how they are isn’t exactly too much to ask for a CPM attending less than 50 births a year.

    • Gene
      March 12, 2014 at 1:39 pm #

      I can’t imagine that they would think that HDN was in any way caused by not giving IM Vit K. They would blame someone/something else.

      • March 12, 2014 at 2:49 pm #

        Babies who don’t produce Vitamin K in adequate amounts obviously have other problems and should not be allowed to pollute the gene pool. Mother nature has a plan who are we to mess with it? (I’m being sarcastic)

      • Laura
        March 12, 2014 at 6:04 pm #

        OT Gene, but I was curious if you can comment about the “controversy” of giving so many vaccine shots to newborns? I had a “debate” with a nurse friend of mine who thought so many shots in such a short time was very concerning. What do you think about this?

        • Jessica S.
          March 12, 2014 at 9:25 pm #

          I know you were asking this to Gene, so forgive my rudeness in advance. 🙂 I asked my friend, who is a pediatrician, this same sort of question once, basically “why so many before two years old? Is it for school? For convenience, since you’re in for so many well-child visits?” Her response: “No! It’s more serious for them to get these diseases when they’re infants, that’s why we vaccinate soon and often.” At least, that was the most import reason it’s done, she said. 🙂 I’m not a doctor, so I can’t verify that statement with expertise, but I think it synchs with what I’ve read elsewhere.

          Ok, I’m butting out now! 🙂

          • Lisa from NY
            March 13, 2014 at 12:13 am #

            Good for your baby, but others must suffer. My crunchy friend says she can sure any sickness with garlic tea.

          • Bombshellrisa
            March 13, 2014 at 1:51 am #

            I am sick and tired of hearing how garlic can cure everything. I rely on it heavily for a favorite dish I make (chili sesame wasabi green beans) but I wouldn’t rely on as a substitute for a flu shot or antibiotics for GBS

          • Dr Kitty
            March 13, 2014 at 10:09 am #

            Hell, I put garlic in EVERYTHING and I don’t think I’d rely on it as anything other than a cooking ingredient.

          • SouthernGal
            March 15, 2014 at 10:48 am #

            I had a nurse tell me to use it to clear up a minor yeast infection. I was skeptical, but I was living abroad and not in a situation where OTC treatments were available to me (hence the visit to the [American] NP). I tried it, things got worse. She told me I wasn’t using enough, that I may need half a bulb or more, and to make sure I was piercing it with a fingernail so the juices could release.

            It got better eventually … after a trip to the hospital because I was in too much pain to sit, stand, sleep, or function as a human being.

          • Box of Salt
            March 13, 2014 at 1:59 am #

            Jessica S “it’s more serious for them”
            Here’s a link to the end of year Pertussis Summary Report for CA 2010, when 10 infants died. As noted, this is a case-fatality rate for infants under 3 mos old of 1.5%.


            HepB can also be more serious, as it is more likely to result in chronic infection when contracted at a younger age (I’ve posted the Science Based Medicine post on this here before; I can’t now as the search function over there isn’t working for me at the moment), which can lead to liver cancer.

          • Young CC Prof
            March 13, 2014 at 3:25 am #

            *Shudder.* SO glad we’ve gotten the two-month shots into him, and the flu/RSV season is winding down.

            Of course, just when you think your child is beginning to be safer from contagious disease, there’s another freaking measles outbreak on the news. Rage rage RAGE against entitled assholes who vacation overseas and can’t be bothered to vaccinate their special snowflakes. (No, they haven’t traced the source yet, but that’s the usual story.)

          • Jessica S.
            March 13, 2014 at 5:14 pm #

            Thanks for this! I’m not completely sure I understand what you’re saying, but maybe that’s b/c I wasn’t clear in my post? I think we’re on the same page, but please correct me if not. I was trying to say that the vaccinations are given at those ages because if (and God forbid, when) babies get these diseases/viruses, the babies are even more at risk. Does that make sense?

            A note on pertussis – I’m currently pregnant and was THRILLED to hear I could get another booster in my third trimester to protect the babe as best as it can until she’s old enough for her own. I live in WA, which happens to have a high vaccination exemption rate. It really irks me.

            I hope that makes sense. I was just making sure my original comment wasn’t sounding as if I was saying it isn’t a big deal at that age. 🙂

        • Gene
          March 12, 2014 at 10:15 pm #

          Complete BS. Our bodies are exposed to hundreds if not thousands of species of bacteria and viruses every day. The things we vaccinate for early (HiB, pneumococcus, rotavirus, pertussis, HepB, etc) are things that are deadly TO NEWBORNS. Just in the past five years, I’ve taken care of babies desperately ill from ALL of the things we vaccinate for at the two month visit (except tetanus and diphtheria, which are less common in the US) and some of those babies have died.

          So, out of the constant barrage of microscopic attackers, antivaxers are concerned that an extra EIGHT inactivated/killed versions of them that could each kill a baby are “too much”.

          • Laura
            March 12, 2014 at 11:44 pm #

            Thank you Gene! I knew you’d have the answer. This is essentially what I told my friend, who is studying to become a Nurse Practitioner. I am just a lowly nursing student, but have read lots on here and elsewhere about vaccines. I also have six kids and have always vaccinated as my doctor has suggested. A friend with three little kids is currently getting over whooping cough,. Thank God for her kids that have gotten their vaccine. Scares the living day lights out of me for all those newborns exposed to her circle of contacts, though.

    • thankfulmom
      March 12, 2014 at 2:12 pm #

      Especially since they all become such good friends instead of keeping it professional.

  29. Laura
    March 12, 2014 at 1:19 pm #

    Even when I was still into woo, I still made sure my daughter got the Vitamin K shot at birth. Because, why not?

  30. R T
    March 12, 2014 at 1:14 pm #

    Oh my God, I have so many risk factors for my babies to have Vitamin K Deficiency Bleeding! No wonder it felt so right to me! I have to take baby asprin and blood thinners during pregnancy, I have Celiac and I breastfeed!


    Maternal anti-sz meds that interfere with vitamin K metabolism (phenytoin, phenobarbital, carbamezepine, or primidone)
    Maternal anti-coagulants (coumadin, aspirin)
    Maternal antibiotics, especially cephalosporins

    Breastfeeding exclusively

    Marginal levels of vitamin K in breast milk
    Cystic fibrosis
    Celiac disease
    Chronic diarrhea
    A1-antitrypsin deficiency

    • Zornorph
      March 12, 2014 at 1:23 pm #

      A kale smoothie would fix all of that.

    • The Computer Ate My Nym
      March 12, 2014 at 1:43 pm #

      If your celiac disease is well controlled and you’re on a gluten free diet, you should be absorbing good levels of fat soluble vitamins and not have any issues. If you’re concerned, call your doctor and/or your child’s doctor and get tested.

      • R T
        March 12, 2014 at 2:18 pm #

        Yes, very well controlled! My son has not been tested, but he currently eats gluten free by default since he eats what I eat!

  31. Jessica
    March 12, 2014 at 1:00 pm #

    The other day on The Bump’s Natural Birth board someone mused if the reason the Vitamin K shot was necessary is because hospitals wipe off the baby’s vernix too soon after birth, preventing the Vitamin K therein from being absorbed through the skin. I was in utter disbelief reading that post.

  32. March 12, 2014 at 12:56 pm #

    I found a facebook post from a utah midwife bragging to other midwives about how she never gives vitamin K shots.

    Maybe I should find her and send her this story?

    • R T
      March 12, 2014 at 12:58 pm #

      Yes! Send her the link to the mother’s blog story!

    • wookie130
      March 12, 2014 at 2:13 pm #

      Yes. Absolutely send her this story, please.

    • March 12, 2014 at 2:33 pm #

      I sent her a link. I don’t know if it will do any good, but hey I tried.

      • The Bofa on the Sofa
        March 12, 2014 at 2:36 pm #

        I’m betting on “won’t do any good”

        • March 12, 2014 at 3:01 pm #

          Gotta stay optimistic Bofa, if nothing else it will probably make her uncomfortable to be confronted about her beliefs. That is something the NCB echo chamber could use.

          • The Bofa on the Sofa
            March 12, 2014 at 3:04 pm #

            if nothing else it will probably make her uncomfortable to be confronted about her beliefs.

            It’s never seemed to help before. She’ll probably just blame the mother.

            (Yep, I’m doubling down on the cynicism)

          • Therese
            March 12, 2014 at 3:54 pm #

            Yes, if only the mom had drunk kale smoothies in pregnancy, she would have had the vitamin K to pass on to her baby.

      • Lisa from NY
        March 13, 2014 at 12:15 am #

        She will say you are using fearmongering tactics to scare her.

    • Certified Hamster Midwife
      March 12, 2014 at 3:08 pm #

      Send it from the mom’s blog, because Dr. Amy is evil.

      • SurfingDumbledore
        July 9, 2018 at 7:01 pm #

        Why is Dr Amy evil?

  33. R T
    March 12, 2014 at 12:51 pm #

    I consented to the vitamin K shot for my son and, trust me, that is not the popular choice to make among my friends in Southern California. It felt very right to me and the nurse, who was a friend of mine, said she completely understood if I didn’t want to give the Hep B vaccine to my newborn, but she strongly supported my babies having a Vit K shot. She let my baby nurse and bond with me in the OR and on the way to recover and gave him the shot later while he was nursing. He didn’t even cry! I felt very good about my choice and still do! My nieces and nephews all got the Vit K shot, as well, even though their mother’s are very pro natural birth and had epidural free births and labored in tubs. They just asked for one hour alone to bond with their newborn before the shots were given.

    • Staceyjw
      March 12, 2014 at 1:11 pm #

      Ugh, nurses that are anti vax, or ok w anti vax. Kills me.

      • March 12, 2014 at 1:49 pm #

        Kills lots of people, actually. Sigh. Stupid is making my head explody. Like Mudd’s Women (rim shot)

        • The Bofa on the Sofa
          March 12, 2014 at 2:35 pm #

          Sorry, Trek reference fail.

          Mudd’s Women’s heads exploded because they couldn’t rationalize the logical contradiction, not because of stupidity.

          • March 12, 2014 at 2:42 pm #

            Butbutbut I can’t rationalize the logical contradictions we discuss here…

          • The Bofa on the Sofa
            March 12, 2014 at 2:46 pm #

            “Some people are stupid” isn’t really a logical contradiction, it’s more like a premise

          • Staceyjw
            March 12, 2014 at 4:28 pm #

            No matter, it’s enough to make a head explode!

          • The Bofa on the Sofa
            March 12, 2014 at 8:10 pm #

            With stupidity, I think a bigger concern is trauma from banging one’s head against the wall

      • Trixie
        March 12, 2014 at 2:12 pm #

        Since my kids got Pediarix at 2, 4, and 6 months, the Hep B vax they got at birth seemed sort of extraneous. Not that it was harmful, but it seems like if the mom was otherwise planning to vax on schedule, skipping the hep B at birth is probably less dangerous than skipping vitamin K. Assuming mom is negative for Hep B.

        • Mishimoo
          March 12, 2014 at 6:21 pm #

          It does seem extraneous, but we had it done anyway. With the older two, it was simply because “Hey, we may as well.” but the youngest was born after my husband’s step-mum had passed away from liver failure that may have been partially related to the Hep B she caught as a kid, so we’re more aware of it now.

          • Trixie
            March 12, 2014 at 10:29 pm #

            Oh sure. My only point is that if you had to talk someone into ONE shot at birth, vitamin K is the one. If this nurse is in Southern Cal, she probably has this conversation multiple times a day, and at least tries to make sure they get vitamin K.

  34. Therese
    March 12, 2014 at 12:44 pm #

    So this happened in Washington State where it is illegal to not administer vitamin K to newborns (parents can refuse, but their refusal must be documented.) Seems like the midwife should be in trouble with the state! Do you think the doctor involved in this case would have reported it or maybe we need to have some concerned citizens reporting it? Of course, the midwife could just claim that she did offer and the parents refused and alter the medical records to state this, so maybe it’s not likely to be effective.

    Also, the reason it was forgotten was because the mom was hemorrhaging. She needed two bags of IV fluid and passed out twice…isn’t this something that should have resulted in a hospital transfer?? It’s still a poor excuse for not remembering the vitamin K because the midwife would have done an exam of the baby a few days later and she should have noticed if there was a blank box on the records that was required to be checked off.

    • Zornorph
      March 12, 2014 at 12:48 pm #

      Records are tools of the patriarchy.

    • R T
      March 12, 2014 at 12:57 pm #

      She may not hold any hard feeling against the midwives at the birth center, but someone should! Why wasn’t she transferred when she began to hemorrhaging and how did they just “forget” about the Vit K shot? I doubt she would have consented to it anyway, but it should have legally been something she had to refuse or consent to! What birth center was this?

    • Staceyjw
      March 12, 2014 at 12:59 pm #

      Cannot blame the CPMs for this one, but of course she is in the PNW……
      IF Im right, Her MW Jane Silver is a CNM, APRN, from Spokane MWs. She has a working relationship with Sacred Heart- the same hospital the baby went to. I wonder if they know this was her mess?

      Something about that particular BC seems so familiar. I know I had looked it up before, because I remembered the bad 1982 deco as soon as I saw it again. There use to be different MWs there, but Im not sure when they changed over.

      There is a decent chance she may have insurance of some type, I hope mom sues. I see mom isn’t blaming her, but if my baby had been through all that because a MW forgot the vit k, I would be livid. I don’t care how nice she was, she forgot something so vital that it almost killed/damaged baby! This is the benefit of the hospital- if you hemmorage, someone else still cares for baby, shots don’t just get forgotten.

      I just loathe the whole NCB culture, presenting these shots as optional. This is a smart, educated mom that loves her family and wants to do the best thing possible. But she isn’t an expert, and shouldn’t have to be. Pawning off these decisions under the guise of “empowerment” is just irresponsible. Wonder how her MW feels now?

      (also wonder what baby died……)

      • Therese
        March 12, 2014 at 1:11 pm #

        The midwives that used to be there were Beth Morrill and Linda Morgan (Not sure if Linda is still there, she’s mentioned on one part of the website but then there is no biography for her.) Beth left after she killed a baby at a twin breech-breech birth and ruptured the patients’ uterus.

        • Dr Kitty
          March 12, 2014 at 1:24 pm #

          I hope “left” means never, ever attending another birth.
          Because that sounds horrendous.

          • Therese
            March 12, 2014 at 1:35 pm #

            Nope, she is still a practicing midwife in the same city. But this way the birth center can tell their patients that they’ve never lost a baby, except for that one with fatal birth defects where the parents refused prenatal testing.

          • Dr Kitty
            March 12, 2014 at 1:44 pm #

            Breech-Breech twin pregnancies are not “variations of normal”.

            Blue, green, hazel and brown eyes are all variations of normal.
            Being born with three eyes, or one eye or with no iris in your eyes at all are NOT variations of normal.

            Breech-Breech twins is not like having blue eyes instead of brown eyes. It is like having an extra eye in the middle of your forehead…a whole different ball of wax to the usual situation.

          • The Bofa on the Sofa
            March 12, 2014 at 2:33 pm #

            I’ve noted in the past that breech vs non-breech is not a continuous variable, they are discrete positions. You can’t be “almost breech” or “almost not-breech.” Given that not-breech is normal, that means that breech is not, nor is it a variation of it. If not breech is normal, then breech is not normal.

            It’s discrete logic, not continuous.

          • fiftyfifty1
            March 12, 2014 at 7:17 pm #

            “If not breech is normal, then breech is not normal. It’s discrete logic, not continuous”

            Except this:
            Alive is normal. Dead is also normal.

          • Amazed
            March 12, 2014 at 7:20 pm #

            … and between those two normal things stands the dreaded unnatural intervention. Clear and simple!

        • Bombshellrisa
          March 12, 2014 at 1:56 pm #

          Linda Morgan has action pending against her currently

          • Therese
            March 12, 2014 at 2:28 pm #

            Where do you find that? All I can find on the DOH website are the older cases, from 1999 and 2004.

          • Bombshellrisa
            March 12, 2014 at 2:49 pm #

            It is on the Washington midwives website

          • Therese
            March 12, 2014 at 3:58 pm #

            But it doesn’t say why? It’s strange, it seems like it should be on the DOH website in their provider database.

          • Bombshellrisa
            March 12, 2014 at 5:58 pm #

            The records are very patchy. Some of the midwives have the documents there so you can read exactly what happened (and unlike what studentmidwife claims, none of those things were as minor as giving a cup of juice to someone, I would love to know if the missing parts of that story include the juice being some kind of way of preventing the doctors from being able to do a c-section). So many don’t have the documents available, or only a few of the cases have documents to view. That is troubling.

          • Karen in SC
            March 12, 2014 at 7:27 pm #

            Drinking some juice wouldn’t stop anything in an emergency. A friend had a rupture right after having dinner, rushed to the hospital and was put under general immediately. She told me to prevent aspiration a weight or something is pressed on the esophagus. She also told me she was very sore. But happy that the baby was healthy.

          • Young CC Prof
            March 12, 2014 at 7:33 pm #

            If you have to have a c-section on a non-empty stomach, they make you drink the uber-antacid of nastiness. Then they go right ahead and cut you open.

            I mean, think about it. Hospitals do emergency surgery on people with full stomachs all the time. There are plenty of protocols to manage the risk.

          • Bombshellrisa
            March 12, 2014 at 8:44 pm #

            A hobbyist birth worker (aka a CPM) wouldn’t know that though-just like they think that evening primrose oil causes cervical dilation and placenta capsules prevent any kind of complication from PPH to low milk supply, they probably reason that a cup of juice would stop the doctors from preventing a c section.

        • Renee
          March 12, 2014 at 3:23 pm #

          THATS why I remembered this place! I knew it was a death, just could not recall which one.

        • fiftyfifty1
          March 12, 2014 at 7:13 pm #

          “Beth left after she killed a baby at a twin breech-breech birth and ruptured the patients’ uterus.”

          !!!!!!!!!!!!!!! Twin breech-breech out of hospital birth?!!!! The insanity doesn’t end.

          • The Bofa on the Sofa
            March 12, 2014 at 8:12 pm #

            Hey, studies show that out of hospital birth is just as safe as in hospital birth for low-risk patients attended by multiple internationally qualified midwives, near a hospital with OB backup.

            Thus, twin breech-breech with hobbyists is just fine.

          • prolifefeminist
            March 12, 2014 at 11:02 pm #

            Don’t forget the ruptured uterus! UGH 🙁

        • AA
          March 7, 2016 at 11:41 am #

          Morrill is still working as an out of hospital midwife. “VBACs welcome”

      • guest
        March 12, 2014 at 4:57 pm #

        Listen, Spokane isn’t Seattle, not by a long shot. You can’t blame this on an overall culture of woo, because Spokane isn’t really like that anymore than Idaho or Utah would be.

        • Therese
          March 12, 2014 at 10:08 pm #

          Homebirth is very popular in both Spokane and Idaho. Perhaps not as popular as in Seattle, but definitely the homebirth rate is higher in the inland northwest than the national average.

  35. anne
    March 12, 2014 at 12:38 pm #

    I’m not sure if Dr. Amy has covered it here but I’d love to see a post on all the things that hospitals do after labor that you don’t receive in a homebirth – monitoring baby and mother, administering shots, visits from the pediatrician. I tested GBS positive during my pregnancy and even with IV antibiotics during labor my son developed some sort of infection. He received IV’s and lots of monitoring while in the hospital.

    • Zornorph
      March 12, 2014 at 12:42 pm #

      Cascades of interventions, you mean?

      • anne
        March 12, 2014 at 1:04 pm #

        At the time it seemed like a bit much for a mild fever but the more I read here the more I understand how little I know of how my labor went, what the OB and nurses were doing, if there ever seemed like there might be complications, or why they were concerned about my son. I remember fragments of conversations about my son’s heartbeat on the strip. Everything was handled smoothly and with such little fuss.

    • Mac Sherbert
      March 12, 2014 at 2:48 pm #

      Also…Clean your room for you, bring you clean sheets, babysit newborn as needed or requested in nursery, bring food to you, lactation consultant on staff…

  36. Zornorph
    March 12, 2014 at 12:36 pm #

    Congrats to this mum for coming forward and trying to help. I had not heard of the Vitamin K thing before I was expecting, but read about it on this blog. I don’t think the nurse acually asked my permission, but just told me when she was about to do it.
    I have an idea of how this mum can help, but I also have doubts about how it might play out. If she went to the birth center where she had her LO and told her story and suggested they make it their policy there to give the Vitamin K shot unless the mum (and/or dad) actively says no. I have a feeling, though, that the ‘wonderful’ midwives there might be more interested in woo idiology and not saving babies and would politely blow her off and not change a thing. But I’d love to be proved wrong.

    • The Bofa on the Sofa
      March 12, 2014 at 12:41 pm #

      Yeah, I think the importance of this is in awareness. Making PARENTS aware of how important it is.

      They are the ones who will pressure the providers who don’t do it. If parents insist, it puts those in opposition in a tough spot.

    • auntbea
      March 12, 2014 at 8:06 pm #

      Mum? I thought you were ‘Murcan!

      • Zornorph
        March 12, 2014 at 8:09 pm #

        Nope! The Bahamas, a former British colony.

      • Comrade X
        March 13, 2014 at 4:28 pm #

        snap, AuntBea!!

  37. Staceyjw
    March 12, 2014 at 12:20 pm #

    The sad irony here is that the babies with the highest risk of having the late Vit K deficiency bleeding because of EBF, are the same ones most likely to have a mom that skipped the shot. Get a crunchy mom that refuses the shot (or its not even offered by the fake MW), and then have her EBF, you’re asking for trouble. (But they are “educated”……)

    People- Breast milk is NOT magic! There *are* things about it that are inferior, and this is one of them (lack of vit D is another). Formula is enriched with these vitamins, and in cases where the mom skips the shot, it’s a real lifesaver. BF pushers claim B milk is superior because it may aid in avoiding an ear infection, but FF can save an actual life.

    I would suggest she sue the BC, but I am sure they don’t have insurance.

    • anne
      March 12, 2014 at 12:24 pm #

      My breast milk didn’t come with federally mandated ratios of fat, vitamins, minerals and other goodies.

      • The Bofa on the Sofa
        March 12, 2014 at 12:28 pm #

        How many gallons of breast milk would you need to get the same nutritional value of one bowl of Total?

        • Zornorph
          March 12, 2014 at 12:30 pm #

          That just made me howl with laughter.

          • The Bofa on the Sofa
            March 12, 2014 at 12:34 pm #

            What I actually have in my head is the commercial for Colon Blow from SNL – “How many bowls of your cereal would you need to get the same amount of fiber as one bowl of Colon Blow?”

          • March 12, 2014 at 12:56 pm #


          • araikwao
            March 12, 2014 at 4:37 pm #

            That’s an *actual* product???! 😮

          • Mishimoo
            March 12, 2014 at 8:18 pm #

            Which in turn makes me think of the ad on the radio for the “Intestinal Broom” which purportedly helps ‘medically diagnosed IBS’.

      • Staceyjw
        March 12, 2014 at 1:14 pm #

        Mine didn’t either, but it sure did come with an enormous, tooth destroying amount of sugar. 🙂

    • Bombshellrisa
      March 13, 2014 at 1:57 am #

      Breast milk is NOT magic, but you will never guess what I heard someone saying they did with it. Someone was using it in a spray bottle like Afrin, claiming it cleared up her sinuses.

      • Young CC Prof
        March 13, 2014 at 3:26 am #

        Um. Well, if saline works…

        …Yeah, I’ll just stick with the saline.

  38. March 12, 2014 at 12:13 pm #

    The birth center should be held accountable – oh wait, what are the chances they carry adequate insurance and that a lawyer would actually find the case lucrative enough to pursue? I applaud the mother for wanting to raise awareness, but nothing makes those who need to be aware more than an acute case of consequences for negligence.

    • Staceyjw
      March 12, 2014 at 1:15 pm #

      They might have some insurance. It would be worth trying anyway.

    • Melissa
      March 13, 2014 at 1:02 am #

      I hope they do get sued. It’s important that people sue in cases like this because it’s the only way to get practices changed. It was probably an accident that the center didn’t give the shot because they were dealing with Mom’s hemorrhage. But that shows that they don’t have a good system in place to make sure that the shot is given. A court judgement will make sure they change that policy. Civil suits are about making people liable for the harms they cause to others, intentional or not. The family shouldn’t have to pay for all of the med bills from this, or any ongoing treatment Olive needs.

  39. Karma Kidney Stone
    March 12, 2014 at 11:58 am #

    This is a timely little gem from MDC today:

    I’m sure her Ped will be thrilled to be schooled on the dangers of Vit K injection using “studies” that are over 30 years old, and for which no actual study can be found.

    • Houston Mom
      March 12, 2014 at 12:44 pm #

      One of her sources isn’t even a study – it’s a book about birth by an anthropologist (Wenda Trevathan).

  40. MaineJen
    March 12, 2014 at 11:47 am #

    I will be posting this story everywhere I can, very soon. A thousand thanks to Olive’s mom for being brave enough to share this!!

  41. March 12, 2014 at 11:35 am #

    Excellent post. One typo to fix; the paragraph where you quote about the doctor explaining the brain bleed is duplicated.

  42. Ra
    March 12, 2014 at 11:28 am #

    In addition to the tragic effects of neglecting to administer Vitamin K, Olive’s mother also hemorrhaged after delivery. From the post with Olive’s birth story:

    “The real fun started when it turned out that I was hemorrhaging. Without going into all the gory details – after passing out twice and receiving two liters of IV liquids everything was (mostly) back to normal. I was pretty weak…”

  43. The Computer Ate My Nym
    March 12, 2014 at 11:09 am #

    Random thoughts:
    1. Smart woman to have recognized lethargy and not simply blown it off as the newborn needing a longer nap.
    2. The ED people clearly suspected vit K deficiency. Why didn’t they give her FFP and vit K before the CT and the LP? (Or maybe they did and it’s just not part of the story). Prompt correction of a coagulation defect can save life and organ function.

    3. Seriously, people, didn’t you get a PT/PTT right off in a lethargic obviously bleeding newborn and see that things weren’t right? FFP and cryo! BEFORE CT. BEFORE LP. Certainly before transfer to another hospital.

    • theadequatemother
      March 12, 2014 at 12:44 pm #

      I hear ya. But if you take a one month old to a community ED who is lethargic and hypothermic, it’s a good possibility that the ERP is going to jump to a diagnosis of sepsis. That’s how I read it – filling in lots of blanks on the story. After the CBC came back normal and the CSF was clear except for blood it sounds like they stared entertaining other diagnoses. VKBD is so rare. Sadly is becoming less rare which means that more babies with similar pictures will likely get more expediant treatment as docs discuss these cases.

      While I’m wondering about care, should a birth center reall discharge a woman home less than 6 hrs after the birth after she’s lost consciousness twic and revive 2 l of slain without a CBC or follow up plan? I wouldn’t think so.

      • Dr Kitty
        March 12, 2014 at 1:19 pm #

        If you have to give someone 2l of fluid as a bolus to get their BP up it suggests a serious bleed that might need transfused.
        And that kind of big PPH commonly messes up milk supply too.
        Discharge at 6hrs without follow up doesn’t seem that smart.

      • The Computer Ate My Nym
        March 12, 2014 at 1:50 pm #

        Ok, so maybe I was a little over the top to say that they should have got the coags before the LP. Meningitis and sepsis are more common than vit K deficiency in the newborn. But when the LP showed blood oozing from the site, shouldn’t someone have thought about it? Not that I’m sure that they didn’t do exactly that…the parents were obviously stressed and probably not watching every last thing that happened.

        And, yeah, 2 liters of saline and not even checking a CBC? WTF? I would think that a responsible midwife working at a reputable birthing center (as various apologists assure us that the vast majority of midwives and birthing centers are), would have called an ambulance after hanging the first bag of saline. Or, better, having someone else do it simultaneously.

        • NICU RN
          March 12, 2014 at 6:19 pm #

          Didn’t she also write that an IV was hard to get – I thought they couldn’t get one until they got to the PICU?

    • drsquid
      March 12, 2014 at 2:10 pm #

      what i didnt get was the need for an iv unless that was to start giving reversal. head ct is always non con for bleed

  44. Karen in SC
    March 12, 2014 at 10:08 am #

    Contrast this to the mother Dr. Amy wrote about awhile back, who was okay with her child having a serious brain bleed after refusing the Vitamin K shot. She said something like, “The worst did happen, and it was okay.” I wonder if she feels the same way now, after several months have passed.

  45. lawyer jane
    March 12, 2014 at 10:05 am #

    Wow. That is pure malpractice that they forgot the shot. Another reason to give birth in the hospital, where there’s a team of professionals standing by to care for the baby.

  46. March 12, 2014 at 9:48 am #

    The only odd thing about this story is that I’ve never heard that the Vitamin K shot was optional or that parents have to request it, only that parents could sign a release that they have been advised against refusal and, in spite of the risks they don’t want it given. Otherwise it is given automatically.

    • Trixie
      March 12, 2014 at 9:49 am #

      I was asked my consent at one hospital and not the other. I am fine with not having been asked my consent the first time, though. It’s a no-brainer.

    • PrimaryCareDoc
      March 12, 2014 at 9:51 am #

      The baby was born in a birth center with midwives.

      Mystery solved.

      • MaineJen
        March 12, 2014 at 11:51 am #

        That was my first thought when she said she had “no idea” if her baby received the shot. In a hospital, you would have to actively refuse the vitamin K shot, just like you can actively refuse the Hep B vaccine (although, in both cases…why would you?).

        • The Bofa on the Sofa
          March 12, 2014 at 12:06 pm #

          And, to be fair, why she didn’t get the shot is not near as important now, only the fact she didn’t.

          If a hospital “forgot” that is clearly an error on their part, and they would damn well know it. If it was a MW run BC, then that’s their policy. So focus on creating awareness for mothers that it’s NOT ok to not get it. That’s what you need to put the pressure on those who fight it.

    • TG
      March 12, 2014 at 10:38 am #

      ditto. no one in SZMC mentioned it. same with silver nitrate. I assume that happened also.

      • Esther
        March 12, 2014 at 10:42 am #

        They haven’t used silver nitrate for years – it’s antibiotic eye goop (erythromycin) these days. And unless you refuse the HBV shot, the baby’ll get that by default too.

        • LMS1953
          March 12, 2014 at 11:37 am #

          Interesting factoid about the use of siler nitrate in the newborn. Eye damage from its inappropriate use led to the case where “Captain of the Ship” was first used to pin liability on the attending for the negligent act of an underling within his supervision.

          • araikwao
            March 12, 2014 at 4:47 pm #

            So what’s the story with routine erythromycin ointment application? We don’t use it in Aus, so I’m interested in the rationale. Is there a NNT?

        • Trixie
          March 12, 2014 at 12:56 pm #

          I was asked for consent both times for Hep B. Also both times the ped did not think it was that huge of a deal either way since they’d end up getting it at 2, 4, and 6 months anyway, so the first shot is sort of redundant in low risk populations.

    • thepragmatist
      March 12, 2014 at 6:29 pm #

      I’ve got in some mighty arguments with friends over the refusal of Vitamin K. It all comes down to ignorance, because the same parents will happily supplement Vitamin D. They just don’t understand. I refused eye antibiotics (MRCS) because I’m allergic to the eye antibiotics (viciously) and we figured that me going into shock might interfere with bonding you know, in a REAL WAY (like if I got it in my own eyes inadvertently, for example) and that he had not passed through the birth canal so it was rather moot, but other than that I CANNOT imagine refusing. We did the heel stick, for example, with nary a cry, and so many of my friends think it’s some barbaric slashjob or something. LOL. My son didn’t even murmur, as he was nursing at the time.

    • Klain
      March 12, 2014 at 8:17 pm #

      I’ve always had to give consent. It comes with the midwives saying that even if we do not give any vaccines, at least do Vitamin K.

  47. Coraline
    March 12, 2014 at 9:47 am #

    Thank you so much for sharing this.

    • lawyer jane
      March 12, 2014 at 10:07 am #

      It’s really weird that the NCB crowd would be so against this VITAMIN shot. In other context they are all about weird herbs and vitamins. They must be against the Vitamin K shot purely because it is recommended by medical doctors. I wonder how they feel about folic acid?

      • Coraline
        March 12, 2014 at 10:14 am #

        That’s exactly what I’m thinking – WHY on earth would they be against the Vitamin K shot? Because an “EVIL DOCTOR!” recommended it? Because you distrust the “medical establishment” and “Big Pharma” and “modern medicine” so much that you’ll throw reasonable, rational thinking out the window? Seriously, I swear these people act like those in a cult. It’s ridiculous.

        • Busbus
          March 12, 2014 at 11:08 am #

          It’s just a general, deep mistrust of medicine and what they call “authority”. (The authority that NCB/woo/”natural” health proponents have over them is ok with them.) I think, psychologically speaking, it is related to conspiracy theories etc. It is cultish, but it’s very widespread.

        • Busbus
          March 12, 2014 at 11:09 am #

          Also, of course, it comes in a syringe, and we all know that those are EVIL.

          • Coraline
            March 12, 2014 at 1:06 pm #

            That’s the problem, when it all boils down to it, I think. They might cite (debunked) studies, or possible adverse side effects, but when it comes down to it, they’re just so soaked up in their ideology that they can’t think rationally (or safely!)

        • Amy M
          March 12, 2014 at 11:13 am #

          I think they believe there are “toxins” in the shots.

        • R T
          March 12, 2014 at 1:00 pm #

          There was some obscure study linking it to lukemia at some point. I think that’s the reason, but it has since been debunked.

          • Aki Hinata
            March 13, 2014 at 10:59 am #

            Woo-ists have told me that the fact the baby cries abut the shot interferes with the all-holy breastfeeding.

      • Mariana Baca
        March 12, 2014 at 10:50 am #

        From what I gather from Mercola, he encourages parents to buy oral vitamin K and give it themselves (I don’t know if the mother takes it and transfers it via the magic of breastfeeding or somehow crushes it and gives it to the baby)? My guess? They encourage vitamins when they can be sold on their websites or at natural remedy stores/hippie coops. If they aren’t the ones administering it, they don’t approve.

        Folic acid they can sell themselves, so I’m sure they are all for it.

        • The Computer Ate My Nym
          March 12, 2014 at 11:03 am #

          Hold on. If vit K causes leukemia, why is it ok for the mothers to take it (risking leukemia themselves) and then transmit it to their newborns via breast milk (risking leukemia in the neonate)? Wouldn’t a single exposure be lower risk all around and avoid any risk at all to the parents? (Yes, I know, vit K doesn’t cause leukemia, but if it did, this approach would be totally illogical.)

          • Mariana Baca
            March 12, 2014 at 11:16 am #

            I didn’t even know of that rationale! I though it was “why cause the pain of a shot on your baby?”

            I don’t try to understand their logic once I read in their websites that wifi causes cancer. :/

          • Mishimoo
            March 12, 2014 at 8:26 pm #

            And for a small fee, you can buy magical stickers and a card that blocks the cancer-causing aspect of the wi-fi and your mobile phones.

          • Therese
            March 12, 2014 at 12:36 pm #

            They believe IM vitamin K causes leukemia because there was a study done showing this. There wasn’t any study done showing oral vitamin K being linked to leukemia, so this isn’t going to be a concern with them.

          • R T
            March 12, 2014 at 1:01 pm #

            I think the thought process is the shot contains too much Vit K and other fillers.

        • Busbus
          March 12, 2014 at 11:03 am #

          Where I am from, a high dose of oral Vitamin K is the usual protocol, and I think it is administered at the hospital and then again at the follow-up visits to your pediatrician (3 times altogether). However, having had a homebirth, we had to do it ourselves and it can be hard to remember to do when you are in a postpartum fog. That’s another reason to prefer the shot, IMO – less potential for babies to be lost to follow-up.

          • The Bofa on the Sofa
            March 12, 2014 at 11:38 am #

            If a baby is given oral vit K, does that mean they can’t be included among the exclusively breastfed group?

            It’ll make the crunchies’ heads explode like the robot women on Star Trek when Spock messed them up with a logical inconsistency.

          • March 12, 2014 at 11:39 am #

            Are you thinking of Nomad the robot? I don’t remember exploding robot women. Or do you mean the “mother” computer in the episode Spock’s Brain? (“Brain and brain. What is brain?”)

          • The Bofa on the Sofa
            March 12, 2014 at 11:41 am #

            No, it was the one where a guy (I almost think it was the same guy from Trouble with Tribbles, but probably not; they just look alike) had a group of robot women, and they made their heads fry up when they told them that Spock always tells the truth, and then Spock told them that he was lying.

          • March 12, 2014 at 11:47 am #

            Mudd’s Women. Not the same guy as Trouble with Tribbles. So the relevant quote would be, “I love my work.” It’s all in the delivery.

            Trekkies. What can I say.

          • The Bofa on the Sofa
            March 12, 2014 at 12:03 pm #

            Mudd. That’s the guy.

          • attitude devant
            March 12, 2014 at 12:14 pm #

            Mudd. Remember how the women turned ‘ugly’ when they didn’t get the elixir, but the guy didn’t care because one of them could cook? Ah the sexism of 60s sci-fi!

          • The Bofa on the Sofa
            March 12, 2014 at 12:20 pm #

            No, I don’t remember any of that. I only remember how they were defeated at the end. It’s a great image, and I’ve used it before. Like in explaining what would happen to Cubs fans if the Cardinals were to hire Ryne Sandberg as manager.

            But enough Star Trek. I do like the conundrum I proposed. Do you give the baby a Vit K shot, or do you give them an oral dose and “mess up their gut flora” or whatever that nonsense that a recent poster was spewing.

          • Karen in SC
            March 12, 2014 at 12:07 pm #

            Harcourt Fenton Mudd!!

          • Medwife
            March 12, 2014 at 12:30 pm #

            Do you remember the one where captain Kirk’s body was taken over by a female alien and disaster almost struck because the captain was suddenly overly emotional and illogical? Watched that one in a sociology lecture.

          • The Bofa on the Sofa
            March 12, 2014 at 12:36 pm #

            I know the one where the wild Kirk split off in the transporter and was running around the Enterprise, basically the ID was let loose. One of the times I saw it was when I was taking psych (but not during class)

          • Karen in SC
            March 12, 2014 at 1:07 pm #

            William Shatner’s acting was spot on for the preconceptions of the times.

          • Mariana Baca
            March 12, 2014 at 12:13 pm #

            I think this is “I, Mudd”

          • March 12, 2014 at 12:51 pm #

            To wikipedia!

            Mudd was in 2 episodes (3 if you count the animated series with the full cast of the original series). My introduction to all things Geek Culture was classic Trek; I think it established the neural pathways I use (abuse) to regurgitate factoids.

          • Mariana Baca
            March 12, 2014 at 1:52 pm #

            except for random TNG episodes in childhood, I didn’t start watching star trek until a couple of years ago. I started with TOS, so I definitely base all my trek knowledge around that (even though DS9 is my favorite). But it can definitely be used to relate to most life situations and trivia knowledge. 🙂

          • Amy M
            March 12, 2014 at 3:42 pm #

            I was looking for other Vit K post on mdc, and seriously found one where someone was concerned about “pristine gut” and the oral Vit K.

          • araikwao
            March 12, 2014 at 4:54 pm #

            That’s funny, because those same “pristine” flora *make* the Vit K

        • MaineJen
          March 12, 2014 at 11:59 am #

          But from what I understood, vitamin K is NOT efficiently transmitted to the baby through breast milk. (Though I don’t remember why.) Which is exactly why hospitals encourage the shot.

          • Mariana Baca
            March 12, 2014 at 12:12 pm #

            Yeah, I wasn’t agreeing with this bizarre reasoning.

          • Karma Kidney Stone
            March 12, 2014 at 3:12 pm #

            Vit K isn’t made by the placenta, either.

            Oral Vit K can be a reasonable substitute, even the Harriet Lane, a Peds quick resource, lists dosages for oral Vit K. There are two major problems. One is parent compliance. The dosages are more complicated, and tired overwhelmed parents of newborns might forget. The second problem is that the gut matures differently in all babies, and there is no way to tell which babies have a gut mature enough to absorb the oral dose, or if they can absorb it, how much is absorbed.

        • March 12, 2014 at 1:05 pm #

          I’mnot sure oral vitamin K would survive gastric juices which are highly acidic, to have a chance to even get into breast milk.

          • araikwao
            March 12, 2014 at 4:50 pm #

            There is a form that’s licensed for oral use now. I think originally it wasn’t. The drawback, of course, is still that it needs to be given twice. Hey, wouldn’t that mean the baby isn’t exclusively BF if it gets oral Vit K?? The horror.. 😛
            ETA: snap, Bofa!

          • The Bofa on the Sofa
            March 12, 2014 at 5:00 pm #

            As my 2 yo used to say, “I winned! I winned!”

      • CognitiveDissonaceHurts
        March 12, 2014 at 9:40 pm #

        Poor baby Olive. This is so sad.

        I refused the shot because I didn’t want my baby to be hurt by a needle after all the trouble we had gone to have a gentle and loving birth. I didn’t know about the bleeding disorder.

        Thanks to Dr. Amy’s previous posts, I encouraged my kids to make sure my grandchildren got this shot.

      • Amy
        March 12, 2014 at 10:02 pm #

        Well, that, and it’s injected by a NEEDLE– just like those eeebul vaccinations are.

  48. Gene
    March 12, 2014 at 9:41 am #

    We had one of these a few months ago. Maternal grandmother was a midwife (unsure if real midwife or CPM/fake) and told mom that she didn’t need it because she was breastfeeding. Mother was FURIOUS in the ED and telling everyone she would never listen to her mother again. Kiddo ended up in the PICU for a long time and I’m not sure of any lasting effects (though I know kiddo survived). Vaccines (and preventatives like Vitamin K and Erythro eye goop) are a victim of their own success. Parents don’t know that babies DIED before they were used.

    • Anj Fabian
      March 12, 2014 at 10:23 am #

      At NGM’s FB page, someone asked what what studies had been done prior to 1961 when the Vitamin K shot was first advised.

      I pointed out that without modern imaging technology (and other modern medical technology) the injuries were probably diagnosed via autopsy.

    • Esther
      March 12, 2014 at 11:08 am #

      Breastfeeding babies are more susceptible to VKDB than FF ones. I vote for Grandma being a CPM.

Leave a Reply

You must be logged in to post a comment.