Vitamin K for Newborns: Why It Matters, Your Options, and How to Request Preservative-Free Formulations

Dr. Jen
3 days ago
3 min read

Vitamin K is one of the most important — and often overlooked — decisions parents make for their newborn. Even though the vitamin K shot has been standard of care for decades, many parents want to understand what it does, what ingredients are in it, and what options they have. The good news: families can support safety while also choosing a formulation they’re comfortable with.

This guide breaks down why vitamin K is recommended, the concerns around preservatives, the availability of preservative-free options, and how oral vitamin K fits into the conversation.

Why Newborns Need Vitamin K

All babies are born naturally low in vitamin K because:

vitamin K does not cross the placenta well
their gut bacteria haven’t developed yet
breast milk contains low levels
the newborn liver is not mature enough to produce clotting factors

This creates a universal risk for Vitamin K Deficiency Bleeding (VKDB) — a serious condition that can cause internal bleeding, including intracranial hemorrhage.

The vitamin K shot has been proven to dramatically reduce this risk, which is why nearly every medical organization worldwide recommends it.

The Vitamin K Shot:

The intramuscular (IM) vitamin K injection:

✔ provides a reliable dose✔ protects against all three forms of VKDB✔ gives months of coverage (important for exclusively breastfed infants)✔ prevents the most dangerous form: late VKDB

For parents who want their baby to receive vitamin K but want to minimize additives, the formulation becomes the key consideration.

Preservatives in Some Vitamin K Shots

Some vitamin K formulations — including common multi-dose hospital vials — contain preservatives such as:

benzyl alcohol
polysorbate 80

These are included to prevent contamination in multi-use vials.

Many parents are comfortable with vitamin K itself, but prefer to avoid preservatives in their newborn whenever possible.

Preservative-Free Vitamin K Shots Exist

This is the most important part parents often don’t know:

✔ There are preservative-free, single-dose vitamin K injections available. The most common one is: Amphastar Pharmaceuticals (Phytonadione Injectable Emulsion, USP)

Benefits of preservative-free formulations:

no benzyl alcohol
reduced chemical exposure
single-use packaging = no contamination risk

These formulations are widely used in integrative hospitals, birth centers, and by families who want vitamin K in the cleanest form possible.

Parents need to ask in advance by calling the hospital to see if it's on formulary. You can also have your ob/gyn request that it's available.

How to Request Preservative-Free Vitamin K at Your Hospital

Here’s the exact language families can use:

“We want our baby to receive vitamin K, but we prefer the preservative-free, single-dose formulation. Can you confirm that the pharmacy has it on formulary? If not, can it be ordered ahead of delivery?”

Key tips for parents:

✔ Ask before admission✔ Request it in writing in your chart or birth plan✔ Some hospitals must order it — so early notice helps✔ Most pharmacies can obtain it if asked

This gives families the best of both worlds:• full protection from VKDB• without the preservatives of multi-dose vials