Baltimore-area pediatricians say they are watching a quiet but troubling shift in the nursery. More parents are declining routine newborn protections that used to be almost automatic, including the vitamin K injection, erythromycin eye ointment, and the hepatitis B vaccine given at birth. Doctors describe these measures as simple, low-risk, and highly effective, yet hospital staff say they are now spending more time counseling families, answering skeptical questions, and documenting refusals before babies ever leave the hospital.
Study documents national rise in refusals
This is not just a local blip. A large analysis published in JAMA found that vitamin K nonreceipt nearly doubled nationwide, rising from about 2.9% of newborns in 2017 to roughly 5.2% in 2024. The study drew on records from more than 5 million births across hundreds of hospitals, according to the Children's Hospital of Philadelphia. Investigators used Epic Cosmos data and reported that the increase persisted even after adjusting for recorded maternal and infant characteristics.
Why the numbers matter
The Centers for Disease Control and Prevention notes that infants who do not receive the vitamin K shot are about 81 times more likely to develop late vitamin K deficiency bleeding, or VKDB. This form of bleeding often shows up as an intracranial hemorrhage and can result in death or long-term disability, according to the CDC. VKDB is rare today precisely because of routine prophylaxis, clinicians say, and skipping the shot removes a safeguard that has quietly protected newborns for decades.
Where doctors are already seeing consequences
Some doctors say the impact is already showing up in heartbreaking ways. At a February meeting of the Idaho chapter of the American Academy of Pediatrics, physicians reported eight infant deaths from vitamin K deficiency bleeding over the prior 13 months, chapter president Dr. Tom Patterson told The Associated Press. Patterson said the pattern emerged in some hospital nurseries where an unusually high share of parents had declined the vitamin K shot, and he called the trend "super worrisome."
Other reporting and clinical analyses link refusal of the small vitamin K injection to a drop-off in other newborn protections, including the hepatitis B birth dose and routine eye prophylaxis. Those measures are used to prevent chronic liver infection and rare but blinding eye infections, respectively, according to Contemporary Pediatrics and federal guidance. Clinicians say that skepticism about one intervention can easily spread to the entire newborn care "bundle."
How hospitals are responding
Nursery teams report that they are stepping up counseling efforts, offering written materials, and documenting parental decisions so that follow-up care is not missed.
Local pediatric practices and national medical societies stress that these newborn interventions are low-risk and highly effective. They urge clinicians to have respectful, evidence-based conversations with families to address questions and misinformation, according to the American Academy of Pediatrics. For now, hospitals in the Baltimore area say they will keep offering the standard newborn protections while working to rebuild and reinforce trust with parents at the very start of a child's life.
