Declining Intramuscular Newborn Vitamin K Prophylaxis: An Exploration of Parental Decision Making and Influencing Factors

Abstract

Objective

Newborn infants are at risk of potentially life-threatening vitamin K deficiency bleeding. This is readily prevented with prophylactic vitamin K at birth. In New Zealand, the recommended route of prophylaxis is intramuscular (IM) but the uptake rates are lower than that of comparable countries. This study investigated the reasoning of parents who opted out of IM vitamin K prophylaxis for their newborn. Study Design Semi-structured interviews were conducted with fifteen families from the Otago/Southland region of New Zealand about their choice to opt out of IM vitamin K. Interview data was analysed using thematic analysis in order to elucidate themes capturing important aspects of parental decision making. Results Parents opt out of IM vitamin K for a variety of reasons. These were clustered into three main themes: parental beliefs and values, concerns about their child’s welfare, and external influencing factors. Parents also raised a number of concerns regarding other perinatal and childhood interventions. Conclusion This study identified factors that influence parental decision making, and lead to a decision to opt out of IM newborn vitamin K prophylaxis. These findings can contribute to the wider body of literature that informs public health initiatives focused on newborn vitamin K prophylaxis.