It's not just vaccines — parents are refusing other routine preventive care for newborns

Doctors across the nation are alarmed that skepticism fueled by rising anti-science sentiment and medical mistrust is increasingly reaching beyond vaccines to other proven, routine, preventive care for babies.

A recent study in the Journal of the American Medical Association, which analyzed more than 5 million births nationwide, found that refusals of vitamin K shots nearly doubled between 2017 and 2024, from 2.9% to 5.2%. Other research suggests that parents who decline vitamin K shots are much more likely to refuse getting their newborns the hepatitis B vaccine and an eye ointment to prevent potentially blinding infections. Rates for that vaccination at birth dropped in recent years, and doctors confirm that more parents are refusing the eye medication.

“I do think these families care deeply about their infants,” said Dr. Kelly Wade, a Philadelphia neonatologist. “But I hear from families that it’s hard to make decisions right now because they’re hearing conflicting information.”

Innumerable social media posts question doctors’ advice on safe and effective measures like vitamin K and eye ointment. And the Trump administration has repeatedly undermined established science. A federal advisory committee whose members were appointed by Health Secretary Robert F. Kennedy Jr. — a leading anti-vaccine activist before joining the administration — voted to end the longstanding recommendation to immunize all babies against hepatitis B right after birth. On Monday a federal judge temporarily blocked all decisions made by the reconfigured committee.

One common thread that ties together anti-vaccine views and growing sentiments against other protective measures for newborns is the fallacy that natural is always better than artificial, said Dr. David Hill, a Seattle pediatrician and researcher.

“Nature will allow 1 in 5 human infants to die in the first year of life,” Hill said, “which is why generations of scientists and doctors have worked to bring that number way, way down.”

Vitamin K and other measures prevent serious problems

Babies are born with low levels of vitamin K, leaving them vulnerable because their intestines can't produce enough until they start eating solid foods at around 6 months old.

“Vitamin K is important for helping the blood clot and preventing dangerous bleeding in babies, like bleeding into the brain,” said Dr. Kristan Scott of the Children’s Hospital of Philadelphia, lead author of the JAMA study.

Before injections became routine, up to about 1 in 60 babies suffered vitamin K deficiency bleeding, which can also affect the gastrointestinal tract. Today the condition is rare, but research shows that newborns who don’t get a vitamin K shot are 81 times more likely to develop severe bleeding than those who do.

Hill has seen what can happen.

“I cared for a toddler whose parents had chosen that risk,” the Seattle doctor said. The child essentially had a stroke as a newborn and wound up with severe developmental delays and ongoing seizures.

At a February meeting of the Idaho chapter of the American Academy of Pediatrics, doctors said they knew of eight deaths from vitamin K deficiency bleeding in the state over the preceding 13 months, said Patterson, who is president of the chapter.

Infections prevented by other newborn measures can also have grave consequences. Erythromycin eye ointment protects against gonorrhea that can be contracted during birth and potentially cause blindness if untreated. The hepatitis B vaccine prevents a disease that can lead to liver failure, liver cancer or cirrhosis.

Even if a pregnant woman is tested for gonorrhea and hepatitis B, no test is perfect, and she may get infected after testing, said Dr. Susan Sirota, a pediatrician in Highland Park, Illinois. Either way, she risks passing the infection to her child.

Why are parents refusing routine care?

Parents give many reasons for turning down preventive measures, like fearing they might cause problems and not wanting newborns to feel pain.

“Some will just say they want more of a natural birth philosophy,” said Dr. Steven Abelowitz, founder of Ocean Pediatrics in Orange County, California. “Then there’s a ton of misinformation. … There are outside influences, friends, celebrities, nonprofessionals and political agendas.”

Abelowitz practices in an area with about an equal mix of Republicans and Democrats.

“There’s more mistrust from the conservative side, but there’s plenty on the more liberal side as well,” he said, “It’s across-the-board mistrust.”

Social media provides ample fuel, spreading myths and pushing unregulated vitamin K drops that doctors warn babies can't absorb well.

Doctors in numerous states say parents refusing vitamin K shots often also decline other measures. Sirota, in Illinois, encountered a family that refused a heel stick to monitor glucose for a baby at high risk for having potentially life-threatening low blood sugar.

Care refusals aren’t a new phenomenon. Wade, in Philadelphia, said she’s seen them for 20 years. But until recently, they were rare.

Twelve years ago, Dana Morrison, now a Minnesota doula, declined the vitamin K shot for her newborn son, giving him oral drops instead.

“It came from a space of really wanting to protect the bonding time with my baby,” she said. “I was trying to eliminate more pokes.”

Her daughter's birth a couple of years later was less straightforward, leaving the infant with a bruised leg. Morrison got the vitamin K shot for her.

Knowing what she does now, she said, she would have gotten it for her son, too.

Doctors and parents want ‘the best for their children’

Doctors hope to change minds, one parent at a time. And that begins with respect.

“If I walk into the room with judgment, we are going to have a really useless conversation,” Hill said. “Every parent I serve wants the best for their children.”

When parents question the need for the vitamin K shot, Dr. Heather Felton tries to address their specific concerns. She explains why it’s given and the risks of not getting it. Most families decide to get it, said Felton, who has seen no uptick in refusals.

“It really helps that you can take that time and really listen and be able to provide some education,” said Felton, a pediatrician at Norton Children’s in Louisville, Kentucky.

In Idaho, Patterson sometimes finds himself clearing up misconceptions. Some parents will agree to a vitamin K shot when they find out it's not a vaccine, for example.

These conversations can take time, especially since the parents doctors see in hospitals usually aren't people they know through their practices.

But doctors are happy to invest that time if it might save babies.

“I end every discussion with parents with this: ‘Please understand at the end of the day, I’m passionate about this because I have the best interest of children in my mind and heart,’” Patterson said. “I understand this is a hot topic, and I don’t want to disrespect anybody. But at the same time, I’m desperately saddened that we’re losing babies for no reason.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.