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They entered the world the way babies should, with piercing cries announcing their arrival. They passed their newborn screening tests. Some made it to their 2-week wellness visits without concern.

Then, without warning, their systems began to shut down. A 7-week-old boy in Maryland developed sudden seizures. An 11-pound girl in Alabama stopped breathing for 20 seconds at a time. A baby boy in Kentucky vomited before becoming lethargic. A brown-haired girl in Texas, not yet 2 weeks old, bled around her belly button.

Desperate to save them, records show, doctors inserted tubes into their airways and hooked them up to IVs. They ordered blood transfusions. They spent half an hour trying to resuscitate one boy until his parents told them they could stop. They shaved another boy’s soft locks to embed a needle directly into his skull to reduce the pressure in his brain.

None of it was enough.

At the morgue, the babies were brought in with their diapers and blankets and with their hospital ID bracelets still wrapped around their tiny ankles. The pathologists’ findings were like those you would typically see in ailing adults, not newborns — the kind of bleeding seen during strokes or brain tissue loss similar to what happens when radiation is administered to treat cancer.

Their autopsies, which took place over the last several years, all came to the same conclusion: The deaths were caused, in whole or in part, by a rare but potentially fatal condition known as vitamin K deficiency bleeding.

In almost every case, the babies’ deaths could have been prevented with a long-standard vitamin K shot. But across the country, families — first in smatterings, now in droves — are declining the single, inexpensive injection given at birth to newborns to help their blood clot.

Many of them are doing so out of a well-meaning but ill-informed abundance of caution. In the hopes of safeguarding their newborns from what they see as unnecessary medical intervention, they have shunned fundamental and scientifically sound pharmaceutical intervention. The trend is also fueled by a contradictory pairing: families’ fierce desire to protect their babies and a cascade of false information infused into their social media algorithms.

Although it is not a vaccine, the vitamin K shot has been swept up in the same post-pandemic tide that has led to a drop in key childhood vaccines, including for measles and whooping cough.

The vitamin K shot is one of the three main interventions, along with the hepatitis B vaccine and an antibiotic ointment in the eyes, that newborns typically receive before leaving the hospital. Leading American institutions and the World Health Organization recommend that newborns get the shot.

In December, the Centers for Disease Control and Prevention stopped recommending that all newborns get the hepatitis B vaccine, which has been highly effective at fighting a virus that can lead to lifelong infections and liver cancer. A federal judge in March temporarily blocked the revised childhood vaccination schedule that included that recommendation. Some families are also rejecting the eye ointment.

Two weeks ago, at a House subcommittee hearing, Rep. Kim Schrier, D-Wash., pressed Health and Human Services Secretary Robert F. Kennedy Jr. to reassure parents that the vitamin K shot is safe. He refused and pushed back.

“I’ve never said, literally never said, anything about it,” Kennedy said.

“That’s exactly the point,” responded Schrier, who is a doctor. “You don’t say anything about it, but the doubt you’ve created about all of medicine and science is causing parents to make dangerous decisions.”

An HHS spokesperson did not respond to questions but in an email blamed the administration of former President Joe Biden for the rise in parents rejecting vitamin K shots. “Vitamin K at birth,” the spokesperson added, “remains the standard of care.”

Meanwhile, families continue to be inundated with advice from self-proclaimed experts using medical terms incorrectly and misunderstanding science to convince parents that getting the shot could put their newborns at risk of grave harm.

Nearly a century’s worth of research and medical advancements shows the opposite to be true.

Babies who don’t get the vitamin K shot, research shows, are 81 times more likely than those who do to develop late vitamin K deficiency bleeding, where in many cases oxygen can’t reach their brains and blood pools around their skulls. Perhaps most alarming is that, according to the CDC, 1 in every 5 babies with vitamin K deficiency bleeding will die.

Determining precisely how many babies have died or suffered severe brain damage because of a lack of vitamin K is difficult. State and federal agencies don’t track data around vitamin K injection refusal or subsequent bleeding, which impedes their ability to quantify and track outcomes, including death.

The number of deaths directly attributed to vitamin K deficiency bleeding appears to be small — fewer than a dozen annually — but has started to climb in recent years, according to death certificate data from federal and state agencies.

But those numbers capture only a fraction of deaths, which often are classified only by other, more immediate causes, such as bleeding in the brain. In 2024, for example, more than 700 newborns died from spontaneous bleeding in their brains, which could have been complicated by liver disease or prematurity. Still, six medical specialists and one official at the CDC said a meaningful portion of those deaths likely were caused by vitamin K deficiency. Many more babies survive the bleeding but suffer massive brain bleeds and lasting injuries.

“A lot of the providers don’t have this on their radar,” said Dr. Jaspreet Loyal, a pediatric hospitalist at Yale Medicine. “The lack of data is almost acting like a reassurance for families that this risk is worth taking.”

Although it is difficult to quantify deaths attributable to vitamin K deficiency, there is clearly a large jump in the number of parents declining the vitamin K shot. Some hospitals have seen refusal rates more than double. A national study of more than 5 million births, published in December, found that the rate of U.S. babies not receiving vitamin K at birth topped 5% in 2024 — up 77% from 2017.

“This was not something we even bothered to spend much educational effort on,” said Dr. Allison Henry, the director of newborn medicine service at Cedars-Sinai Guerin Children’s in Los Angeles, “because there was this simple, safe intervention.”

A cluster of cases 13 years ago was one of the first major signs that something was amiss.

Four babies were rushed to a Nashville, Tennessee, children’s hospital after they suddenly fell ill months apart. Stunned, doctors ran tests that revealed severe bleeding and reached out to Dr. Robert Sidonio Jr., their blood disorder specialist. They learned that the parents had declined vitamin K shots for the babies, each of them between 6 and 15 weeks old.

Once they realized that, the medical team moved quickly to treat them, injecting them with vitamin K and hoping it wasn’t too late. Much to the relief of doctors, they all survived. Only one infant had developmental delays.

The parents explained that they had declined the shot for a number of reasons: a concern, based on long-debunked claims, that the shot could cause leukemia; a belief that the shot wasn’t necessary; and a desire to reduce their baby’s exposure to “toxins.”

The CDC and the state health department opened an investigation and later published a report that found that when the parents declined the shot, their awareness about the risk of bleeding was “incomplete or absent.”

Dr. Anna Morad, a pediatrician at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, said she had witnessed a gradual rise in families refusing vitamin K leading up to the hospitalizations.

She and her colleagues went into the Nashville community to speak at birthing centers and advise families about the benefits of vitamin K. One mother who had refused the shot for her newborn partnered with Morad and described how she came to realize that the shot can save lives.

More than a dozen pediatricians interviewed by ProPublica said they strongly recommend all three of the typical newborn interventions but agreed that the vitamin K shot is the most vital.

“I’m picking vitamin K every day,” Morad said. “Absolutely.”

With time, the number of families who turned down the shot dropped. As the need for the community outreach waned, Morad lost touch with the mother she had teamed up with and refocused her energy on directing the newborn nursery at Vanderbilt Health.

“I’ll be honest, I thought we had turned the corner,” Morad said. “Naively, I thought that would be enough.”

Doctors have yet to understand why some babies who don’t get the vitamin K shot are fine while others bleed uncontrollably. But they do know that the risk increases dramatically. For babies who don’t get the shot, the risk for vitamin K deficiency bleeding from a week after birth to 6 months ranges from 1 in 14,000 to 1 in 25,000 births. With the shot, the research shows, the risk drops to less than 1 in 100,000.

The role of vitamin K is so crucial that researchers were awarded the Nobel Prize in 1943 for their discovery of its ability to form clots and stop bleeding in babies. The official presenting the award called the discovery the vitamin’s “greatest practical importance” and lauded it among the discoveries that have been of great benefit to humankind.

In 1961, the American Academy of Pediatrics recommended that all newborns in the U.S. get a shot of vitamin K. The CDC has supported newborns getting the shot as well, devoting several pages online to raising awareness around vitamin K deficiency bleeding and writing that babies may bleed “into their intestines, or into their brain, which can lead to brain damage and even death.” For decades, medical textbooks and lectures have presented the vitamin K injection as an example of a public health policy success.

After reports that vitamin K deficiency bleeding was on the rise, the American Academy of Pediatrics updated its policy statement in 2022 to stress the shot’s safety and efficacy. The paper included talking points for pediatricians to help them respond to common misconceptions: “Vitamin K injection does not contain mercury. Vitamin K does not cause cancer. The vitamin K injection used in newborns is safe. The dose is not too high for newborns.”

“We’re a victim of our own success,” said Dr. Ivan Hand, the director of neonatology at Kings County Hospital Center in New York and the co-author of the American Academy of Pediatrics statement. “Since we’ve been treating babies with vitamin K, we haven’t seen much deficiency bleeding, so people think it doesn’t exist.”

Seeing photos online of healthy babies who didn’t get the vitamin K shot and reading comments from parents who felt justified in their refusal, it’s easy to think that the risk of bleeding isn’t real, or at the very least that it’s exaggerated.

On Facebook, comments about the shot include: “Don’t do it!” “Huge lie!” and “It’s a scare tactic.” One person wrote, “Never will I ever inject my baby with poisons from big pharma.”

Families have also pointed to a 2023 episode about vitamin K shots by conservative podcaster Candace Owens, who said, “What Big Pharma is saying is that we realize that babies were born wrong. They don’t have enough vitamin K, and so we’re going to give them what they always needed. God designed us wrong.”

Owens did not respond to a request for comment.

Hidden is the agony of parents mourning the loss of their babies. Some are still in denial.

ProPublica spoke with five of those families, but none of them wanted to be identified publicly.

The obituaries, social media posts and GoFundMe pages capture the utter despair of the families, though none of them reckon with the decision not to get the vitamin K shot.

“No one could’ve prepared us for the heartbreak we faced 6 weeks after our little miracle was born,” one mother wrote. “She had a spontaneous unexplained brain bleed that led to brain death.”

“We miss his sweet smell,” another family wrote.

A third family, who made their decision after reading about vitamin K on social media and talking with their midwife, dismissed the vitamin K shot altogether. Instead, the father expressed outrage at the hospital for not delaying the clamping of the umbilical cord. He said he believed doing so would have allowed his son to be infused with vitamin K from the cord blood, a popular theory on social media. Research, however, shows that while delayed cord clamping can raise the baby’s hemoglobin levels, it does not have the same effect on vitamin K.

“I figured the hospital was already pissy with me because we didn’t vaccinate at all,” he told ProPublica. “They lost out on all the money from that.”

The family’s anger has subsided some since the baby’s death, in part because of their trust in God’s plan.

“I can sit here and be upset and sad, but this brought me closer to God,” the father said. “I just can’t wait to be with him.”

Two of the families who went on to have other children found themselves facing the same decision: Would they decline the vitamin K shot again? Both got the shot for their newborn.

In January, she reached out to Sidonio, her former colleague who first recognized the 2013 cluster of cases there, for advice. Sidonio, now a pediatric hematologist oncologist at Children’s Healthcare of Atlanta and professor at Emory University School of Medicine, said he’s more worried than ever.

During that cluster, Sidonio recognized the need to collect data on how often parents decline the shot and what happens to those babies. But in discussions with the CDC, he said, he was told that it would be too difficult.

More than a decade later, nothing has come of it. In a recent email to ProPublica, federal officials said vitamin K deficiency bleeding has never been submitted for consideration as a notifiable condition.

“If you don’t track it, you don’t document it,” said Sidonio, frustration building in his voice. “They have to make it a reportable health condition, just like a new measles case. That’s the only way it’s going to change.”

Like him, Dr. Kristan Scott, the lead author of the national study that found a jump in the number of babies not receiving vitamin K, also landed on a need for a robust system to monitor vitamin K refusals and any subsequent consequences.

“We don’t have a clean data repository provided by public health systems or the state that would allow us to be able to track this in a more systematic fashion,” said Scott, who is a neonatologist at the Children’s Hospital of Philadelphia.

Some doctors failed to recognize the role of vitamin K when a baby came into their emergency rooms, let alone knew how to reverse the damage from the declined shots. Many of them encountered the condition only in medical school textbooks.

Some hospitals have started to run their own numbers, but the effort is scattershot. The data is also usually kept in house, so there’s not a wider knowledge of the problem. Recognizing the urgency of the matter, officials at a handful of hospitals agreed to share their data with ProPublica.

Doctors at St. Louis-based Mercy, which runs birthing hospitals in Missouri, Kansas, Oklahoma and Arkansas, began noticing an uptick in families turning down the vitamin K shot during the pandemic. Last year, 1,552 babies across all Mercy hospitals didn’t get the injection. In 2021, that number was 536.

And at Idaho’s largest hospital system, the refusal rates have gone up every year since the start of the pandemic, and in some cases have more than doubled. In 2020, 3.8% of families across St. Luke’s Health System declined the vitamin K shot for their babies. In 2025, that figure jumped to 9.8%. One hospital even reached 20% of babies not getting vitamin K shots.

At least two babies treated at St. Luke’s died within the last year from complications related to vitamin K deficiency bleeding, hospital officials confirmed. But Dr. Tom Patterson, a pediatrician who treats newborns at some St. Luke’s hospitals and is among the most vocal in warning about the climbing refusal rates, suspects there may be more.

Patterson recently pleaded with a family to allow their baby to get the shot. The father refused and shocked the doctor by going even further. He approached the nurses to complain about Patterson pushing the matter.