How Calling VKDB a Stroke Changes Parents' Minds on Vitamin K

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Vitamin K shot refusals have risen in recent years, which many clinicians believe may be a downstream effect of broader vaccine hesitancy.¹ But a neonatologist noted that she saw refusals on the West Coast well before the latest wave of misinformation about preventive care.

Joanna Parga-Belinkie, MD, attending physician in the Division of Neonatology at Children's Hospital of Philadelphia, trained in Los Angeles and has been an attending for about 10 years. During her training, she encountered vitamin K shot refusals, as she put it, when the highest levels of government began spreading misinformation about preventive care, she said in an interview with The American Journal of Managed Care^®. Although she was already familiar with the type of counseling required to navigate these conversations, she emphasized that other neonatologists and infant-care providers can be trained to do this counseling so it doesn't take as much time as some have reported.

"I think [there are] ways that you can listen and still give good information and make sure to provide parents with what they need to make their decisions in a way that doesn't eat up the entire workday," Parga-Belinkie explained.

Knowing which rumors and myths parents may have encountered is a good starting place, she said. When parents refuse, Parga-Belinkie said they sign a form acknowledging they understand the risk of severe bleeding, a protocol she first used during her training in Los Angeles. Similar documentation can help if an infant later presents with bleeding in a setting such as the emergency department, alerting clinicians to consider vitamin K deficiency bleeding (VKDB), Jaspreet Loyal, MD, MS, section chief for pediatric hospital medicine at Yale School of Medicine, previously told AJMC.²

Often, explaining the risk in familiar terms helps parents understand what's at stake, Parga-Belinkie said. She tells families what she is most scared of: that the baby will have a hemorrhagic stroke.

"When I say stroke, a lot of times I do change families' minds 'cause they didn't understand that bleeding in the brain was a stroke," she explained. "And they've had familiarity with a grandparent or even maybe with someone else in their family having a stroke, and they realize how serious this is."

Even when parents still decline, she counsels them on the signs of a stroke in an infant, which can be nonspecific, and encourages them to go to the emergency room if their baby isn't acting appropriately.

References

1. McCrear S. Vitamin K refusals are rising: what payers need to know. AJMC. September 18, 2026. Accessed October 7, 2026. https://www.ajmc.com/view/vitamin-k-refusals-are-rising-what-payers-need-to-know

2. McCrear S, Loyal J. Why parents are refusing the vitamin K shot. AJMC. October 7, 2026. Accessed October 8, 2026. https://www.ajmc.com/view/why-parents-are-refusing-the-vitamin-k-shot