New York State Requirements for Vitamin K
& Eye Drops at Birth
The school/vaccination law includes a religious exemption, but the vitamin K law, which is a separate law, does not. Below are some links to information about the Vitamin K mandate, eyedrops and a copy of a letter from the New York State Department of Health which
NYS Department of Health
Immunization information: health.state.ny.us/nysdoh/immun/immunization.htm
Health Topics A to Z: health.state.ny.us/healthaz
Public Health Forum: health.state.ny.us/nysdoh/phforum/index.htm
Full Text Search - Official Compilation of NY Codes, Rules and Regulations (NYCRR)
* Title 10 - NYCRR
* Title 18 - NYCRR
* Regulatory Agenda, New York State Department of Health
* Proposed Rulemaking
(Note - to locate the following sections, click on Table of Contents and scroll down to Section 12.)
Effective Date: 07/19/2000
Title: Section 12.3 - Precautions to be observed for the prevention of hemorrhagic diseases and coagulation disorders of the newborn and infants related to vitamin K deficiency
12.3 Precautions to be observed for the prevention of hemorrhagic diseases and coagulation disorders of the newborn and infants related to vitamin K deficiency. It shall be the duty of the attending physician, licensed midwife, registered professional nurse or other licensed medical professional attending the newborn to assure administration of a single parenteral dose of 0.5-1.0 mg. of natural vitamin K(1) oxide (phytonadione) within one hour of birth.
Effective Date: 07/19/2000
Title: Section 12.2 - Precautions to be observed for the prevention of purulent conjunctivitis of the newborn
12.2 Precautions to be observed for the prevention of purulent conjunctivitis of the newborn. It shall be the duty of the attending physician, licensed midwife, licensed nurse or other authorized provider in attendance at a delivery to place into the eyes of the infant, on delivery, an agent effective for preventing purulent conjunctivitis of the newborn, such as tetracycline or erythromycin eye preparation or a one percent solution of nitrate of silver.
Forced Medication of Healthy Newborns with Vitamin K in New York State
Dec 7, 1999 home.att.net/~waterbird
This paper seeks repeal or nullification of New York State Law NYCRR, Title 10, Section 12.3, which mandates the injection of all newborns with a Vitamin K prophylaxis.
hospital vitamin k horror: Caution or coercion? The controversy over vitamin K and eye prophylaxis - Pregnancy, Birth & Midwifery
Mothering, Nov-Dec, 2001 by Mary Beth Tierney
STATE OF NEW YORK DEPARTMENT OF HEALTH
The Governor Nelson A Rockefeiler Empire State Plaza
Albany, New York 12237
Dennis P. Whalen
Executive Deputy Commissioner
September 10, 1999
We have been alerted that a growing number of new parents are refusing to allow their newborns to receive a Vitamin K injection or eye prophylaxis. We are writing to remind you that both these interventions are required in New York State by both the sanitary code and the hospital code (Sections 12.2 and 405.21(e)(4)(v)(b), 10 NYCRR). Neither regulation exempts infants whose parents object to the practice. Since these treatments are mandated by state regulation, informed consent is unnecessary, and hospitals and individual providers cannot be sued for administering them. Conversely, a providerís failure to administer these treatments could result in a citation. A parentís refusal of these treatrnents cars be reported to Child Protective Services
In addition to being required by New York State regulations, Vitamin K and eye prophylaxis are both widely recognized by professionals as the standard of care for newborns. The Guidelines for Perinatal Care, 4th Edition (1997), published by the American Academy of Pediatrics and American College of Obstetricians and Gynecologists, recommend both interventions for all newborns.
Vitamin K is given within an hour of birth to prevent hemorrhagic disease of the newborn, a potentially fatal condition. It must be given by injection, since oral vitamin K has not been shown to be as effective, and thereare no oral vitamin K preparations available for pediatric use in this country. Vitamin K prophylaxis is mandated for all newborns because the condition it prevents is life-threatening and because the intervention is itseff very safe. Vitamin K has been reported on rare occasions to cause hyperbilirubinemia in the newborn, but only at doses many times higher than the 0.5 - 1.0 mg dose recommended for preventing hemorrhagic disease of the newborn.
Eye prophylaxis - either 1% silver nitrate solution or ophthalmic ointment containing erythromycin (0.5%) or tetracycline (1%) is given to prevent gonococcal and/or chiamydial infections of the eyes. These infections were once a common Cause of blindness and have now bean almost entirely eradicated through use of prophylactic medications. Eye prophylaxis is a universal requirement because of the seriousness of the condition prevented and because the treatment is effective and safe. Moreover, targeted prophylaxis, treating only infants of mothers known to be infected with gonorrhea and/or chiamydia, is not an effective approach to prevention in this case. Both these infections are common among women of childbearing age, and both organisms can be very difficult to culture. Targeted prophylaxis would miss many infants at risk and lead to many cases of preventable blindness. Parents may object to eye prophylaxis because they have heard that it causes serious eye irritation. While silver nitrate drops can cause an imtant conjunctivitis in the newborn, both of the antibiotic alternatives have minimal, side-effects and are highly effective.
If you have further questions about the application of these regulations, please contact the Bureau of Womenís Health at (518) 474-1911, or the Bureau of Hospital & Primary Care Services at (518) 402-1004.
Mary Applegate, MD MPH
Bureau of Womenís Health
Frederick J, Heigel
Bureau of Hospital & Primary Care Services