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Conference moira::parenting

Title:Parenting
Notice:Previous PARENTING version at MOIRA::PARENTING_V3
Moderator:GEMEVN::FAIMANY
Created:Thu Apr 09 1992
Last Modified:Fri Jun 06 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:1292
Total number of notes:34837

547.0. "Haemorrhagic Disease vs. childhood cancer" by FORTY2::GOODWIN () Tue Jun 22 1993 08:28

 Hello there,

     First a health warning :-

     Please beware. Don't take my word for any of the following.
         I am qualified in neither medicine nor statistics.

 My wife is about to have a baby and we are trying to decide (among a
 hundred other things!) whether to opt for an intramuscular injection
 of vitamin K or an orally administered dose, or none at all.

 Vitamin K is given to babies shortly after birth, almost as a matter
 of course, to help reduce the chances of Haemorrhagic Disease of the
 Newborn (HDN). This is a very serious condition which can be fatal or
 can cause brain damage.

 Administering vitamin K to babies (who naturally have low levels when
 they are born) is proven to greatly reduce the danger of HDN. I don't
 think there is any doubt about that. An intramuscular injection is the
 most beneficial. An oral dose is also beneficial, but less so.

 The trouble is that a couple of recent studies have indicated a possible
 link between the intramuscular injection of vitamin K and subsequent
 development of childhood cancer.

 So, to make the decision, we really need to know the facts. You would
 think that was simple enough, but the more papers/memos/doctors/midmives
 you go to, the more answers you get and they are all different.

 The best paper I've looked at is the study by Golding et al, published
 in the British Medical Journal in August 1992. This suggests that 
 intramuscular vitamin K doubles the chances of cancer, compared with
 oral or none.

 Childhood cancer occurs 1 in 1000 or 1 in 715, depending on who you ask,
 and rises to 1 in 500 in both cases after intramuscular vitamin K.

 Our real problem is that we get different accounts of the likelihood
 of HDN.  Golding quotes another study which I haven't seen (McNinch,
 BMJ 1991 Vol.303) which says that the risk varied from 4.4 per 100,000
 in those given no vitamin K to 1.4 per 100,000 in those given oral
 vitamin K to 0.11 per 100,000 in those given intramuscular vitamin K.

 4.4 per 100,000 would seem to be 1 in 23,000 BUT I've also seen this
 risk quoted as 1 in 500 or even 1 in 50.
 
 This figure is possibly difficult to establish as Vitamin K has been
 given to most babies in the last 20 years or so and especially to
 those with high risk of HDN. Clearly, though, we need to know the risk
 of HDN before we can balance it against the increased risk of cancer.

 The main question I have, then, is :-

 What are the chances of a baby developing HDN without any vitamin K
 supplement?

 If anybody has gone into this, I would be grateful for any information.

 Also, has any national medical establishment found itself able to
 issue unambiguous guidelines? Not only do the official lines in the UK
 seem to depend on which county you live in, but they are full of ifs and
 buts and often not in english that is understandable (by the pros, never
 mind the layman!).

 Thanks for any help, and sorry for the gloomy subject matter.
 I have also posted this note in the "medical" conference.

 Mike.
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547.1SUPER::WTHOMASTue Jun 22 1993 10:3118
    	I absolutely question the theory of linking a Vit. K shot at birth
    to early childhood cancer. 

    	Cancer is a generic term which covers a multitude of conditions.

    	How can they be sure that the children who had the shots were not
    also exposed to carcinogenic substances while growing up? Was the food
    compared, the quality of air that they breathed compared, were
    chemicals in their environments compared? Were stress levels and
    nutrition compared? Were psychological profiles performed? 

    	I tend to think not.

    	The conclusion from the research that you stated is so very flawed
    that I would not be overly concerned about the injection.

    			Wendy
547.2Ditto Wendy!!MKOTS3::HENMUELLERVickieTue Jun 22 1993 16:451
    
547.3I could be wrong, but ...FORTY2::GOODWINWed Jun 23 1993 04:2155
Wendy,

  I don't think you should dismiss this so easily.

>>    	I absolutely question the theory of linking a Vit. K shot at birth
>>    to early childhood cancer. 

Of course it should be questioned. I have but I am convinced on the
evidence I have seen that there is very likely to be a link between
intramuscular vitamin k & childhood cancer.

>>    	Cancer is a generic term which covers a multitude of conditions.

I know. The research lists the various cancers that the children in the
study suffered. The bulk are leukaemias, lymphomas and nervous system
tumours.

>>    	How can they be sure that the children who had the shots were not
>>   also exposed to carcinogenic substances while growing up? Was the food
>>    compared, the quality of air that they breathed compared, were
>>    chemicals in their environments compared? Were stress levels and
>>    nutrition compared? Were psychological profiles performed? 

>>    	I tend to think not.

Clearly cancers may be caused by a number of factors, or perhaps a
combination of factors, but surely that is not to deny any strong
correlation that may be found between some particular factor & subsequent
cancer. How else can we study it?

This study looked at medical records and so could only investigate any
links between various aspects of the childrens/mothers medical history
and the cancers. It looked for links with a number of such aspects.

It found an increase in the risk of childhood cancer by a factor of 2
in those children given the vitamin k injection. The 95% confidence
interval was 1.5 to 2.5 (these figures are approximate as I don't have
the paper in front of me).

Children's vitamin k concentrations are up to 5000 times the normal
level after the injection. It doesn't seem to be out of the question
for that to have some affects other than the prevention of HDN.
After all, if vitamin k is good for babies, why does mother nature
arrange that they have so little? Or, to put it the other way around,
if vitamin k is really advantageous, surely mother nature (i.e. the
results of evolution) would provide it.

>>    	The conclusion from the research that you stated is so very flawed
>>    that I would not be overly concerned about the injection.

I really have no idea how you can state that the conclusion is flawed
without having read the reasearch. I personally am very concerned about
the injection, but, as I say, I'm not an expert.

Mike.
547.4SUPER::WTHOMASWed Jun 23 1993 10:4533
    	100% of children who breath at birth will eventually go on to
    develop a terminal illness from which they will die (in most cases that
    terminal illness will be old age or accident).

    	If my child receives that shot and is then raised near a nuclear
    dump site and then develops cancer, is it due to the shot or to the
    environment, according to what you have presented that child would fall
    into the shot=cancer category.

    	I'm not saying that the shot is fabulous, there are a lot of things
    that you will be asked to do that are supposedly good for your child
    that you will question (we, for one refused the hep. series now
    routinely given at birth). 

    	As to why we appear to need something that mother nature is not
    providing? Perhaps some children do not indeed need any vitamin
    supplement at birth, some do. In olden days it would have been referred
    to as survival of the fittest, we are now able to increase the more
    "non-fittest" children's chances of survival. Is that to be considered
    bad or not "natural"?

    	I'm not telling you not to worry, it's your decision, worry about
    what you want to (and there will be a million worries with your little
    one ;-)), me? I'm worrying how to teach my kids to be kind to small
    animals and to laugh when they feel the urge.

    	Please keep us updated, I'm interested in your final decision.

    				Wendy

    				Wendy
    	
547.5FORTY2::GOODWINWed Jun 23 1993 11:1518
  Of course the chances are minimal & there are a hundred other things
  to worry about. I just happen to be on this one at the moment!

  As to your nuclear dump site analogy, what if half the children in that
  environment have the shot and a twice as many of that half develop cancer?
  Don't you ignore the environment and concentrate on the shot?

  And as to the "survival of the fittest", might it not be that that very
  mechanism has been selecting in favour of low vitamin k levels all
  the time? I wouldn't think twice about doing something 'unnatural'
  if there wasn't a thought at the back of my mind that maybe we don't
  know everything about what we are doing.

  Anyway, thanks for your interest, I'd better get onto the next of my
  million worries I suppose, or I'll never get through them!

  Mike.
547.6statistical worriesSPECXN::MUNNSThu Jun 24 1993 11:329
    Every parent faces these statistical worries, if they are informed on
    the risks of receiving the various childhood vaccinations.  Even the 
    remote chance of complication can get a parent to worrying.
    
    All you can do is act based on the information you have, however
    incomplete it may be.   If you can learn the risks of getting 
    Haemorrhagic Disease, comparing Vitamin K supplemented kids vs.
    untreated, then perhaps you will have enough information to make
    a decision.                                  
547.7Is this routine in the U.S.?SWAM1::MATHIEU_PAThu Jul 01 1993 20:2916
    Sorry not to be giving you any of the answers that you need, but one 
    thing I was curious about: Are these vitamin K routine in the US? I
    was never asked for consent for any such thing, and I have never 
    heard of vitamin K shots or oral dose before.
    
    Eventually, you'll have to go with your gut feelings when it comes to a
    final decision. Sometimes parental decisions fly in the face of current
    fashion and end up being correct in the long run. For example, I
    insisted on lying my newborn daughter on the back, even though all the
    nurses kept really telling me off. It just looked more "natural" to me,
    and that's the way we were all raised back home. Now of course, medical
    fashion has gone back to back-sleeping, and I feel vindicated.
    
    Good luck in your decision.
    
    Patricia.
547.8Vitamin K shotsCSC32::DUBOISDiscrimination encourages violenceTue Jul 06 1993 15:387
Vitamin K shots are routine in the U.S.  They help the blood clot, which
is especially important if parents decide to circumsize a baby boy before
he is 8 days old.  (I thought it really interesting when our doctor told
us that the blood doesn't clot well until they are 8 days old, and that
this is the age that the Bible suggests circumsizing a boy).

     Carol
547.9Required in Mass.AKOCOA::BOLANDWed Jul 07 1993 14:5625
    
    I've been meaning to enter this note for a while but... well I always
    manage to forget.  Today is my last day (for a while), I'm due with my
    second in two weeks.  
    
    After reading this note, discussing it with hubby and then going thru
    all my Lamaze refresher stuff I discovered that this Vitamin K shot
    is mandatory in Massachusettes.  I left the paper at home, on the table
    where it has been patiently waiting for me to remember to bring it in,
    but alas, I've forgotten again.  The article/paper mentioned the law(?)
    number (if that is the correct term), but basically it seems you don't
    have a choice in Mass.  If you expect your child to attend public
    schools etc. then certain innoculation requirements must be met.  
    
    This always confuses me...since you "MUST" have these shots to attend
    public schools but students without innoculations are in
    schools....hmmm.  Just something to think about.  You may find that
    your state just does things and the hospital/dr you choose has no
    options for you.  
    
    Just a thought....
    
    anxiously awaiting #2,
    
    Rose Marie
547.10CSC32::M_EVANShate is STILL not a family valueMon Jul 12 1993 13:2216
    Vitamin K isn't an immunization, it is a vitamin which is given to
    prevent hemorraging in newborns.
    
    There is some debate among people on whether it is necessary,
    particularly if the mother will be breastfeeding (breastfed babies seem
    to get the bacteria which manufactures vitamin K more quickly than
    formula-fed babies), and there was no use of forceps, or other
    extraction techniques during the birth.  Extraction methods often cause
    some trauma which can cause bleeding.  
    
    I had my two youngest girls at home, so this wasn't an arguement as
    direct-entry midwives can't give innoculations or drugs, or use any
    extraction equipment.  
    
    Meg
    Meg  
547.11Evidence questioned Evidence questioned SEALS::MARSHThe dolphins have the answerTue Jul 13 1993 05:4015
The cancer numbers mentioned in .0  have been questioned by a different team in
Sweden who found no increase in cancer cases in children who had been given Vit
K at birth. This was in "The Guardian" health section about a week ago. I no
longer have the paper.

Given all the other risks we subject children to, I think the Vit K jab is a 
very minor factor. I mean should you put petrol in your car when your child is
is it - what about all those bezene fumes? What is in the water around here?

I live Berkshire, England and I am far more worried about what may be coming 
out of the MoD places around here and the quality of the air and water than 
the fact that my child was given Vit K at birth.

          Celia
547.12Counter-studySTAR::LEWISWed Sep 29 1993 12:4111
    This was in last Thursday's Boston Globe (9/23)
    
    Vitamin-cancer link in infants disputed
    
    The Vitamin K shots given to all newborns to reduce the chance of
    dangerous hemorrhaging do not appear to increase the risk of childhood
    leukemias or other cancers, according to a study in today's New England
    Journal of Medicine. The survey, which included nearly 55,000 children,
    counters two previous smaller studies suggesting a doubling of the
    cancer risk.
    
547.13H-Fever, what is it?DECWET::JOMary had a little lamb, with mint jelly. Dot WarnerMon Sep 19 1994 15:4310
    since this is the only place i've seen heamorrghic mentioned, i'll post
    my question.
    
    i remember being sick in first grade and being told that i had H-Fever. 
    as far as my parents can remember the H stood for heamorraghic.
    
    does anyone know what it is?  i'm 31 today and fairly healthy.
    i'm just curios.
    
    jo