Vitamin K and erythromycin policy
While babies are still in the uterus, maternal vitamin K does not cross the placenta to reach the baby. When they are born, babies have immature liver function and breast milk does not contain enough vitamin K. That means that all newborns have low levels of vitamin K, so they all need supplementation from another source. Vitamin K deficiency can result in bleeding in the intestines and brain during the newborn period that can be fatal. If the infant survives the bleeding episode, it can cause permanent brain damage leading to severe developmental disabilities. Newborns that do not get a vitamin K shot at birth are 81 times more likely to develop severe bleeding that can occur at birth through six months of age. Injectable vitamin K has been the standard of care for the prevention of vitamin K deficiency bleeding since 1961, when it was first recommended by the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC). Since that time, providers have been able to safely and effectively eliminate the risk of bleeding and death.
Erythromycin eye ointment protects newborns from ophthalmia neonatorum, a gonorrhea infection of the eyes that can result in blindness. A simple application of eye ointment can protect the newborn from transmission during birth and saves a child from unnecessary consequences that lead to blindness. Application of the ointment is recommended within one hour of birth to allow for effective bonding between a newborn and his/her mother.
We are proud to say that our policies and practices adhere to the guidelines recommended by the AAP. As a department, we retain the right to opt out of providing care for infants whose parents uniformly and unequivocally refuse vitamin K and erythromycin eye ointment. To be clear, it saddens us to turn any child away. However, we have found that we cannot provide high-level care without using the tools that allow us to prevent disease.
Pediatric immunization policy
Our pediatrics department is committed to delivering the highest quality health care in a safe and welcoming environment. Our relationship with patients and families is based on mutual respect, openness, and trust. With this goal, we partner with families and educate caretakers and children about how to maximize their health. We are proud to say that our policies and practices adhere to the guidelines recommended by the AAP.
With this in mind, we are thankful that today’s medicine allows us to prevent life threatening diseases through the use of vaccinations. Vaccines are consistently monitored by the U.S. Food and Drug Administration (FDA), CDC and the American Committee on Immunization Practices (ACIP). All entities ensure that vaccines remain safe to use and provide the best outcomes. Although adverse reactions rarely occur1, studies have shown that vaccines prevent devastating diseases, decrease infant mortality/disability and keep kids healthy into adulthood2.
Because we believe in delivering health care in a trusting partnership, we must maintain the safety of our offices and communities for patients who have undertaken the responsibility of vaccinating their children. As such, we have established the protocol that, as a department, we retain the right to opt out of providing care and taking responsibility for the health of children whose parents uniformly and unequivocally refuse to vaccinate them. To be clear, it saddens us to turn any child away. However, we have found that we cannot provide high-level care without using the tools that allow us to prevent disease. Therefore, we would be doing both the child and their contacts (at home and in the community) a disservice by continuing to see them at Optum. We always hope that we can work with parents to improve their comfort level and increase their knowledge about the benefits of vaccines. When this is impossible, we must retain the right to sever the relationship and discharge their children from the practice.
1 Preventing and Managing Adverse Reactions. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/adverse-reactions.html. Last reviewed October 18, 2022. Accessed May 15, 2023.
2 NIIW (National Infant Immunization Week). https://www.cdc.gov/vaccines/events/niiw/overview.html. Last reviewed April 11, 2023. Accessed May 12, 2023.