There is certainly benefits and risks to each approach and I am still flumbling around on the fence in regards to my personal stance but here's my views so far.
First off, I do think this is an appropriate spot for this thread. Yes the vitamin K injection occurs after the birth but it is done just hours if not immediately following the birth so it's a decision that parents must make prenatally and many of us pregnant folks don't actually venture over to the parenting boards until after our little babes are born.
Secondly, the vitamin K injection works quite differently then other immunizations. Other immunizations trigger the immune system in attempts to create a relatively long lasting immunity to disease while vitamin K is used to supplements the babies already existent vitamin K supply to help the blood to clot and the protection is relatively short term.... until the baby begins producing their own vitamin K. {interesting but relatively useless fact, babies born vaginally produce vitamin K sooner, because they are more likely to come into contact with bacteria from their mother's anus
... Who knew that would be a good thing?!?! Another reason to lower those c-section rates...) Anyways back to vitamin k, essentially we are giving the baby more of what it already has... plus the additives they use in the formulation of the injection....
And yes there are different "types" of mercury. To date there is no study thus far to indicate that the type they are using is harmful..... But that doesn't mean that in 20 years they won't discover or confirm that what we were giving our babies was actually causing cancer or MS or Autism or ADD or Early Onset Alzheimer or the list goes on and on and on and on..... (note: there were studies that PROVED that links to cancer and autism existed... but then those studies were examined to be "faulty" and the associations were discredited.... Who was actually right.... Who knows???)
Also..... Babies are born with less then 50% of an adults vitamin K concentration.... So as the scientific humans we are, we have decided to fix that.... But I can't help but think that maybe there is a reason babies are born with low concentrations in vitamin K following birth? Perhaps it's crucial for their development in some way or another????? Yes, the babies do get a little vitamin K from the placenta, and a little vitamin K from breastmilk, but even if the mother has an excellent diet and supplements with vitamin K herself... those babies levels have still been shown to be deficient in vitamin k... again maybe's it's suppose to be that way??? Nature doesn't f*ck up that often!
Now onto risk factors... Yes prematurity, hypoxia, birth trauma, c-section and breastfeeding increase the chances the baby will suffer from hemorrhagic disease of the newborn it's important to note that in over 50% of cases there are NO RISK FACTORS.... Now that is the scary aspect of it all that bothers me. Thank god it's relatively rare.
Every study I have looked at states different incidences.. Likely due to the fact that there was a mass movement to give all newborns supplemental vitamin K prior to conducting adequate studies on the incidence of these bleeding conditions.... But anyways, the risk is about 1/10000-15000 if no vitamin K is given and about 1/100,000 -250,000 if vitamin K is given. Regardless of the "exact" numbers it is quite clear that this vitamin K supplementation is highly effective at preventing VKBD. (not like the GBS thing.... when antibiotics are not given babies have a 1/1000 chance of getting it... when antibiotics are given babis have a 1/2000 chance of getting it.... but I won't go there now....) back to vitamin K.
VKBD is a VERY scary thing. I thankfully have never met a baby who has experienced this and I have only ever had a handful of mothers refuse the injection but I did work with a midwife who once had a client who had a baby who experienced this and the results were fatal as they are in up to 30% of cases... And if death does not occur brain damage is likely. The midwife was EXTREMELY shaken by the experience and I think her tension had rubbed off on me a bit.
A little on my thoughts of oral doses... They are good in that they are less invasive and do not cause pain... And they are protective against vitamin k deficiency bleeding in comparison to giving no vitamin k at all, but they are approximatley 4 times less effective then their vitamin K injection counterpart even when compliance is perfect and the baby receives ALL of the doses of the vitamin K. It's suggested that they get atleast 3 doses, but there was one study in Denmark which gives babies oral vitamin k weekly until 3 months of age. Also of interest, there are some countries in which oral vitamin K is not even offered! Canada is one of them. The vitamin K they use has not been "tested" orally and therefore the fomulation they used is suppose to be for injection only. Some midwives will give this vitamin K orally, but they are not suppose to as it is not licenced to be admisisterd orally.
Last but not least... yes I do believe that health care providers go into the profession to help people... But I also believe that they are just regular people... And there are generally two types of people... One group who accepts the norms of society and conforms to what everyone else does, those are the type of "easy" clients who do not question their doctors or midwives recommendations they are also the type of clinical practioners that do not question their "college guidelines", do little research outside the box and just follow mainstream practice until a big "movement" tells them to do otherwise... Then there are the other group of people who analyze everything critically. They don't take everything to be written in stone and they do not conform to societals norms unless doing so is their preferred route. Those health care providers in this group tend to know that there is no hard and fast rule as to what the best plan of care is and they realize that medicine is constantly changing.. What they do now may not be the right thing tomorrow and that acknowlege that clients have every right to question current procedures and decide for themselves how to procede... Just food for thought.....
) Anyways, in my community it is the obs standard of practice to cut and clamp right away (in a teaching hospital!). Often even before they hand the baby to the mother (a non so ideal practice in my opinion 
), then I have met some midwives who do not clamp or cut until the cord stops pulsating. They have somewhere deemed this the most acceptable method and tend not to even discuss it with their clients unless the client brings it up. Then there are midwives who bring this subject up antenatally, engage in an informed choice conversation and then go with whatever the client decides... My point is different health care professionals act in different ways and they all do so for the babies best interest based on their own opinions of the research in addition to what they were "taught" to do.
