Table 3:

Decision making about IM Vitamin K administration: Themes and Subthemes

Theme	Subtheme	Examples
RISK OUTWEIGHS BENEFIT	Additives	“She [the nurse] brought in the actual vial and my husband said that it has 100mcg of aluminum, and I’m not sure if I want to give our minute old baby aluminum”
		“I’m not okay with the things that are in them [IM vitamin K] that are being injected into our bodies”
	Timing of injection	“they are so young and there is so much going in at once and it’s scary”; “if you give a baby a shot within this many hours of life, they’re going to have this much more of a chance of having anxiety later in life.”
	Dose	“..get the oral rather than having something injected at that concentration this young . I think that’s the biggest thing”
	Pain	“not to have, you know, a newborn baby get stabbed…right away.”
	Perceived low risk for VKDB	“…if there was forceps birth or my kid had a big hematoma or circumcision that would’ve changed my opinion.”
	Vitamin K is similar to vaccines	“I don’t like unnecessary vaccines like chicken pox and flu and … vitamin K goes in that realm.”
‘NATURAL’ APPROACHES	Oral vitamin K option	“when I had learned….that there was a more homeopathic natural alternative, it immediately kind of sparked my interest”
		“If they would’ve came out after he was born and said “Oh he definitely needs it” that would be a different story. They were like “Oh, do you want it? Do you not want it?”
	Religious beliefs	“I believe in a Creator who is so wise and created us so wonderfully. Why would he make us in such a way that we lack something that important?”
	Prenatal dietary supplementation	“my pediatrician recommended alfalfa supplements and then just boosting my diet with like greens and like natural forms of vitamin K”
PLACEMENT OF TRUST AND MISTRUST	Self	“When you are making the decision from a public health perspective it might make sense, but as a parent it doesn’t. You have your one baby that you are worried about.”
		“I had enough confidence in my own ability to figure it out…with the information that was available to me from peer reviewed studies and logic.”
	Healthcare providers	“I hate to say it but [I am] not taking MDs for what they say 100%...but that’s the truth.”
		“For all we know, it could be mercury…..they’re trying to, at a low amount, give you metal in your bloodstream and raise the cancer rates so maybe they hit you another way.”
		“My pediatrician… was very supportive. ‘If you want to do this, ok, fine, I’ll support you. If you don’t want to do this, I’ll support you, too’”
		“Why is this country pushing so much for that vitamin K shot when there hasn’t been a willingness to explore another route?....Is it financially motivated?”
	Pharmaceutical companies	“I would say [I trust] my friends who are like, more like-minded”
	Social circle	“I have a lot of antivax friends…their kids have had vaccine reactions”
		“I just Google search things…. on Facebook there’s like ‘Crunchy Mom’ groups…that I belong to and I always follow threads when they talk about things that are pertinent.”
	Internet and social media	“I do my own research, I usually go on PubMed…I like review articles..[they] give you the direct sources if needed”
INFORMED BY EXPERIENCES	Experience with previous pregnancies	“With my first child, they had given it to her and I didn’t even know. My husband told me that they took her, that they had given it to her and they didn’t say anything, and when he did ask they said, ‘It was just a vitamin.’”
	Shared decision making with clinician	“I just appreciate it when a doctor is willing to hear me out because to me…it means that they are in control and they don’t feel threatened and I can most certainly be waved in certain things if I see that willingness on the doctor’s part.”
		“She [pediatrician] wasn’t saying “I’m the doctor, you do what I say….when a doctor does that, I...shut off.”
	Experience in the hospital	“…my husband let them know we didn’t want that [injection] ..the nurses weren’t too happy about that. They gave my husband a bit of a hard time.”
		“We weren’t comfortable signing it [refusal form] because it looked like we were signing that we were okay with our baby bleeding to death which we weren’t, that’s not what we want and we had the oral drops to try to help.”
		“I want her to have the most calm and peaceful experience….in the first few days of life”