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#107: Informed Choice in Newborn Care: Vitamin K, Eye Ointment, Hepatitis B, and More — with Dr. Joel Gator Warsh



In this episode of The Mindful Womb Podcast, Clara is joined by pediatrician and integrative medicine practitioner Dr. Joel Gator Warsh for a calm, evidence-based conversation about routine newborn interventions and how families can navigate them with clarity rather than fear.


Together, they explore the why behind common recommendations — without oversimplification or pressure — so parents can feel informed, grounded, and confident in their choices.


What You’ll Learn

  • Why newborn medical decisions often feel overwhelming

  • What vitamin K does and how it reduces the risk of rare but serious bleeding

  • What erythromycin eye ointment actually prevents

  • Why hepatitis B vaccination is offered at birth — and how guidance is evolving

  • How to think about individual risk vs. population-level recommendations

  • The nuance around Group B strep and antibiotics in labor

  • What the evidence actually shows about Tylenol, vaccines, and autism

  • How to evaluate health information without falling into extremes


Listen to the episode now:

When it comes to welcoming a new baby into the world, families often imagine cozy cuddles, emotional first moments, and seeing their baby for the very first time. But in the background of all this joy sit a series of routine newborn medical interventions — procedures that parents are often asked to consent to within minutes or hours of birth.

In today’s polarized health-information landscape, decision-making around these interventions can feel overwhelming.


In this episode of The Mindful Womb Podcast, pediatrician and integrative medicine practitioner Dr. Joel Gator Warsh joins us to break down what parents need to know about the “big three” newborn interventions — vitamin K, erythromycin eye ointment, and the hepatitis B vaccine — while also exploring Group B strep, acetaminophen (Tylenol), autism concerns, vaccines, and how families can navigate medical decisions with nuance and confidence.



Understanding Integrative Medicine in Pediatrics

Dr. Gator describes integrative medicine as blending conventional medical training with prevention-focused and lifestyle-based approaches — including nutrition, sleep, stress regulation, movement, and root-cause exploration. This lens prioritizes optimizing baseline health and supporting informed consent conversations, especially when parents are weighing interventions that feel emotionally charged.


Parents today aren’t just receiving advice from their pediatricians — they’re navigating TikTok, parenting forums, Instagram threads, and search engines. Dr. Gator emphasizes the importance of evaluating who is providing information, whether they cite evidence, and whether they acknowledge nuance and uncertainty as science evolves.


For families looking for balanced, well-cited summaries of newborn interventions, Evidence Based Birth® offers accessible, research-driven handouts that translate medical literature into plain language.



The Big Three Newborn Interventions

1. Vitamin K Injection

Newborns are born with very low vitamin K levels. Vitamin K is essential for blood clotting, and newborns’ gut bacteria have not yet developed enough to produce it. Breastmilk also contains relatively small amounts. Without supplementation, babies are at risk for vitamin K deficiency bleeding (VKDB), which can include internal bleeding and, in rare cases, devastating brain hemorrhages. 


Evidence summarized by Evidence Based Birth® shows that the intramuscular vitamin K injection dramatically reduces the risk of VKDB, making it very rare in populations where it is routinely used.


Studies have shown that without prophylaxis, rates of VKDB vary widely by type and timing, but can be significant enough to warrant preventive care, especially given the severity of outcomes when it occurs. 


Oral vitamin K is used in some countries and can be effective when given as a multi-dose regimen, though adherence is critical. Evidence Based Birth® explains why the injection is considered the most reliable option, particularly in the U.S. where oral protocols are not standardized. Some hospitals have preservative-free vitamin K injections.


Concerns about a link between vitamin K and leukemia have been studied extensively. Current evidence does not support a causal connection, a conclusion summarized by the American Academy of Pediatrics.



2. Erythromycin Eye Ointment

Erythromycin ophthalmic ointment is intended to prevent ophthalmia neonatorum, a potentially serious eye infection caused primarily by exposure to gonorrhea or chlamydia during vaginal birth. Untreated gonococcal eye infections can lead to permanent eye damage or blindness.


Evidence Based Birth® explains that erythromycin is effective at reducing gonorrheal eye infections and may provide some protection against chlamydial infections.

While many countries risk-stratify and only offer this to patients whose birthing parent is testing positive or exposed to gonorrhea or chlamydia, the CDC continues to recommend newborn eye prophylaxis as a public-health safety net, particularly because STI screening during pregnancy may be incomplete or inaccurate.


However, practices differ internationally. Some countries use a risk-based approach, treating only infants whose parents test positive or have risk factors. Evidence Based Birth® discusses these differences and the trade-offs families may wish to consider, including temporary blurriness, irritation, and early antibiotic exposure. 


3. Hepatitis B Vaccine at Birth

The hepatitis B vaccine is designed to prevent infection with the hepatitis B virus, which can lead to chronic infection, liver disease, cirrhosis, and liver cancer later in life.

Infants who acquire hepatitis B at birth or in early infancy are far more likely to develop chronic infection than those infected later in life — a key reason early vaccination has been emphasized by pediatric organizations and the CDC.


When a birthing parent tests positive for hepatitis B, vaccination within 24 hours of birth is critical and highly effective at preventing transmission. See the publication from the American Academy of Pediatrics. 


For parents who test negative during pregnancy, the immediate risk to the infant is much lower, but not zero. The birth dose also serves as a safeguard when prenatal testing is missed, documentation fails, or household exposure occurs.


In recent years, guidance around hepatitis B vaccination timing has evolved. The CDC’s Advisory Committee on Immunization Practices (ACIP) has acknowledged the importance of individualized decision-making for infants born to hepatitis-B-negative parents, while organizations like the American Academy of Pediatrics continue to emphasize the population-level protective value of the birth dose. 👉



Group B Strep (GBS) & Antibiotics in Labor

Group B Streptococcus (GBS) is a common bacterium that can be present in the vaginal canal, which, while rare, can cause serious newborn infections if transmitted during labor. In the U.S., ACOG guidelines recommend routine screening at 36–37 weeks and antibiotics during labor for those who test positive. More information can be found HERE.


Evidence Based Birth® highlights the complexity of GBS management, noting that colonization can fluctuate and that different countries prioritize different risk-benefit trade-offs, including concerns about microbiome disruption.



Tylenol, Autism, and Vaccine Concerns

Acetaminophen (Tylenol)

Some observational studies have explored associations between acetaminophen use and neurodevelopmental outcomes, but they do not show a clear link. Since then, a large 2024 JAMA study using sibling-control analysis found no association between prenatal acetaminophen use and autism, ADHD, or intellectual disability when confounding factors were addressed.


The American College of Obstetricians and Gynecologists (ACOG) supports the cautious, appropriate use of acetaminophen during pregnancy when medically indicated.


Vaccines & Autism

Extensive research has consistently found no credible evidence linking vaccines to autism. This includes large population studies and systematic reviews conducted by the Institute of Medicine, CDC, NIH, and World Health Organization.


Key summaries:


While science continues to evolve, the best available evidence does not support a causal link between vaccines and autism. Further study would be required to make a definitive link.


Why the Conversation Has Become Polarized

Social media often amplifies extremes, making it difficult for nuanced scientific discussion to rise above emotionally charged narratives. Families seeking reassurance can feel caught between absolutist claims — “vaccines are perfect” or “vaccines are harmful.” Dr. Warsh advocates for returning to curiosity, transparency, and genuine scientific inquiry, rather than fear-based messaging.


How Parents Can Make Informed, Confident Decisions

Dr. Gator emphasizes that newborn decisions shouldn’t feel like rushed checkboxes on a postpartum floor. Parents are allowed — and encouraged — to ask questions, weigh risks and benefits for their unique family, and differentiate population-level public health guidance from individual decision-making.


Curiosity is not anti-science.It is the foundation of science.


Here are five evidence-based strategies:

  1. Interview your pediatrician. Ask about alternate schedules, flexibility, and how they approach families who ask questions.

  2. Understand risk vs. benefit for your unique family. Every choice involves weighing risks of intervention versus risks of declining.

  3. Differentiate population-level recommendations from personal risk. Public health guidance protects populations; your decisions protect your child.

  4. Seek balanced sources. Look for experts who acknowledge nuance, explain uncertainty, and avoid absolutist claims.

  5. Remember: you’re allowed to ask questions. Curiosity is not anti-science — it is the root of all science.


Where to Learn More from Dr. Joel Gator 

Dr. Gator shares more in his book “Between a Shot and a Hard Place” and on his Substack, Instagram, and X accounts—platforms dedicated to bridging the space between polarized medical narratives. Newborn interventions and vaccine decisions do not have to feel overwhelming or contentious. With thoughtful information, balanced discussions, and a supportive care team, families can make decisions that feel aligned, informed, and grounded in both evidence and intuition. Your listeners—and their babies—deserve nothing less.


Thank You for Listening

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