Rebeca M Plank1, Tara Steinmetz, David C Sokal, Martin J Shearer, Santorino Data. 1. Division of Infectious Disease, Brigham and Women's Hospital, Boston, Massachusetts; Botswana-Harvard Partnership for HIV Research and Education, Gaborone, Botswana; the Department of Public Policy, Duke University, Durham, North Carolina; the Clinical Sciences Department, FHI 360, Durham, North Carolina; the Haemostasis Research Unit, Centre for Haemostasis & Thrombosis, St. Thomas' Hospital, London, United Kingdom; and the Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda.
Abstract
BACKGROUND: Early infant (1-60 days of life) male circumcision is being trialed in Africa as a human immunodeficiency virus prevention strategy. Postcircumcision bleeding is particularly concerning where most infants are breastfed, and thus these infants are at increased risk of vitamin K deficiency bleeding. CASE: During a circumcision trial, one infant bled for 90 minutes postprocedure. After discovering he had not received standard prophylactic vitamin K, we gave 2 mg phytomenadione (vitamin K1) intramuscularly; bleeding stopped within 30 minutes. CONCLUSION: Vitamin K's extremely rapid action is not commonly appreciated. Neonatal vitamin K has been shown to be cost-effective. To increase availability and promote awareness of its importance, especially in low-resource settings where blood products and transfusions are limited, vitamin K should be included in the World Health Organization's Model List of Essential Medicines for Children.
BACKGROUND: Early infant (1-60 days of life) male circumcision is being trialed in Africa as a human immunodeficiency virus prevention strategy. Postcircumcision bleeding is particularly concerning where most infants are breastfed, and thus these infants are at increased risk of vitamin K deficiency bleeding. CASE: During a circumcision trial, one infant bled for 90 minutes postprocedure. After discovering he had not received standard prophylactic vitamin K, we gave 2 mg phytomenadione (vitamin K1) intramuscularly; bleeding stopped within 30 minutes. CONCLUSION:Vitamin K's extremely rapid action is not commonly appreciated. Neonatal vitamin K has been shown to be cost-effective. To increase availability and promote awareness of its importance, especially in low-resource settings where blood products and transfusions are limited, vitamin K should be included in the World Health Organization's Model List of Essential Medicines for Children.
Authors: Robert C Bailey; Irene Nyaboke; Mary Ellen Mackesy-Amiti; Erick Okello; Valentine Pengo; Betha Ochomo; Mary Emmaculate Auma; Simon Were; Stella Ojuok; Evelyne Adoyo; Mildred Adhiambo; Marisa R Young; Rebeca M Plank; Fredrick O Otieno Journal: PLoS One Date: 2018-02-14 Impact factor: 3.240