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Understanding Your Child's G6PD Deficiency

 

This article aims to give a basic guide for better understanding of the condition called G6PD Deficiency. A good understanding of G6PD deficiency will lead to better management of the condition so your child can continue to live a normal life. Remember to always seek medical advice for proper diagnosis and care.

 
What is G6PD?

G6PD is an abbreviation for the enzyme, Glucose-6-Phosphate Dehydrogenase. This enzyme protects red blood cells from being destroyed or broken apart which may lead to a condition called hemolysis.

Hemolysis, if left unmanaged, may develop into hemolytic anemia, jaundice, and even kernicterus (a serious and permanent form of brain damage).

G6PD deficiency is a lifelong genetic condition that may either be due to the absence of the G6PD enzyme in red blood cells, insufficient production of red blood cells, or because the G6PD enzyme is not working as intended. Without enough of the G6PD enzyme, red blood cells may become vulnerable to destruction by certain food, medications, and infections.
 
What causes G6PD, and what are the signs/symptoms?

G6PD deficiency is an inherited condition that may be genetically passed down by one or both parents. Some mothers may be asymptomatic carriers while some fathers may be symptomatic carriers.

Children with mild symptoms usually don’t need medical treatment. If a G6PD deficient child is anemic, it may improve as the body makes new red blood cells. Children with more severe symptoms  may need hospital care.

For the health and medical concerns of your child, always seek medical advice from your doctor.

The following are common signs and symptoms of G6PD deficiency:

●        Paleness
●        Extreme tiredness or dizziness
●        Fast heartbeat
●        Fast breathing or shortness of breath
●        Jaundice or when the skin & eyes appear yellow
●        Dark, tea-colored urine

Some symptoms of G6PD deficiency may not be immediately evident. Symptoms from hemolytic anemia may surface as more red blood cells are destroyed. Your doctor may refer your child for additional tests to verify if the symptoms are consistent with G6PD deficiency.
 

What Should I Look Out For?
If your child has G6PD deficiency, seek medical advice from your doctor for guidance on what to look out for. There may be specific food, medications, or vitamins that you will need to avoid that may further damage to the red blood cells.

Triggers or risk factors of G6PD deficiency in children may include:

●        infections (bacterial or viral)
●        medications including fever-reducing medicines
●        antibiotics and antimalarial drugs
●        foods containing soy protein and broad beans.

Always consult your doctor on food and medication intake when caring for your child with G6PD deficiency.


Medications to Avoid

Antibacterial

*Nalidixic acid, Nitrofuran (nitrofurantoin, furazolidone, nitrofurazone/nitrofural),
*P-aminosalicylic acid
Analgesic/Antipyretic

*Acetanilid
Anthelmentic

*B-naphthol, *Niridazole, *Stibophan
Sulfonamides and Sulphones

Dapsone, *Glucosulphone sodium, *Mafenide acetate, *Salicylazosulphapyridine/Sulfasalazine, Stibophen, Sulphacetamide/ Sulfacetamide, * Sulphadimine, *Sulphafurazone, Sulphamethazole/ Sulfamethazole, Sulphanilamide/Sulfanilamide, Sulphapyridine, *Sulphoxone/ Sulfoxone, Sulfasalazine, Salazosulfapyridine
Antimalarials

Chloroquine, *Pamaquine, Primaquine, Pentaquine
Miscellaneous

Acetylphenylhydrazine, Dimercaprol, Futamide, Isobutyl nitrate, Mepacrine, Phenazopyridine, Probenecid, Thiazolesulfone, Urate oxidase/ Rasburicase
Chemicals to Avoid

Methylene Blue, Arsine, Phenylhydrazine, Toluidine blue, Trinitrotoluene, Aniline dyes
Food & Drinks to Avoid

Fava beans, Red wine, Legumes (Abitsuelas, Garbanzos, Kadyos Munggo), Blueberry, Soya Food (Taho, Tokwa, Soy Sauce), Tonic water, Bitter Melon/Ampalaya
Others

Menthol, (Medicated plasters, Massage Oils, Mouthwash, Pain ointmets), Camphor, Napthalene (Moth balls), Henna, Herbs ( Cattle gallstone bezoar, Honeysukle flower, Chimonanathus flower, 100% pearl powder, Figwortflower, Acalypha indica)
Medications Safe to Take in Therapeutic Doses

Acetaminophen (Paracetamol, tylenol), Acetophenetidin/phenacin, Aspirin/Acetylsalicylic acid, Ascorbic acid, Chloramphenicol, Ciprofloxacin, Diphenhydramine, Isoniazid, Isoniazid, Phenytoin, Quinidine, ** Vitamin K analogues/ Phytomenadione
*Not Available in the Philippines

**Should be water soluble

Source: Newborn Screening Reference Center, Fact Sheets: Information for PARENTS about the disorders included in the Expanded Newborn Screening Panel

There is no treatment for G6PD deficiency but it can be managed by avoiding known triggers and strictly following your doctor’s advice and recommendations. Your child can live an active and healthy life as long as these triggers are kept at bay, and he/she is supported with a nutritious diet.

Free From Soy Protein

HiPP Organic and HiPP Organic CS (Combiotic Support) milk formula supplements are Free From soy protein and are suitable for children with G6PD Deficiency. Always seek medical advice before using HiPP Organic milk formula/supplements.


Frequently Asked Questions (FAQs) About G6PD Deficiency


 
1. What should I do to prevent my child who
has G6PD deficiency from having hemolytic anemia?

The best choice is to consult your doctor immediately for proper diagnosis and guidance on how to manage your child’s condition. It is important to observe for signs or symptoms of hemolytic anemia which may include jaundice or tea-colored urine, abdominal pain, paleness, dizziness, difficulty in breathing, and/or rapid & strong heart beats.
 
You may refer to the table provided in this article for guidance
on what medications, foods, and vitamins to watch out for. Alternatively, you
may download this booklet about G6PD deficiency for further guidance.
 
2. The label of my child’s food and/or milk supplement shows one of these ingredients: soy, soya, soybean, soy oil, soybean oil, soy protein isolate, soya lecithin. Is it safe for my child with G6PD Deficiency?

Keep in mind that breastfeeding is best for babies up to 2 years of age and beyond. Although there has not been any report of hemolytic anemia due to food or milk supplement products containing soya, soya food is included in the list of food & drinks that patients with G6PD deficiency should avoid. Take caution in choosing a milk supplement and read the ingredients thoroughly. Consult your doctor immediately before proceeding to use any milk supplement.
 
You may refer to the table provided in this article for guidance
on what medications, foods, and vitamins to watch out for. Alternatively, you may download this booklet about G6PD deficiency for further guidance.
 
3. Ascorbic acid (Vitamin C) is on the list
of drugs safe to take in therapeutic doses. What is the recommended dosage?

According to the 2015 Philippine Dietary Reference Intakes, it is recommended to consume up to 30 mg of Vitamin C (Ascorbic Acid) per day for infants 0-5 months old, 40 mg per day for 6-11 months old, and up to 45 mg per day for children 1 to 12 years old.
 
Always remember that there is no substitute to nutritious, freshly prepared food and a well-balanced diet paired with regular exercise.

4. Is there a contraindication or potential harm risk of any vaccination for my child with G6PD Deficiency?

None.
 
5. Could I have done anything during my pregnancy to have avoided or prevented G6PD Deficiency in my child? 

G6PD Deficiency is a genetic disorder, therefore, a child is born with it and may have inherited it from either of his/her parents. Some mothers are asymptomatic carriers, while some fathers are symptomatic carriers. Hence, if your child has G6PD Deficiency, there is
nothing you could have done as a mother to prevent it. 

References

 

  1. AboutKidsHealth. (n.d.). Retrieved January 25, 2021, from www.aboutkidshealth.ca/Article
  2. Ben-Joseph, E. (Ed.). (2018, July). G6PD Deficiency (for Parents) - Nemours KidsHealth. Retrieved January 25, 2021, from kidshealth.org/en/parents/g6pd.html
  3. Denney, L., Angeles-Agdeppa, I., Capanzana, M. V., Toledo, M. B., Donohue, J., & Carriquiry, A. (2018). Nutrient Intakes and Food Sources of Filipino Infants, Toddlers and Young Children are Inadequate: Findings from the National Nutrition Survey 2013. Nutrients, 10(11), 1730. https://doi.org/10.3390/nu10111730
  4. Glucose-6-phosphate dehydrogenase deficiency: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved January 25, 2021, from medlineplus.gov/ency/article/000528.htm
  5. Newborn Screening Reference Center. (n.d.). Fact Sheets: Information for PARENTS about the disorders included in the Expanded Newborn Screening Panel. Retrieved January 27, 2021, from https://ihg.upm.edu.ph/sites/images/Fact%20Sheets_Parents.pdf
  6. Norliza. (2016, August 26). G6PD Screening in newborn. Retrieved January 25, 2021, from www.myhealth.gov.my/en/g6pd-screening-newborn/