Parents' Guide: Here's what you should know about G6PD deficiency in children

Does your child have G6PD deficiency? Here’s what parents need to know about the condition, and some G6PD foods to avoid.

As parents, one our primary jobs is to make sure that our kid gets the best care possible. We want them to be free from any serious diseases and we want to make sure that they have the right nutrients their body needs. To make sure this happens, we need to know if they have any allergies (especially with food) or if they are not getting enough of a particular nutrient.

Have you heard of Glucose-6-phosphate dehydrogenase or G6PD deficiency? It is the most common enzyme deficiency in humans, affecting 400 million people worldwide. It is a genetic condition that is common in males of Asian descent, and parents can pass it down to their children. Yes, moms, you can still have it without knowing. G6PD cannot be spread from one person to another.

So, how do you know if your child has G6PD deficiency? And what should you do if he does? Are there any prohibited foods or activities? Let’s find out.

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G6PD Deficiency Guide for parents

What is G6PD Deficiency? 

G6PD is an enzyme (protein) in the body that assists the function of red blood cells. G6PD deficiency is when there is not enough G6PD in the body. It is a hereditary condition which means that children born with it had it passed down from one or both of the parents. It occurs because of a mutation to the X chromosome.

What exactly does G6PD do? 

In particular, G6PD is the enzyme responsible for keeping red blood cells healthy and functioning well, so that they can live a normal “lifespan.” However, without adequate G6PD in the body, red blood cell function weakens and can “die” prematurely.

When red blood cells break down early like this, it is known as hemolysis. And when this happens persistently, it can result in a condition known as hemolytic anemia.

The body works constantly to regenerate red blood cells, and by now you know that one of the main functions of G6PD is to assist with this. Hemolytic anemia develops when red blood cells die faster than the body can replace them. Following this, there is less oxygen flow around the body.

Most people with G6PD deficiency don’t have problems most of the time. However, certain food and medications can increase the rate of red blood cell breakdown and trigger anemia.

Signs and Symptoms of G6PD deficiency

Most children with G6PD deficiency won’t show any signs of it. But food and medications can trigger the following symptoms:

• Dark-coloured urine
• Jaundice, or yellowing of the skin and whites of eyes
• Fever
• Paleness
• Dizzyness
• Extreme tiredness
• Rapid heartbeat
• Shortness of breath
• An enlarged spleen.

The good news is that symptoms will generally go away as the red blood cells renew themselves.

G6PD complications

G6PD deficiency can lead to various complications, particularly when exposed to triggers that cause oxidative stress. Here are the primary complications associated with G6PD deficiency:

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Hemolytic Anemia

• Acute Hemolytic Anemia: This is the most common complication and can occur suddenly after exposure to triggers. Symptoms include fatigue, pallor, jaundice, dark urine, rapid heart rate, and shortness of breath. Severe cases may require hospitalization and blood transfusions.
• Chronic Hemolytic Anemia: Less common, but some children may experience ongoing, low-level hemolysis leading to chronic anemia and related symptoms such as weakness and growth retardation.

Neonatal Jaundice

• Severe Neonatal Jaundice: Newborns with G6PD deficiency are at higher risk of developing jaundice soon after birth. If left untreated, severe jaundice can lead to kernicterus, a type of brain damage resulting from high levels of bilirubin.

Gallstones

• Hemolytic Crisis: Recurrent hemolytic episodes can increase the breakdown of red blood cells, leading to an excess of bilirubin, which can form stones in the gallbladder (pigment gallstones).

Splenomegaly

• Enlarged Spleen: Chronic hemolysis may lead to an enlarged spleen, which can cause pain and increase the risk of spleen rupture, particularly during physical activities.

Complications from Infections

• Increased Susceptibility to Infections: Children with G6PD deficiency may have a higher risk of complications from infections, which can exacerbate hemolytic episodes.

Drug Sensitivity

• Adverse Reactions to Medications: Exposure to certain medications can trigger hemolysis. It is essential for children with G6PD deficiency to avoid drugs like sulfonamides, antimalarials (e.g., primaquine), and certain pain relievers.

Favism

• Favism: A severe reaction to eating fava beans (or inhaling pollen from the plant) can cause rapid hemolysis, leading to acute anemia, jaundice, and potential kidney damage.

Complications from Oxidative Stress

• Oxidative Stress: Inability to handle oxidative stress can lead to cell damage, affecting overall health and increasing the risk of complications during illnesses or physical exertion.

Long-term Impact

• Growth and Development: Chronic anemia and repeated hemolytic episodes can impact a child’s growth and development, leading to potential delays and reduced physical stamina.

How do I know if my child has G6PD?

G6PD deficiency in a child generally isn’t diagnosed until symptoms emerge. When they do, doctors will confirm the diagnosis through a simple blood test. Other tests that may be conducted to measure the number of red blood cells in the body are a serum hemoglobin test, a reticulocyte count, and a complete blood count.

If a newborn baby has jaundice that is not improving, then a G6PD test might be conducted to rule out a deficiency of the enzyme. This could be any one or a combination of the blood tests mentioned above.

READ MORE: 

Newborn jaundice and breastfeeding: What you need to know

ALAMIN: Ano ang G6PD deficiency, at paano ito naiiwasan?

Buntis Guide: This is what happens when your blood type is not compatible with your husband’s

G6PD Foods to avoid

For children with G6PD deficiency, certain foods can trigger hemolytic episodes due to their oxidative properties. Here are the primary foods to avoid if your child has G6PD:

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G6PD Foods to Avoid

1. Fava Beans: G6PD Foods to avoid

Fava beans also known as baguio beans in the Philippines is known to cause a severe reaction called favism, which can lead to acute hemolytic anemia.

2. Legumes (Caution): Foods to avoid if your kid has G6PD

While not all legumes are problematic, some may contain similar compounds to fava beans. It is best to exercise caution with other beans, lentils, and peas.

3.  Artificial food coloring

Certain artificial food colorings and preservatives may pose a risk. While specific colorings are not universally identified, it is best to avoid highly processed foods with artificial additives.

4.  Other foods to avoid if your child has G6PD deficiency

Some vegetables, such as bitter melon, may have oxidative properties. Consult with a healthcare provider about specific vegetables to avoid.

5. Highly processed foods | G6PD foods to avoid

Minimize intake of foods with artificial additives, preservatives, and coloring.

General Dietary Guidelines

• Balanced diet: Encourage a diet rich in fruits, vegetables (except those mentioned), whole grains, and lean proteins.
• Hydration: Ensure adequate hydration to help maintain overall health.
• Individual Reactions: Since reactions can vary, keep a food diary to monitor any adverse effects from specific foods.
• Consult Healthcare Providers: Regularly consult with healthcare providers or dietitians to get personalized advice and updates on safe and unsafe foods.

Educating caregivers and the child about these dietary restrictions can help manage G6PD deficiency effectively and reduce the risk of hemolytic episodes.

Other triggers of G6PD deficiency

So what exactly triggers G6PD in children? Here’s a list of food, medication and even household products that a child with G6PD deficiency should avoid:

1. Antibiotics (Sulphonamides, Co-trimoxazole, Dapsone, Chloramphenicol, Nitrofurantoin, Nalidixic acid)
2. Aspirin
3. Some pain and fever relieving medications in the nonsteroidal anti-inflammatory (NSAID) category
4. Antimalarial drugs (chloroquine, hydroxychloroquine, primaquine, quinine, mepacrine)
5. Large doses of vitamin C
6. Some anti-cancer drugs
7. Naphthalene (which is found in mothballs or some pesticides)
8. Infections: Viral and bacterial infections can also trigger hemolytic episodes.

As a precaution, never give a child with G6PD deficiency any medicine (including supplements) without consulting with your doctor first. Doctor’s advice is important to know which medications are safe.

If your child has G6PD deficiency, it’s important to inform every doctor that treats him about his condition. This is to avoid said drugs that might trigger anemia.

Treatment and prevention of G6PD deficiency

Moms and dads, it’s important to familiarize yourself with the list of triggers mentioned above. This is because treatment and prevention of G6PD deficiency is as simple as eliminating these medications and foods from your child’s life.

However, if a child has severe anemia, then they may need a stay in hospital to receive fluids and oxygen, and may need a blood transfusion. It is highly likely they will have to stay in the hospital until they have fully recovered.

So if your child has been diagnosed with G6PD deficiency, bring them to their pediatrician as soon as you notice any of the  following symptoms:

• jaundice (yellow skin and eyes)
• dark coloured urine
• anemia (pale skin and lethargy).

Also, if your newborn is confirmed to have G6PD deficiency (indicated through jaundice), the treatment will likely involve phototherapy to lower the amount of bilirubin in the blood.

Too much bilirubin—caused by destruction of the red blood cells—is what causes newborn jaundice. Phototherapy will help break down this bilirubin in the blood.

Moms, you should avoid eating fava beans (Baguio beans) for as long as you breastfeed your child and avoid taking the medications mentioned above, which act as triggers for hemolytic anemia. If your child is taking formula milk, consult your doctor about which kind of milk is recommended for babies with G6PD deficiency, as some products contain soy in them, which may be a trigger for anemia.

In summary, parents, G6PD deficiency is not a condition to panic too much about. Sadly, it is a lifetime condition. But as long as you steer clear of the triggers (make your G6pd foods to avoid list), your child would be okay. If you have other questions about G6PD deficiency in children, don’t hesitate to consult your child’s pediatrician about it.

Additional information by Camille Eusebio and Jobelle Macayan

Here at theAsianparent Philippines, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advise or medical treatment. TheAsianparent Philippines is not responsible to those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend to consult your doctor for clearer information.