Infants with sickle cell anaemia are very prone to infections. In this post, I share how I plan to strengthen his immunity.
It has been a month since I received Noah’s initial diagnosis and a week since I got the confirmation result. In between the initial diagnosis and confirmation, I prayed for a miracle, but it didn’t come. I was disappointed but I’m grateful for closure and ready to switch to action mode.
My childhood dream was to become a medical doctor; I wanted to help sick people get better. Unfortunately, I fell short of the required grades and studied biomedical sciences instead. I am now a scientist, but the desire to help people has never left me. That is partly why I decided to become a nutritionist – food is medicine.
Once I started thinking of my son as my patient rather than my son, I began to feel emotionally and mentally strong. I have spent my time researching deeper into sickle cell anaemia, and I have learned that early childhood (age 6 months to 5 years) is a vulnerable period for sicklers because they are most at risk of infections.
These infections may have a minor effect in children with normal red blood cells, but in those with sickle cell anaemia, they can be fatal. I will explain why.
WHY CHILDREN WITH SICKLE CELL ANAEMIA ARE PRONE TO INFECTIONS
In everyday life, we are constantly exposed to bacteria and other infectious agents. Under normal circumstances, the spleen removes bacteria in the blood, old and damaged cells and produces antibodies. When you are exposed to bacteria, the speed of blood flow through your spleen reduces to allow the immune cells (known as macrophages) in your spleen to destroy the bacteria and damaged red blood cells.
Sometimes these macrophages recognise the bacterial directly, but most times, the bacteria need a special protein coating to be recognised. Macrophages can efficiently clear bacteria with protein coats. The spleen clears bacteria that do not have proper protein coats. Another type of immune cell (memoryB cells)in the spleen also produce antibodies to help you fight off subsequent infections.
In individuals with sickle cell anaemia, blood flows through the spleen very slowly during an infection. The spleen becomes acidic and the red blood cells lose oxygen very rapidly, causing them to sickle. Instead of fighting off the infection, macrophages start trying to destroy the sickled red cells but they become overwhelmed. This sickling causes congestion and swelling in the spleen, which repeated over time, reduces the integrity of the spleen and causes irreversible damage. At the same time, the infection still persists in the individual and can easily spread from where it started into the bloodstream and affect the whole body (sepsis). Unfortunately, this process can start as early as when a child is 6 months old, and if not carefully monitored and treated, can be fatal.
This is why it is very important to keep up with vaccinations and any prophylactic medication. Noah’s first set of vaccinations are not due until he is eight weeks old, but in the interim and beyond, I want to do everything possible to strengthen his immunity and prevent infections.
STRENGTHENING NOAH’S IMMUNITY
I will exclusively breastfeed Noah until he is six months old. I plan to introduce solids when he is six months old, and I will continue to breastfeed him until he is at least 12 months old. This was my plan prior to his diagnosis, but it is now very crucial that I follow through with it. Why so?
Well because breast milk, especially in the first few days of birth contains numerous immune cells and proteins that fight infection. Breast milk also contains antibodies that protect your baby from pathogens (bacteria, viruses, etc,) that you have been exposed to and from new infections. So it means, for example, that if you have previously fought off a stomach infection, you would pass on the antibodies that your body generated via breast milk to your child.
Breast milk offers strong protection against diarrhoea, which can be serious in children with sickle cell anaemia. In fact, in poor countries, the risk of dying from diarrhoea is 25 times greater for non-breastfed infants than for exclusively breastfed infants. Breast milk also offers strong protection against ear, urinary and respiratory (chest) tract infections. This protection is greatest if you exclusively breastfeed your child for the first six months of its life.
Besides providing him with antibodies and immune cells, another way to strengthen his immunity is by providing him with nutrients. Children who regularly have infections and suffer from frequent painful crisis tend to be malnourished. They are often deficient in a range of vitamins and minerals including, but not limited to vitamin A, D, and zinc. As I am Noah’s only source of nutrition, for now, I am being very mindful of my diet and optimising it to ensure he gets all of the nutrients he needs to keep him healthy.
We tend to associate vitamin D only with bone health, but it is also very important for immunity. Unfortunately, only small quantities of vitamin D from a mother’s diet passes into breastmilk. It is very sunny in London now, so we are trying to soak up as much sunlight as we can. I have also been giving Noah a vitamin D supplement made specifically for breastfed children; I got a sample of it in my bounty pack when he was born. It was pretty easy to use and he seems fine with it, so I purchased a full-size bottle for him from Amazon. It is also available at Boots.
IF YOU’VE RECENTLY HAD A SICKLE CELL ANAEMIA DIAGNOSIS, WILL YOU BE EXCLUSIVELY BREASTFEEDING YOUR CHILD? IF NOT, WHAT IS YOUR PLAN?