Penicillin Is Not Part of My Son’s Sickle Cell Care Plan for Now
Every time I share about my son’s sickle cell disease diagnosis with other parents caring for children with the disease, the question I am always asked is, “Does your son take penicillin?”
It’s such a common question that I feel I should share the answer with you, too. Before I do, though, please remember that I’m not providing medical advice, and you mustn’t change the care plan for your child or children without advice from your medical team.
That said, I understand why the penicillin question is so common. When my son’s pediatrician informed us that he’d need to take penicillin from when he was 3 months old until he was 5 years old, I struggled to accept it. I couldn’t imagine giving him antibiotics twice a day for four years and nine months!
His pediatrician explained why antibiotics were necessary, and while I believed her, I still felt the need to do more research. Of course, there was evidence to support everything she said, but I was still skeptical. I did more research, spoke to other people in my family who live with sickle cell and have had both positive and negative experiences with it, and decided I wouldn’t give my son penicillin.
It sounds crazy, I know, but let me explain.
Children’s immune systems are usually immature and can’t correctly produce antibodies to fight infections. The spleen’s role is to trap harmful agents like bacteria and eliminate them. Unfortunately, children with sickle cell disease have poor-functioning spleens, so they are more prone to infections, particularly from the bacteria that cause pneumonia.
Before a landmark 1986 study, pneumonia infections in children with sickle cell disease were fatal. In that study, researchers found that giving penicillin to children from infancy reduced death from pneumonia significantly, leading to the current recommendations of including daily penicillin in care plans.
While this makes plenty of sense, I still think that some children are more prone to infections than others, possibly because of their genetics, environment, diet, or other lifestyle factors, and therefore, penicillin may not be necessary for all children. For example, a child living in a polluted area with an unhealthy diet could be more prone to infections than one living in a less contaminated area with a nutritious diet.
So, should both children take penicillin despite lifestyle differences?
Besides that, evidence shows that nursing mothers can pass on antibodies to their children. While to my knowledge, there’s no evidence showing that breastfed infants with sickle cell disease are less prone to infections than children who aren’t breastfed, I firmly believe that I can protect my son with breast milk to some degree.
My main reason for deciding against penicillin for now, though, is my son’s gut health. Without going into too much detail, evidence about the importance of a healthy gut microbiome (the types of bacteria present in the gut) for immunity and general well-being is mounting.
Antibiotics are the chief destructors of good gut bacteria, which can be detrimental to health. A recent study even showed that long-term use of penicillin in hospitalized children with sickle cell disease reduces beneficial gut bacteria and increases the number of gut bacteria associated with poor health.
While I’m convinced that penicillin’s benefits outweigh the possible long-term risk for some children, I’m not convinced it does for all children.
Penicillin isn’t currently part of my son’s care plan because he’s indoors with limited exposure to the outside world and contaminants. I prefer to focus on building a solid immune system by breastfeeding and nourishing him with a whole food based diet.
When or if it becomes necessary to add penicillin to his care plan, we’ll do so.
Is penicillin part of your care plan? Please share in the comments below.
Note: Sickle Cell Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sickle Cell Disease News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sickle cell disease.