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| |    General Medical Care for Children With Sickle Cell Disease by Lewis Hsu, M.D., Ph.D. reviewed by Laura Jana, M.D., F.A.A.P. With a little forethought and care, children with sickle cell disease can live full lives and enjoy most of the activities that other children do. However, paying extra attention to a few medical details can make a big difference in how much their bodies will be affected by the disease. Some of these details can be lifesaving, others are simply common-sense considerations that help a child and his family live more comfortably. Arrange appropriate medical supervision. You should make sure that your child's care is supervised by a medical team that understands sickle cell disease. The team should include someone who keeps up to date on new developments, because sickle cell care is changing quickly. If you're not sure about where to find appropriate care, ask for pediatric hematology (blood disease) specialists in your area, or check with sickle cell community groups (such as the Sickle Cell Disease Association of America, a national organization that can connect you with your local chapter or genetic counseling organizations in your area. Take care to prevent infections. From infancy on, any child who has been diagnosed with sickle cell disease should receive daily antibiotics to prevent serious infections. The antibiotic of choice is usually penicillin, given as a liquid or a tablet twice a day. (Since bacteria are changing their resistance to antibiotics, doctors are actively studying whether to change this recommendation, but this is current as of January 2001.) Immunizations are important. Your child should receive all of the recommended childhood immunizations, including the pneumococcal vaccine. Take fever seriously. You should make sure that you know how to accurately check your child's temperature. Fever in a child with sickle cell disease always signals the need for prompt medical evaluation and antibiotic medication. Ensure that your child receives enough folic acid. In general, taking the B vitamin known as folic acid, or folate, daily helps the body to make new red cells. Vegetables and fruits are good sources of folic acid, as is enriched flour in the USA. However, most children do not eat enough of these foods to meet the high folic acid needs of people with sickle cell (2 1/2 times as much as a pregnant woman requires!). If a child is low on folic acid, his body will keep making blood cells by stealing folic acid from other places in the body that also depend on this vitamin. Most doctors will prescribe a folic acid tablet of one milligram a day for children with sickle cell. This tablet can be crushed and mixed in any food or drink. You don't have to worry about giving too much--there's no danger from an overdose because any unneeded amount just gets flushed out in the urine. The folic acid tablet does not treat pain or infection.
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