G6PD Deficiency: Foods, Medicines and Household Items to Avoid

In this article, we examine some G6PD deficiency foods to avoid, and other things you and/or your child should stay away from, in case of this condition...

Most parents meet G6PD deficiency in the same way: a nurse mentions the cord blood result, your baby stays in hospital a bit longer than the mums in the next bay, and you go home with a leaflet of things to avoid. The reassuring part comes first. Most children with G6PD deficiency grow up completely healthy. The condition only causes trouble when something on the trigger list breaks down their red blood cells faster than the body can replace them.

This is the list, organised the way parents need it: food, medicines, traditional remedies and household chemicals, followed by the warning signs that mean a hospital visit.

The one food every G6PD-deficient child must avoid is fava beans, also called broad beans, and the everyday household risk is mothballs.

Beyond those two, the list is mostly medicines. Tell every doctor, dentist and pharmacist about the diagnosis before anything is prescribed, and keep the hospital’s written list in your phone.

What G6PD deficiency is

G6PD stands for glucose-6-phosphate dehydrogenase, an enzyme that protects red blood cells from damage. A child born with too little of it has red blood cells that break apart more easily when exposed to certain substances. That breakdown is called haemolysis, and when it happens quickly it causes anaemia and jaundice.

It’s inherited and lifelong, passed on the X chromosome, so it’s far more common in boys. In Singapore it affects about 5% of the Chinese population, and every newborn is screened for it through the umbilical cord blood at birth. Babies found to have it are kept in hospital for at least 72 hours so that any early jaundice is caught and treated, because severe untreated newborn jaundice can damage the brain. Routine screening has made that outcome rare here.

Foods to avoid

Fava beans (broad beans)

This is the food with the strongest evidence, and the reason the condition is sometimes called favism. Fava beans contain compounds that trigger haemolysis in G6PD-deficient people, and even the pollen of the plant has been reported to cause reactions. Watch for them in:

Fresh, dried or canned broad beans, and dishes like ful medames
Snack mixes and roasted bean snacks, common in Middle Eastern and Chinese grocers
Some gluten-free flours and plant-based protein products that use fava bean flour. Read the label.

Breastfeeding mothers should avoid fava beans too, since what you eat reaches your baby through your milk. In those first weeks, while you’re still working out feeding cues like the rooting reflex in babies, it’s worth doing one sweep of your own kitchen shelves as well as the baby’s.

Foods that appear on some lists

Other legumes such as peas, lentils and peanuts are sometimes advised against, though the evidence is much weaker than for fava beans, and Singapore hospitals don’t list them. Bitter melon (bitter gourd) and bitter melon supplements appear on several overseas lists. High-dose vitamin C supplements, tonic water (quinine) and some artificial food colourings are also mentioned in international guidance. None of these is on the National University Hospital’s core list, so treat them as items to raise with your child’s doctor instead of a blanket ban.

Medicines to avoid

Singapore’s hospitals give parents a standard list. These are the medicines the National University Hospital names, and they apply to breastfeeding mothers as well as the child:

Antibiotics: sulphonamides, co-trimoxazole, dapsone, chloramphenicol, nitrofurantoin, nalidixic acid
Antimalarials: chloroquine, hydroxychloroquine, primaquine, quinine, mepacrine
Chemicals used in medicine: methylene blue

Some overseas guides add high-dose aspirin and a few other painkillers. The practical rule is simple: every time your child is prescribed anything, including over-the-counter fever syrups, say the words “G6PD deficient” before you pay. Pharmacists in Singapore are used to hearing it and will check.

Traditional Chinese medicine and herbal remedies

This is where well-meaning grandparents can cause a problem. Hong Kong’s Department of Health, whose G6PD guidance is widely used in the region, lists these herbs as unsafe for G6PD-deficient people:

Rhizoma Coptidis (Huang Lian)
Flos Lonicerae (Jin Yin Hua, honeysuckle)
Flos Chimonanthi Praecocis (La Mei Hua)
Calculus Bovis (Niu Huang)
Margaritas (pearl powder), including the infant remedy Bo Ying Compound, which contains it

Huang Lian and pearl powder are common in traditional “cooling” preparations given to babies and young children, so it helps to tell the whole family, not only the person who does the pharmacy runs. When a sniffle starts and someone reaches for a herbal brew, it’s easier to redirect if you already know what really helps a child’s cold. Henna, used for skin decoration during Deepavali and weddings, is also on the Hong Kong list and shouldn’t be applied to a G6PD-deficient child.

Household chemicals

Mothballs are the big one. Traditional mothballs contain naphthalene, which can trigger haemolysis through the fumes alone, so a baby sleeping in a room with mothballs in the wardrobe is at risk without touching anything. Clear them out of the home, and check clothes that have been stored at a relative’s place, since the smell lingers in fabric. Cedar blocks and sealed containers do the same job safely.

Warning signs of a haemolytic episode

If your child has been exposed to a trigger, the signs usually appear within a day or two. Go to the children’s emergency department if you notice:

Skin or the whites of the eyes turning yellow
Dark, tea-coloured or cola-coloured urine
Unusual paleness, tiredness or floppiness
Fast breathing or a racing heartbeat
Fever together with any of the above

Infections can also set off an episode. That’s the reason doctors ask you to watch closely whenever a G6PD-deficient child is unwell, even if no trigger has been eaten. A week of school bugs going around means paying attention to more than the fever chart: our guide to stomach bugs and keeping a child hydrated covers what to track, and with G6PD deficiency you’re also watching urine colour and skin tone.

Living with it day to day

Children with G6PD deficiency go to school, play sport, travel and eat almost everything their friends eat. The habits that keep them safe are small: a note in the childcare and school health forms, a line in your phone you can show any pharmacist, a word to grandparents about herbal remedies, and no mothballs at home. The hospital’s counselling session at birth covers all of this, and the written handout is worth keeping where you can find it.

Common questions

What foods should a G6PD-deficient child avoid?

Fava beans, also called broad beans, in every form, including flours and snack mixes that contain them. Other foods such as bitter melon, other legumes and high-dose vitamin C supplements appear on some overseas lists with weaker evidence, so ask your child’s doctor about those.

Can a G6PD-deficient child eat peanuts and soy?

Singapore hospital lists don’t restrict peanuts, soy or other common legumes. The proven food trigger is fava beans. If your child reacts to anything else, tell the doctor.

Is G6PD deficiency an allergy?

No. It’s an inherited enzyme deficiency, not an immune reaction. The “G6PD allergy list” people search for is the list of foods, medicines and chemicals that can break down red blood cells.

Can a breastfeeding mother eat fava beans if her baby has G6PD deficiency?

No. Breastfeeding mothers are advised to avoid the same foods, medicines and chemicals as the child, because they pass through breast milk.

Are mothballs dangerous for G6PD-deficient babies?

Yes. Naphthalene mothballs can trigger haemolysis through fumes, so remove them from the home and from stored clothing.

Does G6PD deficiency go away with age?

No. It’s lifelong. The risk of severe jaundice is highest in the newborn period, and after that most people stay well by avoiding the trigger list.

How common is G6PD deficiency in Singapore?

About 5% of the Chinese population, and it’s more common in boys. All newborns in Singapore are screened at birth using cord blood.

The two words to say before you pay

Clear the mothballs out this weekend, skip the broad beans, and say “G6PD deficient” to every doctor, dentist and pharmacist before a prescription is filled. If yellow skin, dark urine or unusual paleness shows up after any exposure or illness, that’s an emergency department trip the same day, not a wait-and-see. Do those few things and your child’s childhood looks like every other child’s: messy, loud, and mostly nothing to do with an enzyme.