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Giving paracetamol-based medicines such as Calpol to babies can increase their chances of developing asthma in later life, a large international study suggests.
Researchers who analysed data on more than 200,000 children found strong links between their exposure to paracetamol as infants and the development of asthma and other allergic conditions.
Mothers are advised that after two months, in babies weighing over 4kg (9lb), they can treat fevers with medicines or suspensions that contain paracetamol. But the study raises questions about the long-term effects of using medicines such as junior paracetamol and Calpol at such a young age.
Children under 12 months who were given a paracetamol-based medicine at least once a month more than tripled the chances of suffering wheezing attacks by the age of 6 or 7, the researchers found. The painkiller was also associated with an increased risk of rhinoconjunctivitis or hay fever and eczema. The researchers add that increased use of paracetamol because of earlier fears about giving children aspirin could be a factor in causing rising rates of asthma in many countries.
Previous research had already suggested a link between paracetamol and asthma, and scientists believe that the painkiller may cause changes in the body that leave a child more vulnerable to inflammation and allergies.
The authors of the study, published in The Lancetmedical journal, empha-sise that the findings do not constitute a reason to stop using paracetamol for relief of pain and fever in children. Instead, they support existing guidelines of the World Health Organisation that paracetamol-based medicines should not be used routinely, but should be reserved for those with a high fever (38.5C or above). Experts point out that in these cases, giving children medication outweighs the risks of not doing so.
Paracetamol is not licensed for use in infants under 2 months old by mouth and is only recommended after that in “junior” doses or medicines that contain less than the standard adult dose.
More than one million children in the UK equivalent to one in ten now have asthma and the number of cases has trebled since the 1960s. The rise has in part coincided with paracetamol becoming the preferred drug to treat fevers and pain in children.
The study, part of a worldwide investigation called the International Study of Asthma and Allergies in Childhood, spanned 73 centres in 31 countries. It found that giving children paracetamol in the first year of life increased the risk of later asthma symptoms in children aged 6 and 7 by 46 per cent.
Taking paracetamol at least once a month classified as “high use” increased the symptoms risk 3.23 times.
Using the drug in the first year of life increased the risk of hay fever and eczema at the age of 6 and 7 by 48 per cent and 35 per cent respectively.
The researchers had to rely on written answers from parents who filled in questionnaires about their children’s health and use of paracetamol, which may be subject to error.
Professor Richard Beasley, who led the study at the Medical Research Institute of New Zealand, said that there were good reasons to suggest that paracetamol was a factor in causing health problems, rather than merely being associated with them.
The research highlights a “dose-dependent” response, with more exposure to the drug resulting in more asthma attacks, pointing to a cause-and-effect relationship, he said.
The researchers said that more research, in the form of randomised controlled trials, was needed urgently.
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I don't see why so many people are moaning about this article and the study itself. This is useful information to make a sound judgement. Based on this EVIDENCE, sound judgement would seem to be that's its ok to use Calpol but only in moderation when you really, really need to.
Rupert, London,
So another study another causal relationship. What is clear is that we are witnessing an increase in chronic diseases. Asthma, diabetes, Autism etc etc. And science is always looking for a particular thing to blame. Yet the answer is never clear. Perhaps it is time to examine alertnative views.
Paul, Bristol, UK
A fever in children is not a bad thing( unless we are talking furiously high temperatures) and shows that the childs body is naturally trying to fight infection . Using calpol suppresses the immune system leading to internalising the problem and deeper acting disease like asthma. See homeopathy
Lynne , Lisburn, UK
I agree with Diana. It is more likely that repeated respiratory tract infections due to viruses or bacteria is the culprit rather than the paracetamol used to treat them.
Deepu Bhaskar, Dewsbury, UK
But nurofen for kids is supposedly not to be used on asthmatic children, so what should I give my 9 year asthmatic son when he has the occasional headache/fever, if not calpol nor nurofen?
Thushara, London, UK
Andrew in Sydney - i don't think paracetamol is an anti-inflammatory - although it's often used in conjunction with non-steroidal anti-inflammatories (eg ibuprofen).
Tania, London,
Sorry Andrew, but paracetamol is anti-pyretic (anti-fever) and analgesic (anti-pain) but unlike ibruprofen has virtually no anti-inflammatory effect.
alice, London,
Son,, (4 months ), Calpol every time he had his vaccinations. I had a choice of letting him suffer (no fever but very groggy and grizzly all day and next) or give him a 2.5ml dose as soon as he was out of surgery (rapid recovery). Is it the vaccinations (on ave. 2/month in first 4mths) causes asthma
Meg, Hampshire, UK
I was never given calpol at at the grand old age of 40, have never had an allergy. My son (23) was never given capol (that I can remember) and he also has never had any allergies. He has also only ever had antibiotics once as a baby.
Coincidence or just genetically strong immune systems?
kim, london,
And growing older increases your chances of dying sooner than later.
Red Indian, Moscow , Russia.
Another day another study another worry. The Lancet is not everyday reading yet it seems that this report has been plucked out and rejigged for daily newspapers so we dont see it in context with all the other research into causes of asthma. Is this information useful to parents? im not so sure
anne, london,
I have only given my children Calpol..and when we lived in Canada they had Tylenol(same stuff)..when they have really needed it..I think the study is good but if I had a young infant <12 months old..I would be quite worried because of the reports..and What do you do if they are really poorly??
nic, bristol, uk
The rise in the incidence of child asthma began in the USA and spread to Europe but not to much of the Third World. It basically followed the introduction of unleaded fuel. Has anyone ever done any research to see if there is a connection?
Roger Tilbury, Worthing,
Everybody we know used Calpol. Can they really be sure that its the Calpol that is causing the athsma and not something else. i.e. Everybody used Calpol, there has been an increase in Athsma for some reason. They jump to the conclusion that its Calpol. Sorry not convinced.
Keith Sloan, Nr Winchester, UK
Asthma is inflammation of the lungs, paracetamol is an anti-inflammatory. It could be that the paracetamol is preventing the body developing natural anti-inflammation functions. In which case you may also see it where young children have been given Ibuprofen.
Andrew, Sydney,
Pretty much every parent I know gives there kids calpol does this mean they will all have Asthma? I think not.
Lizzie I think is right over cleaning house with chemicals more likely. As a child I spent most my time sat in my parents dogs basket playing and getting grubby. I have no allergies at all
Simon, Bristol, England
Almost all children have been given Calpol. Most children do not have asthma. It is like saying something as comon as chicken pox gives you something as rare as cancer.
I don't believe these stats.
Sue Doughty, Twyford, UK
The problem with evidence based medicine is that it is only that - evidence -and not fact and that works both ways; you shouldn't completely rely on the evidence nor ignore it. Caution with any drug is wise. Ibrupofen is also a painkiller i would stay well away from for my family both young & old.
James, London, UK
I've been told not to give ibruprofen to my child, who has hypermobile joints and therefore alot of pain, because of potential liver damage, so whats the alternative. See your child crying in pain or let them take drugs that may hurt thm long term. There are no easy answers.
Stephanie, Pickering, Uk
Risking a lifelong burden of athsma and hay fever (and who knows what else) in order save your child the discomfort and inconvenience of a mild fever and the routine aches and pains of childhood seems a bit cracked. Sponging is effective treatement for fevers; achy or sick children should be in bed
Delilah, Washington DC, USA
Diana's skepticism is smart. Trust a mom (right?) to outthink the PhD's.
Scare headlines never properly assess causation vs correlation. Besides Diana's explanation there may be other unrelated new factors (modern pollutants/chemicals, over-cleaning homes) separately causing asthma/need for Calpol
Lizzie, London,
Surely a child who has symptoms requiring Calpol as often as once a month from early babyhood was always going to have a higher rate of medical problems as an older child.Ibuprofen did not use to be available for babies in the UK, are we going to see similar studies in the future for ibuprofen.
Diana, Derby,