The researchers recommend
paracetamol should only be used
on babies with a fever over
38.5˚C.
Image: iStockphoto

Use of paracetamol in the first year of life is associated with risk of asthma, rhinoconjunctivitis and eczema at age 6 to 7 years, concludes an article in September's asthma special issue of The Lancet.

As part of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme, which incorporates researchers from The University of Auckland, parents or guardians of children aged 6 to 7 years completed written questionnaires about symptoms of asthma, conjunctivitis and eczema, and several risk factors — including use of paracetamol for fever in the first year of the child’s life and frequency of paracetamol use in the previous 12 months. More than 200,000 children from 73 centres in 31 countries were analysed.

The researchers found that use of paracetamol for fever in first year of life was associated with a 46 per cent increased risk of asthma in children aged 6-7 years. Current use of paracetamol was associated with a dose-dependent risk of asthma symptoms - with medium use increasing risk by 61 per cent and high-dose increasing risk by over three times. Paracetamol use was also associated with increased risk, of 22-38 per cent, of severe asthma symptoms. Finally, paracetamol use in the first year of life increased risk of RC by 48 per cent and eczema by 35 per cent; for use in the previous 12 months, and as with asthma there were dose-dependent increased risks of these conditions (medium use: 18 per cent eczema, 32 per cent RC; high-use 87 per cent eczema, 1 per cent RC).

The authors conclude: "Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk-factor for the development of asthma in childhood."

They add, "We stress the findings do not constitute a reason to stop using paracetamol in childhood. Paracetamol remains the preferred drug to relieve pain and fever in children. However the findings do lend support to the current guidelines of the World Health Organisation, which recommend that paracetamol should not be used routinely, but should be reserved for children with a high fever (38.5˚C or above)."