For many parents, paracetamol and ibuprofen are the first medicines used when a young child is unwell.
While earlier studies have reportedly raised concerns about possible links between the use of these medicines in infancy and conditions such as eczema and asthma later in life, a new landmark study offers reassuring evidence about the safety of these widely used painkillers.
The study, published in The Lancet Child & Adolescent Health, found no link to eczema or bronchiolitis, a common respiratory illness.
“Our study found that paracetamol and ibuprofen are incredibly safe to use in young children,” says lead researcher Professor Stuart Dalziel, Cure Kids Chair of Child Health Research at Waipapa Taumata Rau, University of Auckland, and paediatrician at Starship Children’s Hospital.
“These results give parents and health professionals high confidence to continue to use these important medications.”
The study
Almost 4000 babies across New Zealand participated in the randomised controlled trial from birth, with half randomised to ensure their parents provided paracetamol and half to ensure their parents provided ibuprofen when the infants required medication for fever or pain relief in the first year of life.
The researchers asked parents at regular intervals whether their children had eczema or asthma symptoms, or bronchiolitis. They also checked prescribing and hospital records.
Results
Eczema affected about 16% of babies given paracetamol and 15% of those given ibuprofen.
Bronchiolitis occurred in about 5% of babies in both groups.
These differences were not significant. Serious side effects were rare, and none were caused by the medications.
The study found no association between either medication and eczema or bronchiolitis and confirmed that both drugs were safe to use.
Study part of a longer project
This paper is part of a longer project dubbed the ‘Paracetamol and Ibuprofen in the Primary Prevention of Asthma in Tamariki (PIPPA Tamariki) study’.
PIPPA Tamariki is the largest trial ever conducted in New Zealand, and participants are being followed from birth to age 6.
The researchers will soon publish findings on the same children at age 3 and again at age 6.
The long-term objective of the study is to test whether there are any links between paracetamol and specific conditions that can only be accurately diagnosed once children reach school age.
“We know that two‑thirds of children who are wheezy at age 3 don’t develop asthma by age 6,” says Professor Dalziel.
“Thus, we need to wait until school age to ultimately test if paracetamol in the first year of life causes asthma.”
Similarly, developmental disorders such as autism and attention-deficit hyperactivity disorder (ADHD) are more accurately diagnosed as children get older.
“Ultimately, the study will provide important evidence regarding the link between paracetamol use and asthma, eczema, hay fever, and developmental disorders, such as autism and ADHD,” says lead author Dr Eunicia Tan, a senior lecturer at the University of Auckland and emergency physician at Middlemore Hospital.
