A recent study of more than 200,000 children has suggested that the use of paracetamol in babies increases the risk of developing asthma five years later.
Children given the painkiller for fever in the first year of life had a 46% increased risk of suffering from asthma by the age of six or seven.
An increasing use of paracetamol in children has coincided with rising cases of asthma over the past 50 years. The latest study, carried out in 31 countries, is the largest ever to look at paracetamol use and childhood asthma. Parents of children aged six and seven were asked questions about symptoms of asthma, eczema and related allergic conditions in addition to information on paracetamol use for fever in the child's first year of life and the most recent 12 months.
The results also showed that higher doses and more regular use of the drug are associated with a greater risk of developing asthma. Analysis of current use in 103,000 children showed those who had used paracetamol more than once a month in the past year had a three-fold increased risk of asthma.
Researchers are unsure if the drug directly increases the risk of asthma or if another underlying factor is to blame. Medical experts said parents should still use the drug for high temperatures.
The use of paracetamol was also associated with more severe asthma symptoms and increased risk of eczema and hayfever.
One explanation for the findings is that paracetamol may cause changes in the body that leave a child more vulnerable to inflammation and allergies. Another is that the use of paracetamol in children may be a marker for something else which is causing increased rates of asthma, such as lifestyle issues or the underlying infection causing the fever.
The leader of the study, Professor Richard Beasley from the University of Auckland said: "We stress the findings do not constitute a reason to stop using paracetamol in childhood.
"However the findings do lend support to the current guidelines of the World Health Organization, which recommend that paracetamol should be reserved for children with a high fever (38.5C or above)."
Professor Jeffrey Aronson, president of the British Pharmacological Society, said the dose relationship with paracetamol and asthma suggested there was a real association between the two.
Leanne Male, Asthma UK's assistant director of research, said: "If we can establish the mechanisms behind how paracetamol might affect it, this could go some way towards helping to prevent the condition in the first place.
"At this stage however, the use of paracetamol should not be a concern for parents or carers who are worried about the development of asthma in their children."
Sept 2008
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