Posted by - Seventh Generation
the Inkslinger
In the last 30 years, the rate of childhood asthma has left its historical levels in the dust and skyrocketed to what most agree are epidemic proportions. But why? Is it the pollution in our air? The chemicals in our bodies? The dust mites in our homes or the mold in its walls? Maybe. But some now think the real cause might be in our medicine chests.
In the last few years, a new theory about why childhood asthma has exploded in the western world has emerged and the culprit is more than a little surprising: acetaminophen, the pain reliever and fever reducer in virtually everyone's first aid kit.
Suspicions first emerged when doctors noticed that that spike in asthma rates among kids began in the 1980s just around the time that aspirin was linked to Reye's syndrome in children, and doctors started advising parents to use acetaminophen instead. While that's curious, it's hardly proof that acetaminphen is causing asthma rates to jump. Yet the anecdotal evidence was intriguing enough to persuade researchers to look into it.
What came next were some 20 studies that all seemed to support the idea along with a solid theory about exactly how acetaminophen might promote asthma in young bodies. Now one physician, Dr. John T. McBride, a pediatrician at Ohio's Akron Children's Hospital, has declared in a paper published in the journal Pediatrics that the handwriting on the wall is solid enough for doctors to advise parents of children who have asthma or are at risk of developing the condition to skip the acetaminophen.
It should be noted that the medical community is not in lockstep agreement with this recommendation and that only one randomized controlled study (i.e., the kind that could actually provide proof) has been conducted. However that study found that kids who took acetaminophen for a fever were more than twice as likely to seek treatment for asthma later on versus those who took ibuprofen.
There are additional studies in the pipeline and eventually a more concrete answer to the question is expected to emerge. The real issue is what do us parents do in the meantime?
On that count, a precautionary approach is being recommended by many. While you should always consult with your family physician before making any medical decisions (this is, after all, just a blog post written by someone who's never even driven past a medical school, let alone attended one), the general advice is to use acetaminophen sparingly until more is known. That means reserving its use only for very high fevers and relieving serious pain. Resist the common temptation to administer it for low-grade illness, minor complaints, and ordinary pain like a simple headache or teething soreness. Science has also found that acetaminophen can reduce our antibodies' response to vaccines so the drug should also be avoided prior to any immunization.
That all sounds reasonable to me, and I think any suggestion that helps us avoid unnecessarily medicating our kids is good advice regardless of the reason it's been given. I know the urge to do something positive to relieve even my daughter's minor discomfort can be strong indeed. This news reinforces the idea that my wife and I need to resist the impulse to run immediately to the medicine cabinet for every little ache, pain, and overly warm forehead. Over-the-counter drugs all have their place our health care arsenal, but we should save them until they're truly needed, and it's starting to look like maybe we should save the acetaminophen for a much later date altogether.
In the last 30 years, the rate of childhood asthma has left its historical levels in the dust and skyrocketed to what most agree are epidemic proportions. But why? Is it the pollution in our air? The chemicals in our bodies? The dust mites in our homes or the mold in its walls? Maybe. But some now think the real cause might be in our medicine chests.
In the last few years, a new theory about why childhood asthma has exploded in the western world has emerged and the culprit is more than a little surprising: acetaminophen, the pain reliever and fever reducer in virtually everyone's first aid kit.
Suspicions first emerged when doctors noticed that that spike in asthma rates among kids began in the 1980s just around the time that aspirin was linked to Reye's syndrome in children, and doctors started advising parents to use acetaminophen instead. While that's curious, it's hardly proof that acetaminphen is causing asthma rates to jump. Yet the anecdotal evidence was intriguing enough to persuade researchers to look into it.
What came next were some 20 studies that all seemed to support the idea along with a solid theory about exactly how acetaminophen might promote asthma in young bodies. Now one physician, Dr. John T. McBride, a pediatrician at Ohio's Akron Children's Hospital, has declared in a paper published in the journal Pediatrics that the handwriting on the wall is solid enough for doctors to advise parents of children who have asthma or are at risk of developing the condition to skip the acetaminophen.
It should be noted that the medical community is not in lockstep agreement with this recommendation and that only one randomized controlled study (i.e., the kind that could actually provide proof) has been conducted. However that study found that kids who took acetaminophen for a fever were more than twice as likely to seek treatment for asthma later on versus those who took ibuprofen.
There are additional studies in the pipeline and eventually a more concrete answer to the question is expected to emerge. The real issue is what do us parents do in the meantime?
On that count, a precautionary approach is being recommended by many. While you should always consult with your family physician before making any medical decisions (this is, after all, just a blog post written by someone who's never even driven past a medical school, let alone attended one), the general advice is to use acetaminophen sparingly until more is known. That means reserving its use only for very high fevers and relieving serious pain. Resist the common temptation to administer it for low-grade illness, minor complaints, and ordinary pain like a simple headache or teething soreness. Science has also found that acetaminophen can reduce our antibodies' response to vaccines so the drug should also be avoided prior to any immunization.
That all sounds reasonable to me, and I think any suggestion that helps us avoid unnecessarily medicating our kids is good advice regardless of the reason it's been given. I know the urge to do something positive to relieve even my daughter's minor discomfort can be strong indeed. This news reinforces the idea that my wife and I need to resist the impulse to run immediately to the medicine cabinet for every little ache, pain, and overly warm forehead. Over-the-counter drugs all have their place our health care arsenal, but we should save them until they're truly needed, and it's starting to look like maybe we should save the acetaminophen for a much later date altogether.
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