Parents should not give children with a mild fever regular
spoonfuls of paracetamol and ibuprofen, doctors advise today, as they warn that
doing so could extend their illness or put their health at risk.
A misplaced “fever phobia” in society means parents too
frequently use both medicines to bring down even slight temperatures, say a
group of American paediatricians, who warn that children can receive accidental
overdoses as a result.
As many as half of parents are giving their children the
wrong dosage, according to a study carried out by the doctors.
In new guidance, the American Academy of Pediatrics advises
that a high temperature is often the body’s way of fighting an infection, and
warns parents that to bring it down with drugs could actually lengthen a
child’s illness.
Family doctors too readily advise parents to use the
medicines, known collectively as “antipyretics”, according to the authors of
the guidance.
GPs also often tell parents to give their children alternate
doses of paracetamol and ibuprofen – known as combination therapy – believing
the risk of side effects to be minimal.
In its official guidance, the National Institute for Health
and Clinical Excellence (Nice) says the use of the drugs “should be considered
in children with fever who appear distressed or unwell”.
Although Nice says that both drugs should not “routinely” be
given to children with a fever, it states that this approach “may be
considered” if the child does not respond to being given just one of them.
Children’s paracetamol solutions such as Calpol and
ibuprofen solutions such as Nurofen for Children are sold over the counter in
chemists. Recommended dosage quantities vary by age.
There is a range of solutions for different age groups,
meaning it is possible for parents with children of different ages to mix up
which they are giving.
According to the British National Formulary, which GPs
consult when prescribing or advising on medication, children should receive no
more than four doses of the right amount of paracetamol in a 24-hour period,
and no more than four doses of ibuprofen a day.
In its guidance today, however, theAmerican Academy of
Pediatrics notes that both medications have potential side effects and says the
risks should be taken seriously.
Doctors, the authors write, should begin “by helping parents
understand that fever, in and of itself, is not known to endanger a generally
healthy child”. “It should be emphasised that fever is not an illness but is,
in fact, a physiological mechanism that has beneficial effects in fighting
infection.”
Despite this, the academy says, many parents administer
paracetamol or ibuprofen even though there is only a minimal fever, or none at
all.
“Unfortunately, as many as half of all parents administer
incorrect doses,” the authors say. A frequent error is giving children
adult-sized doses, while children who are small for their age can also receive
doses that are too high even if their parents follow the instructions correctly.
Paracetamol has been linked to asthma, while there have been
reports of ibuprofen causing stomach ulcers and bleeding, and leading to kidney
problems.
“Questions remain regarding the safety” of combination
therapy, say the authors, led by Dr Janice Sullivan, of the University of
Louisville Pediatric Pharmacology Research Unit, and Dr Henry Farrar, of the
University of Arkansas.
Dr Clare Gerada, the chairman of the Royal College of GPs,
said: “In my experience of 20 years as a GP, parents are usually pretty
careful.
“I think the most important thing to be worried about is
keeping medicines out of the reach of children, because some taste quite nice.”
This article was originally published on telegraph.co.uk
Parents should not give children with a mild fever regular spoonfuls of paracetamol and ibuprofen, doctors advise today, as they warn that doing so could extend their illness or put their health at risk.
This article was originally published on telegraph.co.uk
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