Is Tylenol safe to give to children with asthma?

Here are the facts:

• Nearly 9% of children in the U.S. suffered from asthma in 2005...that was likely an underrepresentation of the true number of cases and 6 years later, the numbers have undoubtedly risen.
• 13 million school days are missed each year due to asthma in children
• There are somewhere in the range of 3,000 deaths each year in the U.S. due to asthma
• The annual estimated economic cost of asthma in the U.S. is $19.7 billion.

If reading those statistics doesn't make a strong argument that we should be devoting more time to identifying better ways of treating asthma in children, then I don't know what does.  If you have a child with asthma, you know first-hand, how it impacts your entire family.

An article is published in the upcoming December issue of Pediatrics journal, that looks at a possible link between Tylenol (or generic acetaminophen) use and asthma in kids.  It has been a well-established fact that some people with asthma can have asthma flare-ups if they take aspirin.  Now, the most widely-given over-the-counter medication, acetaminophen, is being called into question, in terms of its safety for children with asthma.  The article looked at multiple studies that have been conducted in recent years, one of which involved over a half a million children in 54 different countries.  In some cases, when children took acetaminophen more than once a month, their risk of asthma was nearly tripled.  It's unclear to the researchers whether increased use of acetaminophen causes asthma in children, or whether children who are already predisposed to having asthma just tend to take acetaminophen more often.  It's also unclear whether taking acetaminphen less often (say, once or twice a year) has any impact on a child's risk of asthma.  Either way, it makes a strong argument to turn to alternative treatments for fever in chidren, like ibuprofen (Children's Motrin/Advil).  There does not appear to be that same association between ibuprofen and asthma in children.  (And no, I'm not getting paid by the makers of ibuprofen to say that!)

Those that know me well, know that I am not an alarmist, and I certainly wouldn't say that it's time to panic.  This is a no-brainer for me, though.  The alternative treatment sits right next to acetaminophen on the shelf at the pharmacy.  I'll be recommending ibuprofen for fever control in children with a history of asthma or a strong family history of asthma, from now on.