Acetaminophen has got to be one of the first and most common medications given to infants and young children. And usually, as parents, we give it without much concern. We hope we are relieving our child's pain or reducing fever so he will feel better.

However, a study published in the November 2011 Journal of Pediatrics has delineated a strong link between acetaminophen use and an increased incidence and risk of asthma. Based on more than 20 studies in children and adults, author and pediatrician Dr. John McBride asserts that acetaminophen must be proven safe for those with asthma and/or at increased risk for it.

In 2008, a study reported in Lancet concluded that children given acetaminophen during their first year of life had a 50 percent greater risk of developing asthma compared with children who did not. In addition, many studies support a dose-response relationship between acetaminophen use and asthma incidence.

It makes sense that acetaminophen use may simply be one piece of the puzzle when considering the causes and risk for asthma, such as family history, exposure to secondhand smoke and repeated viral infections in the first year of life.

I understand the complex relationships at play here. Determining which factors truly are causative and which are merely coincidental is not necessarily clear cut. However, as a mother and pediatrician, acetaminophen is a common household and clinic item.

Will this change the way I treat high fevers and pain in children?

It will. This information is significant enough to educate parents about and counsel those with asthma or at risk for asthma to avoid or limit its use until further studies are completed.

This also is a good opportunity to further emphasize the prudent use of acetaminophen among children in general.

When faced with a fever in your child, remember to look at your child instead of the number on the thermometer before reaching for that fever reducer. Not only will this reduce exposure to unnecessary medication, your child's fever will actually help her recover from her illness more quickly.

Do not pretreat your child with acetaminophen prior to routine immunizations. Offer other forms of comfort, such as breast feeding, pacifier use, holding and distraction. Also, the use of acetaminophen prior to vaccinations has been shown to blunt the immune response.

If your child's pain or fever is not amenable to other comfort measures, then by all means, give him some medicine to make him feel better. Just be mindful to use only when necessary and if your child has asthma or a strong family history of asthma, choose ibuprofen instead.

The bottom line is that like most medications, acetaminophen does carry some risks. As parents, we should always take medicating our children seriously. I prefer to use any medication sparingly and only when necessary. Acetaminophen is no different. I'm not removing acetaminophen from my medicine cabinet, but I am advocating that it be used in moderation and under the appropriate circumstances.

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Dr. Melissa Arca is a mother of two, a writer and a blogger. Her blog, www.confessionsofadrmom.com, is where her worlds of doctor and mom come together, and it is featured on The Bee's blog and community news network, Sacramento Connect.

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