Mothers who frequently use over-the-counter (OTC) pain relievers are more likely to give them to their children too, according to a new Danish study.

More parents are giving OTC medications, such as acetaminophen, to their young children, often without the advice of health care professionals, the study team says.

“Half of all the medications used worldwide are non-prescription - it is a huge and growing industry under limited control from the health care system,” Dr. Janne Fangel Jensen, who led the research, told Reuters Health by email.

Jensen is a researcher with the Department of Public Health at the Faculty of Health and Medical Sciences, University of Copenhagen, in Denmark.

Acetaminophen - sold as paracetamol outside of the U.S. - is the most widely used drug in many developed countries. It’s a safe treatment for many forms of mild pain and has few known side effects, Jensen said.

But overdosing with acetaminophen can be dangerous, she cautioned. “In my opinion it is important to limit the use of paracetamol to when it is indicated and to prevent an increasing ‘over-medication’ especially in children.”

To gauge whether a mother’s use of painkillers influences how often children take the drugs, the researchers surveyed mothers of 131 Danish children ages 6 to 11.

Jensen and his colleagues asked how often the children were given non-prescription pain relievers during the previous three months and during the past year. They also asked how often the children had felt pain. In addition, there were questions about the mothers’ use of medication and general health.

The researchers found that 45 percent of the children had been given OTC pain relievers, mostly acetaminophen, during the previous three months. And 22 percent were given acetaminophen at least every other month for the previous year.

One-third of the mothers said they had chronic pain and 39 percent reported taking OTC pain relievers at least once per month, Jensen’s team reports in Pediatrics.

The researchers discovered that mothers who believed their children had recurrent pain tended to give them acetaminophen at least every other month.

And, in general, mothers who took pain relievers themselves every month also reported giving acetaminophen to their children more often during the previous three months.

“Our main finding is that mothers who use more OTC analgesics themselves have a tendency to also give it more often to their children,” Jensen said.

Jensen added that many mild symptoms such as cough, colds, sore throat or headaches are self limiting and do not need treatment with an OTC drug to go away.

“I would like parents to think twice when they treat their child with an analgesic,” she said.

It can be difficult for parents to know when they are giving their children too much medication, experts acknowledged.

“Too much is when analgesics are given by the parent as a solution for any time the child complains of not feeling well or has some small pain,” Dr. Lonnie Zeltzer told Reuters Health by email.

Zeltzer directs the Children’s Pain and Comfort Care Program at the Mattel Children’s Hospital at University of California, Los Angeles. She was not involved in the new study.

“Parents need to assess when their child is in significant pain that the child is having trouble coping with or is interfering with daily activities, said Zeltzer, who is also a professor of pediatrics at the David Geffen School of Medicine at UCLA. “There are many behavioral ways of helping a child cope with pain besides just giving medications.”

“Parents need to learn to use judgment in the provision of over the counter analgesics to their child. If parents are giving analgesics to their child on a regular basis several times a week then their child needs to see a pediatrician,” Zeltzer said.

Both Jensen and Zeltzer worry that overuse of medications can train children to believe that’s the only way to deal with symptoms.

“Parents need to be aware that if they give medication every time their child complains about a symptom, their child will learn that the ONLY way to get relief is through medications,” Zeltzer said.

If children feel there are no other alternatives whenever they don’t feel well they won’t learn good self-management/self-coping skills, she added.

“In many cases bed rest, a glass of water, staying indoors or just ignoring the symptom would be just as effective,” Jensen said.

“What is important is that the child is seen by a physician if symptoms persist, or if the child seems generally ill in any way,” Jensen said, “and all parents should make sure that they are giving their children the right dosage of a medication before administrating it.”

SOURCE: Pediatrics, online January 6, 2014.

###

Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

OBJECTIVE: Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child’s frequency of pain into account.

METHODS: A quantitative cross-sectional survey was conducted on 131 children aged 6 to 11 years and their mothers in the framework of the Demonstration Of A Study To Coordinate And Perform Human Biomonitoring On A European Scale (DEMOCOPHES) European project. Participants were selected from 1 urban and 1 rural area of Denmark, and equally distributed in age and gender. Data were collected through structured interviews with all children and self-report questionnaires for mothers regarding health, pain, and medicine use.

RESULTS: After adjusting for several sociodemographic and health parameters, maternal use of OTC analgesics was significantly associated with self-medication with OTC analgesics, particularly PCM, in our population of schoolchildren, even when the child’s pain was adjusted for (odds ratio 3.00, P = .008). A clear association between child pain and OTC analgesic use was not found. Additionally, maternal health (self-rated health, chronic pain, chronic disease, daily medicine intake) did not significantly influence child use of OTC analgesics.

CONCLUSIONS: Maternal self-medication with OTC analgesics is associated with self-medication of OTC analgesics, predominantly PCM, among school-aged children, perhaps more than the child’s pain. Maternal health seems of less importance. Information to parents about pain self-management is important to promote appropriate PCM use among schoolchildren.

  Janne Fangel Jensen, MD,
  Mathilde Gottschau, MB,
  Volkert Dirk Siersma, PhD,
  Anette Hauskov Graungaard, PhD,
  Bjørn Evald Holstein, mag.scient.soc, and
  Lisbeth Ehlert Knudsen, PhD