Paracetamol and Ibuprofen Usage during Infancy and the Risk of Eczema and Bronchiolitis
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on April 1st, 2026
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Eczema and bronchiolitis are common atopic conditions that have become more prevalent in developing countries, which have imposed a significant public health burden to these nations. A couple of previous observational studies had found that usage of paracetamol during infancy can increase the risk of eczema and other atopic disease. However, these studies are less concrete due to their design, so a randomized control study was conducted to better understand the risk of eczema in infants who were treated with paracetamol.
Funding Source(s): Health Research Council of New Zealand
The clinical trial was conducted in New Zealand, and it included 3908 infants with an average age of 4 days old at the time of entering the study. 11.0% of the children were born prematurely, and 16.1% of them were smaller than their gestational age. Family history investigation found that between 10% to 30% of them have at least one parent who had previously been diagnosed with either eczema, asthma, or hay fever. During pregnancy, the paracetamol is frequently used, with 75.6% of the mothers treated with it; usage of aspirin and other NSAIDs is less common at 15.4% and 8.1%, respectively.
The children were randomly assigned to be in either the paracetamol or the ibuprofen group, and the caregiver was instructed to only give the medication provided by the study when the children experienced fever. After one year, the researchers found that there is no significant difference in the risk of either eczema or bronchiolitis between children treated with paracetamol or ibuprofen. Due to the scale and the controlled nature of the study, it had eliminated confounding variables that might have influenced the association between paracetamol usage and eczema in previous studies. The author also noted that they cannot rule out that the ibuprofen used as the control in this study might have influenced the risk of eczema, but it is not possible to perform the study with a placebo control, because some form of antipyretic is essential to control fever in these children.
Funding Source(s): Health Research Council of New Zealand
The clinical trial was conducted in New Zealand, and it included 3908 infants with an average age of 4 days old at the time of entering the study. 11.0% of the children were born prematurely, and 16.1% of them were smaller than their gestational age. Family history investigation found that between 10% to 30% of them have at least one parent who had previously been diagnosed with either eczema, asthma, or hay fever. During pregnancy, the paracetamol is frequently used, with 75.6% of the mothers treated with it; usage of aspirin and other NSAIDs is less common at 15.4% and 8.1%, respectively.
The children were randomly assigned to be in either the paracetamol or the ibuprofen group, and the caregiver was instructed to only give the medication provided by the study when the children experienced fever. After one year, the researchers found that there is no significant difference in the risk of either eczema or bronchiolitis between children treated with paracetamol or ibuprofen. Due to the scale and the controlled nature of the study, it had eliminated confounding variables that might have influenced the association between paracetamol usage and eczema in previous studies. The author also noted that they cannot rule out that the ibuprofen used as the control in this study might have influenced the risk of eczema, but it is not possible to perform the study with a placebo control, because some form of antipyretic is essential to control fever in these children.