Calpol: Is it really a safe cure-all for our children?

All parents know the value of Calpol, the paracetamol-based medicine that can reduce a high fever and soothe aches and pains. Indeed, many will admit they have become semi-reliant on it, at times, as a kind of safe cure-all.

Comedian Michael McIntyre perhaps explained it best, saying: "You give it to them for their runny noses and colds, but there are side effects: it calms them down, makes them more lucid, they sleep through the night... they become better people."

Yet, last week, parents were warned that their enthusiasm for the soothing syrup might have got out of hand. In his new BBC One documentary series The Doctor Who Gave Up Drugs, Chris van Tulleken cautioned that many are overusing it. That might be as a response to a "crying baby" or "misbehaving child" but could also be in part, he said, due to an industry apparently exploiting parents' emotions for profit.

Children are taking three times more of the medicine than 40 years ago, he revealed, and we spend ￡64 million every year on it.

As an example, Dr van Tulleken told of a mother who kept bottles of Calpol in every room "just in case" and spoke to a GP who said: "We have children almost addicted to Calpol. Not the drug itself, but the process. Some describe it as 'the heroin of childhood'."

GP Dr Shan Hussain, who is based in Nottingham, is sympathetic to Dr van Tulleken's point of view.

"In a number of cases," he says, "Calpol is being relied on too much. If your child has a low-grade fever (below 100F/38C), and is otherwise happy and comfortable, there is no reason to give it. And it shouldn't be used for more than three days consecutively."

When Kate Kirrane, a 45-year-old yoga teacher, first started using Calpol on her then three-month-old daughter, Isla, she remembers it as a godsend. "Isla was a 'hot' baby. It was great for managing her temperature and for teething too."

As a pharmacist, I would say think twice before you dose your child. It should be a last resort

Kirrane, who lives in Beaconsfield, Buckinghamshire, with her husband, 48-year-old Michael, a builder, and Isla, now eight, and Isaac, six, adds: "But what I really relied on Calpol for was help with her severe colic."

But after a while, Kirrane noticed that her daughter seemed to be drowsy all the time. "Her head would drop and she would be moaning. It went on for about three months. I didn't know what was going on."

Worried, Kirrane took Isla into A&E where a consultant paediatrician examined her and could find nothing wrong. His advice was to go home and give her Calpol.

"I remember my mother-in-law saying that she thought I gave Isla a lot, but I defended myself by saying I only gave her what was allowed."

Two months later, when Isla was nearly two, Kirrane had an epiphany. "I thought she is behaving like she is drugged. I reduced how much we gave her and the symptoms went."

Pharmacist Sandra Gidley chairs the English board of the Royal Pharmaceutical Society and admits that now she is a grandmother, she notices Calpol is used "quite a lot" by the younger generation of mothers.

"But I can understand it," she says. "When their child is unwell, parents want to do something, and the default reaction is to reach for the Calpol."

She thinks the problem stems partly from what parents are being told.

"I do community pharmacy locum work and I have seen mums come into the pharmacy with prescriptions for 500ml of Calpol or ibuprofen. That's a lot. It sends a message that these medicines can be used as a routine thing.

"Plus the culture has grown up where it is almost expected at the end of a consultation. For a GP it's an answer you can give to a worried parent."

At the pharmacy, parents may be asked if they have used an antihistamine before, but that is unlikely to be the case when you buy a bottle of liquid paracetamol, which is considered a household staple, she says.

Gidley believes this is something the medical and pharmacy professions need to think about. "It hasn't been high on the agenda until now but when I read about Dr van Tulleken's programme, it struck quite a chord."

So how worried should we be about dosing up our children with Calpol?

"People think it has been around for years," says Gidley, "and it is just paracetamol so it is safe. But prolonged use or accidental overdose can be dangerous. There may also be a link to childhood asthma. As a pharmacist, I would say think twice before you dose your child. It should be a last resort."

WHAT TO GIVE WHEN

She notes two ways in which Calpol may be given inappropriately. The first is when a child is not in pain and the temperature is only slightly raised. The other is when parents "get into the habit of giving it at bedtime in the hope it will calm a restless child. But there is no effect on sleep patterns".

And Gidley warns against that other parenting habit of alternating paracetamol and ibuprofen. "A child has to be quite ill before they need that level of medication. Some people also don't realise ibuprofen has to be given with food to avoid stomach problems. Prolonged use can cause kidney injury."

She points out: "We focus on what these medications do to adults, but it does seem no one has thought about the longer-term consequences of dishing this stuff out to children. I think it would be helpful for the National Institute for Health and Care Excellence to look at this in the round."

What if you find yourself dispensing antihistamines such as Piriton quite often too? "I would say if you have to give a child something for hay fever or an allergy, question whether you want to give a sedating one which could affect performance at school rather than a non-sedating one like Clarityn?"

Kirrane is now careful about what she gives to her children. "I tend to use children's ibuprofen for preference and only then when I'm sure they need it."

Dr Hussain says: "I wouldn't want parents thinking they can't give Calpol for a fever. If your child has a temperature above 38C or is unwell with symptoms of pain or distress, then you can use it. Or call 111 for advice and guidance from the NHS."

For more information: see NHS Choices