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You may have heard that Aspirin isn't safe for kids — but why is that, when can they start taking it, and what painkiller should children use instead of Aspirin?

So, your child's got a fever, viral illness, or aches and pains? Rather than rushing to see your pediatrician, there are certainly going to be times when raiding your own medicine cabinet seems like the best choice. An informal "investigation" of a bunch of friends and acquaintances, ranging from their late 30s to early 60s, revealed that they all took Aspirin as children — and nothing bad happened. You may have heard that Aspirin is now no longer considered safe for kids under 16 [1] (or 12, or 19, what's up with that?), but is the popular OTC med you probably took yourself as a child really that dangerous? At what age is it OK for a young person to start using Aspirin? And does this also mean that you cannot take aspirin during pregnancy?

Aspirin In Children And The Risk Of Reye's Syndrome

Reye's syndrome is a rare but dangerous condition that causes swelling in the brain and liver. While its cause remains unclear, we do know that Reye's syndrome strikes people who have recently had viral infections. Although Reye's syndrome can, contrary to popular belief, develop in people of any age, it overwhelmingly affects children. Reye's syndrome patients, who may initially suffer nausea and vomiting, irritability, and delirium, and even fall into a coma, may recover completely with  the right treatment. They can also, however, sustain permanent brain damage, and may even lose their lives. The likelihood of a complete recovery depends on the severity of the swelling. [2, 3]

When scientists discovered that those children who developed Reye's syndrome were disproportionately more likely to have taken Aspirin or products containing Aspirin [4], alarm bells were sounded and parents were quickly advised not to offer Aspirin to their younger children anymore.

Though it's still not clear why there is an association between Reye's syndrome and Aspirin use in children, later research confirmed that the idea of a link wasn't due to diagnostic bias, but indeed real [5]. 

So, At What Age Can Children Take Aspirin Safely?

This is a bit like drinking alcohol during pregnancy — just like no particular amount of alcohol during pregnancy has ever been proven to be safe, there is no definite age at which Aspirin use suddenly becomes safe. The vast majority of Reye's syndrome cases occur in children under the age of 15, however. A relatively low 8.3 percent of Reye's syndrome cases happen in teens between the ages of 15 and 17, while the condition is exceedingly rare in adults. [6]

These scientific findings have led a whole bunch of medical organizations in the US, including the FDA and the American Academy of Pediatrics, to recommend that no person under 19 should take Aspirin for fever-causing illnesses [7]. British regulatory bodies, on the other hand, concluded that Aspirin shouldn't be taken by people under 16 [8]. 

There are exceptions, however — a doctor may recommend that a child under the age of 19 or 16 uses Aspirin if they suffer from a condition for which Aspirin has been proven to be particularly beneficial [6], such as Kawasaki disease [9] and juvenile arthritis [10]. 

I'm Pregnant: Can I Take Aspirin?

There is a weak association between the use of aspirin during pregnancy and miscarriage — but the association is stronger for other NSAIDs [11]. Some women who have suffered recurrent miscarriages will even be advised to take aspirin to prevent miscarriage, as it may prevent the formation of blood clots within the placenta that could cut the baby's blood supply off [12]. If you're just suffering from a headache, though, other, safer, options are available to you, notably paracetamol/tylenol [13]. 

OK, Aspirin's Out, But What Should I Give My Child Instead?

So, in the name of "better safe than sorry", you're obviously not going to choose Aspirin for kids unless a doctor specifically explains why it is beneficial. What over-the-counter analgesic and fever reducer is safer for children? No analgesic should be used for prolonged periods of time without consulting a doctor, whether in children or adults — both because the long-term use of these medications may cause adverse effects, and because long-term use indicates an underlying and untreated medical problem. 

However, if you're talking about keeping a child comfortable during a viral illness or helping them through aches and pains, you may use either acetaminophen (tylenol) or ibuprofen. Both are generally considered safe for children — acetaminophen may be used from two months and up, while ibuprofen is suitable for children aged three months and over if they weight at least 11 lbs. [14]

Always talk about the appropriate dosage and the numbers of times a day your child may receive either of these analgesics with your pharmacist prior to administration, read the package insert carefully, and never exceed the recommended dose. Whenever you are worried, consult your child's pediatrician. This is always a good step to take if you are looking for ways to treat your infant. Do not give any other analgesic, such as codeine, to your child without a doctor's prescription!

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