The role of paracetamol in child care: an underexplored tool

Paracetamol is rarely administered to sick children in child care, despite the fact that it can benefit both children and their parents. This view is shared by our founder and medical director, Bernard Leenstra.

Imagine you are just in a busy meeting or in the middle of an important task, when you get a call from daycare: your child has a fever and needs to be picked up right away. Once home, you give your child a paracetamol, and within a short time there is little sign of the symptoms of illness. The child is relieved, but your workday is lost. Why can't a child in daycare be given paracetamol so that this scenario might be prevented?

For children suffering from fever, pain or other discomfort, paracetamol can often provide relief. If parents were already planning to give paracetamol, why not give it earlier, such as during daycare? It could make the child feel better faster, experience less pain and be able to eat and drink better again.

Yet childcare centers are often reluctant to provide paracetamol. The reasons vary: some refer to guidelines from the GGD, while others fear legal problems if something goes wrong. It is also often thought that paracetamol could lead to febrile convulsions, pose a greater risk of infection for other children, or mask serious symptoms of illness.

However, these concerns are debatable. Paracetamol cannot hide serious illness, and there is no scientific evidence that its use causes febrile convulsions or increases the risk of infection. Sick children are often infectious before symptoms become apparent. Both the GGD and RIVM are not adverse to the administration of paracetamol by childcare workers. While prescription medication falls under specific guidelines, this does not apply to paracetamol. As long as parents provide written consent, this does not change the legal responsibility of the daycare center.

Administering paracetamol earlier can be beneficial not only for the well-being of the child and parents, but also for the workplace in the Netherlands. With some 41 million childcare days annually in the Netherlands (not counting out-of-school care and guest parents), between 1% and 10% of children are sent home earlier each day due to illness or fever. At best, this means that more than 400,000 working hours are lost annually.

Therefore, as in some other countries, child care centers might consider giving children a single dose of paracetamol under certain conditions. Of course, with written parental consent that clearly states dosage and method of administration. If the child does not recover within an hour, the parents should still come and collect their child. This ensures that the staff can continue to focus their attention on the other children, while sick children can recover at home.