Infant Use of Tylenol - Liver Damage

[Mommy Whitman]

Over the course of my daughter's first 13 months of life she had the misfortune of having relentless ear infections, until she had tubes placed in her ears at 13 months of age; now all is well.  My concern is over the Tylenol use she had during those tender, developmental months of 2 months to 13 months old.  For the better part of her first 13 months of life my daughter suffered from one long, uncured ear infection; no anitbiotics would work.  She would go 2 weeks at a stretch without problems only to have another ear infection pop up; and in addition to this, often when prescribed an antibiotic it would not work so her ear infections would last for 1 month instead of the 10 day cycle of an antibiotic.  With all this said my concern is how much this child was on Tylenol during this time, in an attempt to ease her constant pain.  We never gave her an actual overdose of Tylenol, nor did we ever give the Tylenol more than every 4 hours, but on atleast 3 seperate occasions I can remember her being on the Tylenol around the clock for days until she would vomit upon taking a dose, then we would call the doctor and the doctor would say give it to her with food, but we just stopped giving her Tylenol all together for a break, until what we thought was stomach upset, would subside.  I am now wondering if this prolonged use caused liver damage, and that the vomiting was actually the first stage of liver damage?  I am concerned about her liver today; if damage was occurring during these times when she would vomit; does the liver repair itself in any way, how do you think her liver is today.  Her peditrician is not concerned because I never went over the recommended doseage, but I have this motherly instinct inside that feels as though something is not right.  Are there any syptoms (symptoms) I could look for on a day to day basis which would show me residual effects of possible liver damage?  Your insight into my concerns would be greatly appreciated.

[Kevin Pho, MD]

If appropriate dosing has been done, then it is very unlikely that there has been liver damage from the Tylenol.  Typically those at risk would be children who receives more than 90mg/kg or those who have received adult-strength preparations.  

Although there have been cases where liver enzymes were elevated while on recommended doses, this is very rare.  If the liver is a concern at all, you can consider periodic liver enzyme checks to ensure that there has been no damage from the liver.  

Vomiting can be a sign of liver damage, however there are many other things that are more common that can cause vomiting.  If the vomiting continues, I would suggest a pediatric GI referral.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b