{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:42:10Z","timestamp":1760197330322,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T00:00:00Z","timestamp":1522195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>Background: Paracetamol may be used as an antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain post-vaccination in infants. The use of paracetamol during fever may be or may not be recommended since it may alter the natural human body immune response, although it may reduce fever and fussiness. Objectives: The aims of this study are to describe the effectiveness of breastfeeding in reducing pain and paracetamol in reducing fever and pain post infant vaccination. Methods: Data sources and study selection was conducted by electronic searching of six databases. Manual reference checks of all articles on paracetamol and breastfeeding post infant vaccination published in the English language between 1978 and 2017. Two levels of screening were used on 9614 citations, which include screening of abstracts and titles followed by full text screening. The data synthesis were tabulated into study characteristics, quality, and effects. Results: Systematic review of breastfeeding included three studies from 9614 database searches found significant benefit from breastfeeding in pain scores and the duration of crying, as well as behavioural changes. None of the studies stated the detriment of breastfeeding before, during, and after immunization. Systematic review of paracetamol effectiveness included four studies from 1177 database searches found significant benefit from prophylaxis paracetamol in fever, one study found significant benefit from prophylaxis paracetamol in fussiness, and one study\u2019s results were found to be not significant. Two studies on evaluating the safety of prophylactic paracetamol in 2009 found that antibody responses to several antigens were significantly reduced, and the other study in 1988 found that antibody titres to DTP bacteria of placebo and PCM did not differ significantly. Conclusions: The relevancy of giving paracetamol post all types of vaccination may be questionable. Breastfeeding before, during, and after immunization are recommended for pain reduction and are proven effective. Further research is required in deciding if paracetamol is to be of rational use following infant immunization.<\/jats:p>","DOI":"10.3390\/pharmacy6020027","type":"journal-article","created":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T05:26:37Z","timestamp":1522301197000},"page":"27","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Relevancy of paracetamol and Breastfeeding Post Infant Vaccination: A Systematic Review"],"prefix":"10.3390","volume":"6","author":[{"given":"Nurain","family":"Suleiman","sequence":"first","affiliation":[{"name":"Pharmaceutical Services Division, Johor State Health Department, 81200 Johor Bahru, Johor, Malaysia"},{"name":"Kulliyyah of Pharmacy, International Islamic University Malaysia, 25710 Kuantan, Pahang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siti Hadijah","family":"Shamsudin","sequence":"additional","affiliation":[{"name":"Kulliyyah of Pharmacy, International Islamic University Malaysia, 25710 Kuantan, Pahang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Razman","family":"Mohd Rus","sequence":"additional","affiliation":[{"name":"Kulliyyah of Medicine, International Islamic University Malaysia, 25710 Kuantan, Pahang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samsul","family":"Draman","sequence":"additional","affiliation":[{"name":"Kulliyyah of Medicine, International Islamic University Malaysia, 25710 Kuantan, Pahang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Taib","sequence":"additional","affiliation":[{"name":"Ara Damansara Medical Centre, 40150 Shah Alam, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,3,28]]},"reference":[{"key":"ref_1","unstructured":"American Pharmacists Association (2006). Acetominophen. Drug Information Handbook, Lexi-comp."},{"key":"ref_2","unstructured":"Bahagian Pembangunan Kesihatan Keluarga (2008). Panduan Program Imunisasi Kebangsaan Kanak-Kanak Untuk Anggota Kejururawatan."},{"key":"ref_3","unstructured":"College of Paediatrics (2001). Malaysian Immunization Manual, Academy of Medicine Malaysia."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jackson, L.A., Peterson, D., Dunn, J., Hambidge, S.J., Dunstan, M., Starkovich, P., Yu, O., Benoit, J., Dominguez-Islas, C.P., and Carste, B. (2011). A Randomized Placebo-Controlled Trial of Acetominophen for Prevention of Post-Vaccination Fever in infants. PLoS ONE.","DOI":"10.1371\/journal.pone.0020102"},{"key":"ref_5","unstructured":"Paddock, C. (Medical News Today, 2009). Routine Use of Paracetamol (Acetaminophen) After Vaccination Not Recommended for Infants, Study, Medical News Today."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/S0140-6736(09)61208-3","article-title":"Effect of prophylactic Paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: Two open-label, randomised controlled trials","volume":"374","author":"Roman","year":"2009","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Cooper, C., Atkinson, E.J., O\u2019fallon, W.M., and Melton, C.J. (1992). Incidence of Clinically Diagnosed Vertebral Fractures: A Population-Based Study in Rochester, Minnesota, 1985\u20131989, Department of Health Sciences Research, Mayo Clinic and Foundation.","DOI":"10.1002\/jbmr.5650070214"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S0022-3476(83)80278-9","article-title":"Seizures following childhood immunization","volume":"102","author":"Hirtz","year":"1982","journal-title":"J. Pediatr."},{"key":"ref_9","unstructured":"Centre for Clinical Practice at NICE (2013). Feverish Illness in Children Assessment and Initial Management in Children Younger Than 5 Years."},{"key":"ref_10","unstructured":"Katrin, S.K., Michael, M., Michael, B., Marcy, C.J., Ron, D., John, H., David, N., Edward, R., and the Brighton Collaboration Fever Working Group (2004). Fever after Immunization: Current Comcepts and Improved Future Scientific Understanding, Infectious Diseases Society of America."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Das, R.R., Panighari, I., and Naik, S.S. (2014). The effect of prophylactic antipyretic administration on post-vaccination adverse reactions and antibody response in children: A systematic review. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0106629"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Janice, E., Sullivan, M.D., Henry, C., Farrar, M.D., and the Section on Clinical Pharmacology and Therapeutics, and Committee on Drugs (2011). Clinical Report: Fever and Antipyretic Use in Children, American Academy of Peadiatrics.","DOI":"10.1542\/peds.2010-3852"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/0142159021000061468","article-title":"A systematic review of postgraduate teaching in evidence-based medicine and critical appraisal","volume":"25","author":"Coomarasamy","year":"2003","journal-title":"Med. Teach."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e1448","DOI":"10.1542\/peds.2009-1911","article-title":"Breastfeeding and risk for fever after immunization","volume":"125","author":"Pisacane","year":"2010","journal-title":"Peadiatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1136\/pmj.79.934.438","article-title":"Assessment and management of pain in infants","volume":"79","author":"Mathew","year":"2003","journal-title":"Postgrad. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Rose, M.A., Juergens, C., Schmoele-Thoma, B., Gruber, W.C., Baker, S., and Zielen, S. (2013). An open-label randomised clinical trial of prophylactic paracetamol coadministered with 7-valent penumococcal conjugate vaccine and hexavalent diphteria toxoid, tetanus toxoid, 3-component acellular pertusis, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b vaccine. BMC Peadiatr.","DOI":"10.1186\/1471-2431-13-98"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/j.1651-2227.1988.tb10741.x","article-title":"Effect of prophylactic acetaminophen administration on reaction to DTP vaccination","volume":"77","author":"Uhari","year":"1988","journal-title":"Acta Paedistr. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/BF02760577","article-title":"Intermittent clobazam therapy in febrile seizures","volume":"72","author":"Rose","year":"2005","journal-title":"Indian J. Peadiatr."}],"container-title":["Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2226-4787\/6\/2\/27\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:58:45Z","timestamp":1760194725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2226-4787\/6\/2\/27"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,28]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,6]]}},"alternative-id":["pharmacy6020027"],"URL":"https:\/\/doi.org\/10.3390\/pharmacy6020027","relation":{},"ISSN":["2226-4787"],"issn-type":[{"type":"electronic","value":"2226-4787"}],"subject":[],"published":{"date-parts":[[2018,3,28]]}}}