Amy Banulis, MD, is a board-certified obstetrician and gynecologist with the Mid-Atlantic Permanente Medical Group. She also is associate medical director for Women’s and Maternal/Child Health. Dr. Banulis sees patients at the Kaiser Permanente Falls Church Medical Center.
Recent headlines have sparked concern among expectant parents about the safety of Tylenol (acetaminophen) during pregnancy. As a board-certified OB-GYN at Kaiser Permanente and associate medical director for Women’s and Maternal/Child Health, I want to reassure expectant parents that appropriate use of acetaminophen is safe.
Q: Why are so many people worried about Tylenol and other brands of acetaminophen?
A: The concern stems from recent public statements suggesting a possible link between acetaminophen use during pregnancy and autism. Even though the medical community has not found evidence to support this claim, the statement understandably caused anxiety. Many pregnant patients now ask, “Is it really safe to take Tylenol?” I understand that it’s hard to ignore something you have heard widely discussed, even when medical experts say otherwise.
Q: What does the research show?
A: Researchers have studied the use of acetaminophen during pregnancy for more than two decades. None of the research conducted during that time has shown any risk associated with the appropriate use of acetaminophen in pregnancy. This is why organizations such as the American College of Obstetricians and Gynecologists (ACOG), American Academy of Pediatrics, and the Society for Maternal Fetal Medicine continue to recommend acetaminophen as the safest option for pain relief during pregnancy, when used as directed.
Q. Is there any truth to the claim that Tylenol causes autism?
A: No. Decades of research show that autism has complex causes, including both genetic and environmental influences. It is not caused by anything parents did or did not do. There is no single factor that leads to autism, and nothing parents could have done differently to prevent it. Bottom line: High-quality studies have not found an association between the use of acetaminophen during pregnancy and children’s risk of autism, ADHD, or intellectual disability.
Q: Are there alternatives to acetaminophen for fever and pain relief during pregnancy?
A: For mild aches and pains, you may consider trying heat, ice, or massage. To avoid headaches, try hydrating, getting adequate sleep, exercising, and relieving stress. Be sure you are up to date on your flu and COVID vaccinations to prevent fever associated with these common viral illnesses. But if these suggestions do not lead to relief, taking Tylenol is okay. In fact, not treating fever and persistent pain in pregnancy can be dangerous for mom and baby. High fevers during pregnancy can increase the risk of neural tube defects (NTDs) and other birth defects. Untreated pain can increase stress hormones and affect the body in other ways, all of which can negatively affect a fetus.
Acetaminophen is generally considered the safest option for pain and fever during pregnancy. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are usually not recommended. Before trying any alternative, consult your healthcare provider.
Q: How should pregnant people use acetaminophen safely?
A: Use the lowest effective dose for the shortest amount of time needed to relieve your symptoms. Always follow the dosing instructions on the package or those given by your healthcare provider. (This is true for all medications used in pregnancy, both prescription and over the counter.) If you find yourself needing pain relief frequently, talk to your doctor to rule out more serious underlying issues.
Q: What’s the bottom line for expectant parents?
A: Don’t panic. The overwhelming body of research supports the safety of acetaminophen when used appropriately during pregnancy. If you would like to read more, I recommend the FAQ from the American College of Obstetricians and Gynecologists.
If you have questions or concerns, bring them up with your healthcare provider. They can help you make the best decision for your health and your baby’s health.
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