If you’re pregnant and have reached for Tylenol (commonly known as acetaminophen) to ease a headache or lower a fever, you’re not alone. More than half of pregnant women use acetaminophen at some point during pregnancy. My wife, the mother of our nine children, used to get debilitating headaches while she was pregnant and would ask me what to do. “Two extra-strength Tylenol,” I would tell her.
To be clear, as a board-certified Maternal Fetal Medicine Doctor who specializes in high-risk pregnancies, I would never recommend anything to my wife or my patients if I thought it would be harmful to the baby.
Why is there controversy?
The safety of Tylenol during pregnancy for pain and fever has become a hot-button issue recently. In the last 10 years, there has been a questionable association between acetaminophen and conditions like asthma, lower IQ, gross motor development, communication problems, ADHD, and most recently, autism.
The Department of Health and Human Services has recently stated taking acetaminophen during pregnancy causes autism, based on findings in a recent BioMed Central Environmental Health article. The author of this study, along with health experts are working hard to clarify that this study only shows an association, not a direct causal link. Additionally, the association to autism is the strongest when taking acetaminophen for four or more consecutive weeks.
What are other health experts saying?
- Food and Drug Administration (FDA) acknowledges the association but says no causal link has been established. They advise using acetaminophen only when medically necessary and at the lowest effective dose.
- American College of Obstetricians and Gynecologists (ACOG) reaffirms that acetaminophen is safe and essential for treating pain and fever during pregnancy.
- The Society of Maternal-Fetal Medicine (SMFM) also acknowledges the association but says no causal link has been established. They continue to advise that acetaminophen is an appropriate medication to treat pain and fever during pregnancy.
Are there alternatives to Tylenol?
Many over-the-counter pain relievers, like ibuprofen or aspirin, are not recommended during pregnancy. Here are a few non-drug options to try first:
- Cool compress for fever
- Prenatal messages for aches
- Ginger or chamomile tea for nausea and mild discomfort
- Rest and hydration
What is the bottom line?
Women can and should continue using acetaminophen in pregnancy. Tylenol is still the safest pain reliever for pregnant people when used properly – only when needed, at the lowest effective dose and not for long-term use without medical advice.
Sean Kenney, MD, FACOG
Center for Maternal & Fetal Care
