Q&A: Acetaminophen Use During Pregnancy

Last month, the Food and Drug Administration issued a statement advising pregnant women to avoid taking acetaminophen, linking its use to autism and ADHD. However, a large number of studies on the topic have failed to establish a conclusive link. This conflicting information has led to confusion and anxiety.

Hugh Taylor, MD, chief of obstetrics and gynecology at Yale New Haven Hospital and professor of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine, provides answers to common questions about acetaminophen use in pregnancy.

What is the recommended dose of acetaminophen for pregnant women?

Take the standard dose as recommended, unless a lower dose takes care of your symptoms. If the bottle says “take two pills every 4-6 hours” but your fever goes away with just one pill, then take only one pill. Acetaminophen is a safe over-the-counter medication, but we should still take it judiciously.

Can acetaminophen interact with prenatal vitamins or other medications I’m taking?

It does not interact with other medications or vitamins. However, it’s important to remember that many other cold and flu remedies also have acetaminophen in them and you could be taking more than the recommended dose if you combine medications. High doses of Tylenol can cause liver damage if you take much more than what's recommended. Pay attention to the ingredients in the medications that you consume.

Should I consult with my doctor if I need to take acetaminophen during pregnancy?

It’s always a good idea to consult with your doctor if you have a fever or are experiencing pain when you are pregnant.

What should I do if I have a fever or pain during pregnancy?

It’s important to treat certain conditions that come up in pregnancy – because the consequences of not treating them can be harmful to both the mother and baby. Fevers in particular are not good for fetal development and have been associated with a variety of birth defects.

Does acetaminophen affect my baby’s growth or development?

The science is far from settled. Some studies have indicated a possible slight association between acetaminophen use during pregnancy and a child’s neurodevelopment; however, other studies contradict this finding. As with any medications, talk to your doctor if you have concerns.

Are there better alternatives?

Tylenol is probably the safest drug we have out there to reduce fever or to fight pain in pregnancy. There isn't an alternative pain medication that pregnant women can take. Pregnant women should not take nonsteroidal anti-inflammatory drugs (i.e. ibuprofen, such as Advil or Motrin) or narcotics for pain because those medications pose real risks.

Is it okay to take acetaminophen while breastfeeding after pregnancy?

As in pregnancy, it is safe to use Tylenol while breastfeeding. However, don’t take more than the minimum amount needed to resolve the problem (fever or pain).

What should pregnant women know about taking acetaminophen?

As with any medication, take the lowest dose you need for the shortest duration possible that resolves your underlying symptoms. In other words, take only what you need for only as long as you need to take it.