Tylenol and Pregnancy
What the evidence shows and what you can do
On September 22, President Trump warned pregnant women to avoid taking Tylenol, the most popular brand of acetaminophen. While this advice was presented in an alarming manner and has generally been denounced by the media, it is backed by compelling scientific evidence.
In 2021, 91 scientists, clinicians and public health professionals from all around the world wrote a Consensus Statement recommending that:
- Pregnant women should forego Paracetamol, otherwise known as acetaminophen, unless medically indicated.
- Pregnant women should consult with their physician or pharmacist if they are uncertain whether use is indicated and before using on a long-term basis.
- Pregnant women should minimize risk by using the lowest effective acetaminophen dose for the shortest possible time
An August 14, 2025 study published in Environmental Health, “Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology” analyzed 46 studies and found that the majority of the studies reported positive associations between prenatal acetaminophen and neurodevelopmental disorders such as autism and ADHD, especially if acetaminophen is taken for four weeks or longer.
Of the studies, 27 reported a positive association, nine showed no significant link and four indicated protective effects. Higher-quality studies were more likely to show positive associations.
The authors conclude that “appropriate and immediate steps should be taken to advise pregnant women to limit acetaminophen consumption to protect their offsprings’ neurodevelopment.”
In a September 23 statement, Andrea Baccarelli, MD, PhD, co-author of the study, Dean of the Faculty and Professor of Environmental Health at Harvard T.H. Chan School of Public Health said:
I believe that caution about acetaminophen use during pregnancy — especially heavy or prolonged use — is warranted.
Dr. Baccarelli also acknowledges that high fever during pregnancy can pose risks to both mother and baby and suggests:
Patients who need fever or pain reduction during pregnancy should take the lowest effective dose of acetaminophen, for the shortest possible duration, after consultation with their physician.
Risk of high fever in early pregnancy
A 2014 meta-analysis published in Pediatrics found that maternal fever during pregnancy, especially during the first 8 to 12 weeks of pregnancy, may increase the chance of birth defects like cleft lip and palate, congenital heart defects, and neural tube defects. A 2017 study found that this association was weaker among mothers who took 400 micrograms of folic acid daily during pregnancy.
What about ibuprofen for fever?
The Food and Drug Administration (FDA) recommends avoiding the use of nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin, ibuprofen and naproxen around 20 weeks or later in pregnancy because they may cause kidney problems in the unborn baby, which can lead to low levels of amniotic fluid. Taken earlier in pregnancy, NSAIDS may increase the risk of birth defects.
What’s an expectant mother to do about fever?
At the first sign of illness, rest and drink lots of fluids.
Soak a washcloth in chilled water alone, or with some apple cider vinegar added, and place on your forehead, palms, armpits and neck and /or wrap around the soles of your feet. Take a lukewarm bath.
Eat foods high in Vitamin C like oranges, lemons, limes, grapefruit, broccoli, kale, brussels sprouts, red peppers, black currants and strawberries. Make yourself homemade lemonade/limeade. Cook with garlic. Make a chicken bone broth.
If you are taking a prenatal vitamin, Vitamin C will be included, but you may want to take extra Vitamin C if you’re getting sick. Check with your midwife or doctor to see what they recommend.
Elderberry syrup has a long history of use to reduce fever and boost the immune system. It is generally used for short-term (5 to 7 days) treatment of upper respiratory infections rather than as a daily booster. While pregnant women have not reported any adverse effects from its use, there are no animal or human studies to confirm its safety during pregnancy. Check with your midwife or doctor.
Brew a cup of ginger tea, which helps with nausea in early pregnancy and has antibacterical and antiviral properties. Chop a few slices of fresh ginger and put into a cup. Cover with boiling water and let steep for a few minutes. Add lemon and honey.
Peppermint tea is safe to use during pregnancy, helps to relieve nausea and has antibacterial and antiviral properties.
Raisens and black currants have antibacterial and antimicrobial properties and can help relieve bacterial infections or fever caused by viruses.
Pain in pregnancy
For back pain or other pain in pregnancy, physical therapy, gentle exercises like prenatal yoga, relaxation techniques such as deep breathing and the use of heat or cold therapy can help.
Acupuncture is generally considered safe during pregnancy and no significant adverse effects have been found. Other modalities that can relieve pain during pregnancy include manual therapy, water therapy, transcutaneous nerve stimulation, stabilization belts, and chiropractic.
Again, consult with your midwife or doctor.
Bottom Line
Ibuprofen, aspirin, and acetaminophen are no longer recommended in pregnancy. However, it is important that pregnant women avoid high fever in the first 8 to 12 weeks of pregnancy. While caution is warranted, these things may make a difference.
- Take the lowest effective dose of acetaminophen.
- Take acetaminophen for the shortest possible time.
- Avoid heavy or prolonged use (four weeks or longer).
Remember, taking acetaminophen during pregnancy does not inevitably lead to adverse effects. An association has been shown, especially if acetaminophen is taken for a prolonged time, but you can minimize your risk. Consult with your midwife or doctor in regards to your own personal risk-benefit calculation.
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