Nationwide Children’s Hospital Guidance for Parents about Acetaminophen Use

Recently, the U.S. government department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) announced a link between acetaminophen use during pregnancy to neurodevelopmental disorders, including Autism Spectrum Disorder (ASD). There is conflicting information about the federal announcement, which can be confusing for parents.

What is Autism Spectrum Disorder?

Autism Spectrum Disorder is a complex condition. It is influenced by genetics (at birth), the environment, and society.

What is acetaminophen?

Acetaminophen is an over-the-counter medicine commonly used for reducing pain and fever. It is most commonly known as Tylenol™. It has been widely used since the 1950s and is considered safe when used as directed.

Is acetaminophen safe for babies and children?

Several professional medical associations that represent thousands of pediatricians and specialists, including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, have said that acetaminophen is one of the few pain medications that is safe to use during pregnancy and when breastfeeding, and for babies and children when used only as needed, in moderation, after consultation with their doctor.

I’m confused about the recommendations. Does acetaminophen cause Autism Spectrum Disorder?

There is no evidence that taking acetaminophen when you are pregnant or giving it to your young child causes Autism Spectrum Disorder. It is widely known that there is no single cause of ASD.

Who says that acetaminophen is safe in these situations?

Multiple doctor’s groups have looked at the research and have said they will keep recommending acetaminophen to help with managing pain and fever during pregnancy and when breastfeeding and for babies and children.

These groups include:

• American Academy of Pediatrics (AAP)
• American Academy of Family Practitioners (AAFP)
• American Psychiatric Association (APA)
• American College of Obstetricians and Gynecologists (ACOG)
• Society for Maternal-Fetal Medicine (SMFM)

Are there other pain relievers or fever reducers my baby or child can take instead of acetaminophen? What about ibuprofen (Motrin) or aspirin?

Ibuprofen, commonly known as Motrin® or Advil®, and aspirin are known to have adverse effects for mothers, babies and young children. Ibuprofen is not recommended for babies younger than 6 months of age and aspirin is not recommended in infants and children with rare exceptions.

My child is on the Autism spectrum, I hear there’s a new recommendation that could help with speech issues.

The federal government announcement recommended using leucovorin (folinic acid), to help with speech-related problems associated with ASD. A type of B vitamin, leucovorin, has shown promise in small trials but larger, well-controlled trials are needed to show it is safe and effective as a treatment option.

I’m pregnant. Instead of taking acetaminophen, can’t I just wait it out?

There are notable risks to mothers and babies related to pain, fever or inflammation that is not treated during pregnancy. As always, after talking with your doctor, take the lowest effective dose for the shortest amount of time to treat your symptoms.

If you have questions, ask your child’s doctor or pharmacist.