The Trump administration has associated acetaminophen use during pregnancy with autism. Here’s an overview of what medical experts and scientific studies reveal.
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For decades, acetaminophen-commonly known by the brand name Tylenol-has been a trusted remedy for headaches, muscle aches, and fevers, including during pregnancy and childhood when used appropriately. However, former President Trump recently issued a strong warning against its use, claiming it contributes to the increasing rates of autism spectrum disorder.
During a White House briefing, Trump urged, “Avoid Tylenol if you’re pregnant, and don’t give it to your children,” repeating this caution multiple times and emphasizing the need to “fight like hell” to stay away from the medication.
Medical organizations and Johnson & Johnson, the manufacturer of Tylenol, quickly refuted the president’s claims, emphasizing that current scientific data does not support such assertions and warning that discouraging acetaminophen use could have unintended harmful effects on pregnant women and their babies.
This controversy has left many expectant parents and caregivers uncertain about whether acetaminophen remains a safe option for managing pain and fever.
What Does the Research Say About Acetaminophen and Autism?
Scientists have long investigated potential connections between prenatal acetaminophen exposure and autism, but findings remain inconclusive. The FDA recently issued guidance to healthcare providers highlighting that while some studies suggest a possible link, others contradict these results, leaving the relationship unclear.
One challenge in this research is the reliance on parental recall of medication use during pregnancy, which can be inaccurate. To address this, a 2019 study published in JAMA Psychiatry measured acetaminophen levels directly in umbilical cord blood from nearly 1,000 mother-child pairs. The study found that children with the highest acetaminophen concentrations were about three times more likely to be diagnosed with autism or ADHD compared to those with the lowest levels. However, the lead author stressed that this study only identified an association, not a cause-and-effect relationship.
In a more extensive 2024 study involving over two million Swedish children, researchers initially observed a slight correlation between prenatal acetaminophen use and autism. Yet, after controlling for genetic and environmental factors by comparing siblings with differing exposure, the association disappeared. This suggests that genetics and other influences, such as infections or fevers during pregnancy, likely explain the observed link rather than acetaminophen itself.
Brian Lee, a co-author from Drexel University, explained in an interview that the evidence to date does not support acetaminophen as a cause of autism. “While the research is ongoing, the strongest studies so far do not indicate a causal connection,” he said.
Conversely, epidemiologist Ann Bauer from the University of Massachusetts, whose research has hinted at a possible increased risk, believes the question remains open. She advocates for informing expectant parents about potential risks while acknowledging the current uncertainty and cautions against premature government advisories.
Why Is Avoiding Acetaminophen During Pregnancy Not Always Advisable?
President Trump suggested there is no harm in completely avoiding acetaminophen during pregnancy, encouraging women to endure discomfort instead. However, experts specializing in maternal-fetal health warn that untreated fever and pain can pose significant dangers to both mother and fetus.
The Society for Maternal-Fetal Medicine highlights that fevers, especially in the first trimester, are linked to increased risks of miscarriage, birth defects, and premature delivery.
Untreated pain can also contribute to complications such as depression and hypertension. Dr. Nicole Baldwin, a pediatrician from Cincinnati, shared her personal experience of falling during pregnancy and how acetaminophen was essential for managing her pain over several months.
Other common pain relievers, like ibuprofen, are contraindicated during pregnancy due to risks such as fetal kidney damage, making acetaminophen one of the few safe options available.
The American College of Obstetricians and Gynecologists emphasized that medication decisions during pregnancy should weigh both potential risks and benefits carefully. The FDA similarly advised clinicians to minimize acetaminophen use for mild fevers but acknowledged it remains the safest over-the-counter choice for managing pain and fever in pregnant patients.
Navigating Conflicting Information: Whom Should Parents Trust?
With ongoing debates and evolving research, parents may feel overwhelmed trying to discern the truth about acetaminophen and autism risk.
Brian Lee empathizes with this confusion, noting that conflicting expert opinions can make it difficult for families to know what to believe.
Helen Tager-Flusberg, director of Boston University’s Center for Autism Research Excellence, advises parents to seek guidance from qualified medical professionals rather than non-experts or sensationalized sources. “Consult your healthcare providers who understand the current science and can offer personalized advice,” she recommends.
Dr. Baldwin uses a simple analogy to explain the difference between correlation and causation: just as ice cream sales and shark attacks both rise in summer without one causing the other, studies linking acetaminophen and autism show association but not proof of cause.
“It’s crucial for parents to understand that the science is still developing, and no definitive conclusions have been reached despite some claims to the contrary,” Baldwin concludes.
