For decades, moms have trusted acetaminophen as the go-to pain reliever and fever reducer for their children. They’ve even used it for themselves when pregnant. Regulatory agencies and the U.S. Food and Drug Administration classify it as category B for safety in pregnancy. In other words, no risks have been found in humans. It’s also widely considered the drug of choice for fever and pain for pregnant and breastfeeding women, so much so that two-thirds of American women take acetaminophen when pregnant to help with aches and pains.  But was that trust misguided?
FOLLOWING THE SCIENCE
A study from Johns Hopkins University, published by Oxford Academic’s American Journal of Epidemiology, reveals that prolonged in-utero exposure to acetaminophen for developing babies is related to an elevated risk of ADHD and ASD (Autism Spectrum Disorder). 
A 2022 systemic review found links between acetaminophen and neurological outcomes, including autism spectrum disorders, lower IQ, ADHD, isolated language, attention, executive function, communication, psychomotor development, and behavior. 
The FDA does not review or approve OTC (over-the-counter) drugs, but they may be marketed to the public if they comply with the appropriate regulations and policies. The insert for acetaminophen says that the FDA has not evaluated it. 
ACETAMINOPHEN, ADHD, AND AUTISM
Acetaminophen has been shown to pass through the placenta. If the mother is taking acetaminophen, so is the developing baby. According to data gained from animal trials, acetaminophen affects brain cells and hormones that can impact brain development. 
Xiaobing Wang, M.D., of the Johns Hopkins University Bloomberg School of Public Health, Baltimore, conducted a long-term study on acetaminophen use during pregnancy. Researchers collected umbilical cord blood from 996 births and compared the data with the child’s development nearly 8.9 years later. Here are the results:
- 8% had been diagnosed with ADHD only
- 6% had been diagnosed with ASD only
- 2% had been diagnosed with ADHD and ASD
As the amount of acetaminophen and its byproducts increased in the cord blood, so did the risk of developing these conditions. 
According to study reports published in The American Journal of Epidemiology, several that evaluated acetaminophen’s potentially neuro-disruptive properties reported that, in rats, acetaminophen has direct neurotoxic effects in cortical neurons. These studies find that even small doses of acetaminophen can affect neurodevelopment, sometimes years after exposure. Given how common the use of acetaminophen is during pregnancy and the sharp increases in ADHD and ASD, this information is concerning. 
NOT JUST IN UTERO
In 1980, the CDC started warning parents against using aspirin for children. This recommendation effectively drove sales away from children’s aspirin and replaced them with acetaminophen sales.
The NIH has expressed concern regarding this transition from aspirin to acetaminophen, showing a rise in cases of autism beginning in 1980. There is no good evidence that acetaminophen is better for children than aspirin. The NIH shows evidence that acetaminophen use is linked to ASD and recommends reviewing it for safety. In the same study where they say as much, they also say they were able to recognize the link in young infants and toddlers after normal development. 
The NIH credits over half of ASD cases to environmental factors of some kind, with a subset having gone through “normal development” before appearing to regress. Much like The Wellness Way philosophy, they point out that if ASD wasn’t there originally, and then it was, it is likely that some outside source triggered it. The use of acetaminophen was higher in the children that appeared to regress. 
Pain reliever and fever reducer usage in young children can be high, considering mothers often give them for teething, fevers, vaccinations, and other illnesses or injuries. It is easy to see how acetaminophen could be overused. Long lost is the idea that we should support fevers rather than suppress them, as a fever is there for a reason – to raise the body temperature to help it fight infections. Learn more by reading our article on how to support a child with a fever.
NOT JUST ADHD AND AUTISM
Reading a 2016 article published in Nature, it’s apparent the concern isn’t limited to the U.S. nor ADHD and autism. In a publication under the consensus statement section from September 2021, a group of scientists, doctors, and researchers called for a “precautionary action” regarding paracetamol, an international name for acetaminophen. They explain that male reproductive and urogenital disorders have only increased in prevalence and that data support the contribution of environmental exposure in utero, including pharmaceutical exposure, to an increase in these disorders and neurological ones. 
Look Before You Leap
Before reaching for a drug, we should stop and think about how the body functions and what it’s trying to tell us. Fevers aren’t fun, and watching your precious little one suffer can be difficult. But again, fevers help the body heal, and often the best thing you can do for your little one – or yourself – is to let the fever run its course and allow the immune system to do what it’s supposed to. Aches and pains can come from the overuse of muscles, and we need rest. Sometimes we need to contact a trusted healthcare professional if there is a serious problem, and the body needs support. Everything should happen within the context of listening to the body and researching causes and effects before grabbing an OTC medication.
What to do Instead of Acetaminophen
If acetaminophen can contribute to the development of autism or ADHD down the road, what can you do to help relieve aches, pains, or fevers instead?
Getting your allergies, gut, and immune system tested can tell you your starting point and give you a way to move forward to help the body function properly. Removing inflammatory foods and incorporating organic whole foods that support your body will provide the necessary building blocks to keep your body functioning correctly and help alleviate aches and pains.
Women need more sleep and rest than men – even more so during pregnancy. Children need more rest to allow their bodies to grow and heal. That’s okay – that’s what’s normal and healthy. It’s not helpful to drive yourself into the ground with little sleep and food with little to no nutritional value. We all want to help our children feel better when they are hurting or not feeling well. But we need to take a step back and assess the situation.
Doc and Christy Flynn have done a fantastic job putting together a series of videos called Healthy Kids “Medicine” Cabinet, available on YouTube. You can find some of those videos here:
- Healthy Kids “Medicine” Cabinet: Sore Throat
- Healthy Kids “Medicine” Cabinet: Pain Relief
- Healthy Kids “Medicine” Cabinet: Christy Cough
- Healthy Kids “Medicine” Cabinet: Fever
Chiropractic adjustments are also a great way to support the immune system, put the body back into alignment, and release physical stress and the pain that sometimes accompanies it. To get tested, adjusted, or begin a personalized nutrition program, contact a Wellness Way clinic!
- Oxford Academic: American Journal of Epidemiology: Prenatal Exposure to Acetaminophen and Risk for Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorder: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Cohort Studies
- WebMD: Acetaminophen in Pregnancy Might Raise Children’s Odds of ADHD, Autism
- Johns Hopkins University: Taking Tylenol during pregnancy associated with elevated risks for autism, ADHD
- A Systematic Review of the Link Between Autism Spectrum Disorder and Acetaminophen: A Mystery to Resolve: NIH
- FDA: EXTRA STRENGTH ACETAMINOPHEN- acetaminophen tablet WALGREENS
- Acetaminophen Attenuates invasion and alters the expression of extracellular matrix enzymes and vascular factors in human first trimester trophoblast cells: NIH
- Paracetamol (Acetaminophen) and the Developing Brain: NIH
- Acetaminophen Exposure in Pregnancy May Be Linked to Higher Risk of ADHD, Autism: NIH
- Nature Reviews Endocrinology: Paracetamol use during pregnancy — a call for precautionary action