Expectant moms know that they have to be extra cautious about being exposed to anything that might be harmful to their baby. A cigarette, a wedge of Brie, a sip of champagne, a Starbucks PSL — for the sake of a healthy child, most moms-to-be would stoically do without. But how much Tylenol can you take when you're pregnant? What about taking acetaminophen to ward off a backache or a fever? Is this one more thing we have to cross off the no-no list the minute the plus sign appears on the pregnancy test?
Acetaminophen (paracetemol), the generic name for Tylenol, is more often than not our go-to for headaches, backaches, fever, and other assorted aches and pains, whether or not we're pregnant. It also appears in many OTC medicines, such as cold and flu relievers.
"As far as medications, Tylenol is pretty much it for pain [during pregnancy]," Monica McHenry Svets, MD, an OB/GYN at the Cleveland Clinic in Ohio, tells Romper in an email. "NSAIDS such as ibuprofen, Aleve, Motrin, etc., and, of course, narcotics, have their own set of risks, and we try to avoid them altogether in a pregnancy."
As far as dosage, "Acetaminophen should be used at the lowest possible dosage and for the shortest time," says Dr. Svets. For pregnant women, he adds, that means 650 mg every six hours, or 1,000 mg every eight hours. Adds OB/GYN Iffath Hoskins, MD, a clinical professor in the Department of Obstetrics and Gynecology at NYU Langone Health: "During the first trimester, the least amount of any medications, including Tylenol, should be taken. For the other two trimesters, Tylenol can be used as needed, while staying within the 'safe amount,' or less than 4 grams a day."
In recent years, however, some troubling information has come to light about the potential risks of taking acetaminophen during pregnancy. In one recent study from Sweden published in the journal European Psychiatry, language delays were more prevalent in 2-year-old girls whose mothers took acetaminophen than in daughters of mothers who took little or none of the drug. (The same effect was not noticeable in boys.) Another study, published in JAMA Pediatrics, found an "association" between ADHD in children and acetaminophen use during pregnancy; the risk increased with long-term use in pregnant women.
As scary as that all sounds, it doesn't mean that you should quit Tylenol for the duration. "Many doctors disagree about the strength of the evidence in these studies linking Tylenol to ADHD, autism, developmental delays or behavioral problems. No study actually proves these claims. They only suggest a possible association," Dr. Svets points out. Dr. Hoskins agrees: "Any medication taken during pregnancy could cause harmful effects. However, ADHD and speech delays are quite common, regardless of whether or not they are associated with any external agents ingested." As with many such studies, much more research needs to be done to determine whether there's an undeniable connection between Tylenol use in pregnant women and developmental issues in their children.
Dr. Svets also points out that not taking Tylenol may actually be more risky than taking a safe dosage. Running a high fever during the first trimester of pregnancy can increase the baby's risk of developing congenital heart defects or facial abnormalities such as cleft lip or palate, according to a study published in the journal Science Signaling. Untreated chronic pain can also have "poor outcomes for both mother and fetus," says Dr. Svets, so trying to tough out the pain without any relief isn't a good solution, either.
Bottom line: If you're pregnant, it's always best to talk to your doctor about what meds are safe to take, depending on your situation. "As with any med in pregnancy, if you don't really need it, you shouldn't take it," says Dr. Svets. But if your doctor okays Tylenol, then go ahead and take the recommended dose needed to treat your pain or fever. And don't forget about heating pads, ice packs, or massages. These time-honored home remedies "can be used for pain relief (or stress relief)" all throughout pregnancy, Dr. Hoskins points out.