Acetaminophen and Autism: What Parents Should Know About the Latest Research
Over the past year, headlines have reignited concern about whether taking acetaminophen (Tylenol or paracetamol) during pregnancy could increase a child’s risk of developing autism or ADHD. As pediatricians, we understand how unsettling these stories can feel for expectant and new parents. Let’s take a closer look at what the most reliable studies actually show, why some of those fears have been overstated, and how you can use medications safely and confidently.
Where did this concern come from?
The conversation picked up again after the U.S. Food and Drug Administration (FDA) announced it was reviewing acetaminophen’s labeling to determine whether to include language about potential neurodevelopmental risks. This came after a series of studies suggested a possible association between acetaminophen use in pregnancy and later diagnosis of autism or ADHD in children. However, many of those studies were limited by the fact that they relied on parental memory of medication use years later and didn’t fully account for other factors that might influence a child’s development—like genetics, family environment, or the reasons the mother took acetaminophen in the first place (for example, fever or infection).
The strongest recent study: Sibling comparisons
One of the most important and reassuring pieces of research was published in 2024 by Swedish scientists who studied over 2.4 million children born between 1995 and 2019. In the overall population, they found a slight increase in autism and ADHD among children whose mothers used acetaminophen during pregnancy. But when they compared siblings born to the same parents—where one pregnancy involved acetaminophen use and the other did not—the difference disappeared.
In these “sibling comparison” analyses, the risk for autism or ADHD was no higher in the child who was exposed to acetaminophen in the womb compared to their unexposed brother or sister. This finding suggests that the small associations seen in broader studies are likely due to other shared family factors—not the medication itself.
Why sibling studies matter
Comparing siblings helps scientists account for many of the hidden factors that could confuse the data, such as family genetics, parental health conditions, and household environment. If acetaminophen truly caused autism, we would expect to see differences even between siblings who share the same parents and home—but that’s not what this study found.
This research is especially important because it directly addresses the concern many parents have: What if I took Tylenol while pregnant before we knew all this? The Swedish study offers strong reassurance that occasional use is unlikely to pose meaningful risk.
What experts and professional groups say
The American College of Obstetricians and Gynecologists (ACOG) continues to recommend acetaminophen as the preferred pain and fever reliever during pregnancy when needed. It has a decades-long safety record and, when used appropriately, remains far safer than other pain medicines such as ibuprofen or aspirin during certain trimesters.
Experts also emphasize that untreated fever in pregnancy can itself be harmful, increasing the risk of complications like neural tube defects or preterm labor. In other words, avoiding all medication out of fear may actually create more risk than taking a recommended dose when it’s truly needed.
How parents can use this information
Here are some practical takeaways for expecting parents:
Don’t panic if you used Tylenol during pregnancy. Current evidence does not support a causal link between acetaminophen and autism. The most rigorous data show no difference between exposed and unexposed siblings.
Use the lowest effective dose for the shortest time needed. This has always been the safest approach for all medications in pregnancy.
Treat fever promptly. High fevers can harm both the pregnant person and the developing baby. Acetaminophen remains the best first-line treatment.
Talk with your healthcare provider if you find yourself needing frequent doses for chronic pain or headaches. They can help identify underlying causes or suggest complementary strategies.
Avoid guilt and fear. Autism is a complex, multifactorial condition influenced by genetics and many environmental factors. A single medication exposure is extremely unlikely to determine an outcome.
Looking ahead
The FDA is still reviewing whether any additional label changes are needed, and research continues. For now, every major professional medical organization still considers acetaminophen safe when used appropriately during pregnancy.
As a pediatric practice that embraces both integrative and evidence-based care, our goal is to help families navigate emerging research calmly and thoughtfully. Science evolves, and so does our understanding—but right now, the best evidence available suggests that occasional, appropriate acetaminophen use during pregnancy does not increase autism risk.
If you’re ever unsure about which medications are safest in pregnancy or while breastfeeding, please reach out. We’re here to help you make informed choices grounded in both compassion and solid science.
