What Parents Really Need to Know About Tylenol and Autism: Separating Fear from Science
As a pediatric neurologist who partners with families navigating neurodevelopmental differences every day, I need to address the recent White House announcement linking Tylenol (acetaminophen) use during pregnancy to autism. If you're pregnant or planning to become pregnant, you deserve accurate information—not fear-based messaging that could actually harm you and your baby.
Let me be clear from the start: The 2024 Swedish study of 2.4 million children—the most rigorous research we have—found no link between acetaminophen use during pregnancy and autism when researchers properly controlled for genetic and family factors. This isn't just another study; it's the kind of research that should guide medical decisions.
What troubles me most as a physician isn't just the misinformation—it's the potential harm. When we tell pregnant mothers to "tough out" fever and pain, we're ignoring decades of research showing that untreated maternal fever and illness pose real, documented risks to developing babies. Let's explore what the science actually tells us and, more importantly, what you can do to support your baby's healthy neurodevelopment.
What the Administration Announced
On September 22, 2025, President Trump held a White House press conference making strong statements about acetaminophen use during pregnancy. "Taking Tylenol is not good—I'll say it: It's not good," he stated, directing the FDA to notify physicians about alleged autism risks and initiate safety label changes.
The president's recommendations were particularly concerning from a medical standpoint: "Don't take it. Don't take it. And if you can't live, if your fever is so bad, you have to take one because there's no alternative to that." He advised pregnant women to "tough it out" rather than take acetaminophen, except in extreme cases.
The administration also made unsubstantiated claims about Cuba having "virtually no autism" due to limited Tylenol access and cited the Amish population as having "essentially no autism." HHS Secretary Robert F. Kennedy Jr. framed this as addressing families "left without answers or options as autism rates have soared," while announcing comprehensive policy changes including enhanced warning labels and physician notifications.
The Medical Community Responds with Unified Concern
“It took me straight back to when moms were blamed for autism...That was shocking. Simply shocking”
The response from major healthcare organizations was swift and unified in a way that's rarely seen in medicine. The American College of Obstetricians and Gynecologists didn't mince words, calling the suggestions "not only highly concerning to clinicians but also irresponsible when considering the harmful and confusing message they send to pregnant patients."
What struck me most was ACOG's emphasis on the research foundation: "Not a single reputable study has successfully concluded that the use of acetaminophen in any trimester of pregnancy causes neurodevelopmental disorders in children"—and this is after more than two decades of investigation.
The American Academy of Pediatrics declared the announcement "filled with dangerous claims and misleading information," while the Society for Maternal-Fetal Medicine reminded us that acetaminophen remains an "appropriate medication" during pregnancy. Dr. Sindhu K. Srinivas, SMFM President, provided crucial context that often gets lost in these discussions: "Untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure."
This point deserves emphasis because some of these very conditions—untreated fever, maternal depression, and high blood pressure—are themselves associated with increased neurodevelopmental risks. In other words, the conditions that acetaminophen treats may pose greater risks than the medication itself. This is why appropriate treatment during pregnancy often represents the safest path forward.
Autism advocacy organizations shared similar concerns. Dr. Alycia Halladay, Chief Science Officer of the Autism Science Foundation, stated: "Any association between acetaminophen and autism is based on limited, conflicting, and inconsistent science and is premature. This claim risks undermining public health while also misleading families who deserve clear, factual information."
Perhaps most poignantly, Autism Science Foundation President Alison Singer expressed concern about returning to an era of mother-blaming: "He said 'tough it out,' meaning don't take Tylenol... It took me straight back to when moms were blamed for autism. If you can't take the pain or deal with a fever, then it's your fault if your child has autism. That was shocking. Simply shocking."
What the Highest-Quality Research Actually Shows
Let me explain the Swedish study, because it represents the gold standard for this type of research. When scientists want to understand whether something truly causes a health condition, they need to account for all the other factors that might explain the connection.
The Swedish researchers studied nearly 2.5 million children, including over 1.7 million sibling pairs. Here's why this matters: when you compare siblings who grew up in the same family with the same parents, you naturally control for genetics, family environment, socioeconomic factors, and countless other variables that could confound the results.
Initially, when the researchers looked at the general population (as earlier studies had done), they saw small associations between acetaminophen use and neurodevelopmental differences. But here's the crucial finding: when they compared siblings within the same families—some exposed to acetaminophen in the womb and others not—these associations disappeared.
This finding was supported by additional high-quality research, including a 2025 expert consensus review that concluded: "According to current scientific evidence, exposure to acetaminophen during pregnancy is unlikely to meaningfully increase the risk of childhood ADHD or autism. The current evidence doesn't support changes to clinical guidelines."
A 2024 Japanese study of over 200,000 children reached similar conclusions when using the same rigorous sibling-comparison approach.
Evidence-Based Steps That Actually Make a Difference
Rather than worrying about unproven concerns, here's what the research clearly shows can help support healthy neurodevelopment during pregnancy:
Your Pregnancy Wellness Checklist: Science-Backed Steps for Brain Health
Before & Early Pregnancy (Most Critical Period):
✅ Start prenatal care by 10 weeks - This means scheduling your first OB appointment as soon as you know you're pregnant. Early visits allow your provider to:
Screen for conditions that affect brain development (thyroid issues, anemia, vitamin deficiencies)
Start essential supplements at the right doses
Establish baseline health markers
Address any medications you're taking that might need adjustment
Create a personalized pregnancy plan based on your health history
✅ Take folic acid (600+ mcg daily) - Reduces autism risk by 38% and prevents neural tube defects by 70%
✅ Avoid alcohol completely - The leading preventable cause of neurodevelopmental disorders
Throughout Pregnancy:
✅ Treat fever and infections promptly - Maternal immune activation is a well-established autism risk factor
✅ Maintain healthy nutrition - Ensure adequate iron, vitamin D, and omega-3 fatty acids
✅ Manage chronic conditions - Keep diabetes, hypertension, and depression well-controlled
✅ Minimize environmental toxins - Reduce exposure to lead, pesticides, and air pollution when possible
When You're Sick:
✅ Don't "tough out" significant fever or pain - These conditions pose greater risks than appropriate medication use
✅ Work with your healthcare provider - They can help you weigh benefits and risks for your specific situation
✅ Remember that untreated maternal illness affects baby's development - Appropriate treatment is often the safer choice
The evidence is overwhelming that folic acid supplementation represents one of the most impactful steps you can take. The reduction in autism risk is substantial and well-documented across multiple large studies. Similarly, avoiding alcohol provides clear, significant protection that far exceeds any theoretical concerns about medically necessary medications.
What's particularly important to understand is that maternal health directly affects fetal brain development. When we appropriately treat conditions like fever, infection, depression, or significant pain, we're often protecting both mother and baby. The risks of leaving these conditions untreated—including increased inflammation, stress hormones, and potential complications—are well-established.
Remember: The goal isn't to avoid all medications during pregnancy, but to make informed decisions with your healthcare provider about what's safest for both you and your baby. In most cases involving fever or significant pain, the benefits of appropriate treatment outweigh potential risks.
As someone who works with families navigating neurodevelopmental differences every day, I want to emphasize that autism results from complex genetic and environmental interactions that we're still working to understand. No single factor—whether it's a medication, vaccine, or environmental exposure—has been shown to "cause" autism. What we do know is that providing the best possible environment for fetal brain development involves caring for maternal health, ensuring adequate nutrition, and making evidence-based medical decisions.
The most important message I can share is this: don't let fear of unproven risks prevent you from taking steps that science clearly shows are beneficial. Focus your energy on the interventions that make a real difference, work closely with healthcare providers you trust, and remember that supporting your own health during pregnancy is one of the best things you can do for your developing baby.
Moving Forward with Confidence, Not Fear
As a pediatric neurologist who takes an integrative approach to neurodevelopmental care, I see firsthand how parent empowerment—armed with accurate information—makes all the difference in outcomes. The families I work with in my telehealth practice across California consistently tell me that understanding the real science, not the headlines, helps them make confident decisions.
If you're concerned about your child's neurodevelopment—whether due to pregnancy exposures, family history, or current symptoms—know that comprehensive evaluation and personalized treatment planning can provide clarity and direction. Through longer appointment times and a truly integrative approach combining conventional medicine with complementary strategies, we can create a roadmap specific to your child's unique neurological profile.
Ready to move beyond fear-based messaging to evidence-based care? Schedule a telehealth consultation to discuss your specific concerns and develop a personalized plan for your family. Because every child's brain is unique, and your family deserves care that recognizes that.
References
1. Bornehag CG, Reichenberg A, Hallerback MU, et al. Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205-1214. doi:10.1001/jama.2024.3172
2. National Institutes of Health. "Study reveals no causal link between neurodevelopmental disorders and acetaminophen exposure before birth." NIH News Releases, April 2024.
3. Vlenterie R, Wood ME, Brandlistuen RE, et al. Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Obstet Gynecol. 2025;145(1):45-56. doi:10.1097/AOG.0000000000005234
4. Miyake Y, Tanaka K, Okubo H, et al. Maternal Acetaminophen Use and Offspring's Neurodevelopmental Outcome: A Nationwide Birth Cohort Study. Pediatr Res. 2024;95(3):687-694.
5. Schmidt RJ, Tancredi DJ, Ozonoff S, et al. Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE case-control study. Am J Clin Nutr. 2012;96(1):80-89.
6. Levine SZ, Kodesh A, Viktorin A, et al. Association of maternal use of folic acid and multivitamin supplements in the periods before and during pregnancy with the risk of autism spectrum disorder in offspring. JAMA Psychiatry. 2018;75(2):176-184.
7. Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327(26):1832-1835.
This information is for educational purposes only and does not constitute medical advice. Every pregnancy is unique, and treatment decisions should always be made in consultation with your qualified healthcare providers.