President Trump declared this week that Tylenol is “no good” for pregnant women — unless they have an extremely high fever — because it can increase the baby’s chance of developing autism.
He suggested mothers “tough it out” if they are in pain.
“Don’t take Tylenol. Don’t take it. Fight like hell not to take it,” Trump said Monday as the Food and Drug Administration initiated a Tylenol label change to warn about a possible link between prenatal exposure and an increased risk of neurodevelopmental disorders like autism and ADHD.
Trump’s comments triggered swift backlash within the medical community, and pregnant women were left wondering what they should take if they feel ill.
Acetaminophen — an over-the-counter medication sold under the brand name Tylenol — is used to relieve mild to moderate pain and reduce fever.
Fevers can be common in pregnancy, and if they are not addressed, they can lead to dangerous complications for mother and baby.
Decades of research and medical understanding have indicated that Tylenol is safe and can be beneficial during pregnancy.
The American College of Obstetricians and Gynecologists (ACOG) reiterated that stance Monday, calling the Tylenol announcement “highly unsettling” and “dangerous.”
“Maternal fever, headaches as an early sign of preeclampsia and pain are all managed with the therapeutic use of acetaminophen, making acetaminophen essential to the people who need it,” the ACOG statement read.
“The conditions people use acetaminophen to treat during pregnancy are far more dangerous than any theoretical risks and can create severe morbidity and mortality for the pregnant person and the fetus.”
Pregnant women should consult with their doctor before taking any medicine — here’s a look at their options if they are in pain.
Acetaminophen
Dr. Kecia Gaither, a double board-certified physician in OB/GYN and maternal fetal medicine, called acetaminophen the “preferred” pain reliever.
One or two regular-strength tablets every four to six hours or one or two extra-strength tablets every six hours is generally OK, she said.
Don’t exceed 3,000 milligrams a day of acetaminophen, and avoid chronic daily use unless advised by a physician.
“This is well-studied and generally considered safe,” Gaither, director of perinatal services/maternal fetal medicine at NYC Health + Hospitals/Lincoln in the Bronx, told The Post about acetaminophen.
“To my knowledge, no strong evidence exists for an increased risk of birth defects or neurodevelopmental disorders with recommended use.”
There has been conflicting research on acetaminophen use in pregnancy and increased risk of autism, a developmental disorder that affects how people learn, behave, communicate and interact with others. Autism rates have been rising in recent years.
An analysis last month by Mount Sinai and Harvard did not find that acetaminophen directly causes neurodevelopmental disorders, but the results showed the medication “may increase the risk” of these conditions, underscoring the need for more research.
NSAIDs
Aspirin, ibuprofen (Advil and Motrin) and naproxen (Aleve) are nonsteroidal anti-inflammatory drugs (NSAIDs), which means they are used for pain, fever and inflammation. Tylenol has little to no anti-inflammatory effect.
“Low-dose aspirin (81 mg daily) is sometimes recommended by OBs to lower risk of preeclampsia — but this is very different from taking standard pain-relief doses,” Dr. Kate McLean — chief medical officer and OB/GYN at Evvy, the precision vaginal health platform — told The Post.
Preeclampsia is a serious pregnancy complication often characterized by high blood pressure and high levels of protein in urine, a sign of kidney damage.
“Baby” aspirin can help prevent this dangerous condition by reducing inflammation, improving blood flow and stopping the formation of blood clots. It’s typically recommended from the second trimester until birth.
Other NSAID use is generally prohibited in pregnancy.
“First and second trimester use may increase risk of miscarriage or certain congenital abnormalities,” McLean said.
“[NSAIDs] are not recommended in the third trimester, since they can cause premature closure of the ductus arteriosus in the baby’s heart and increase risk of kidney problems or low amniotic fluid.”
Opioids
Dr. Dawnette Lewis, director of the Center for Maternal Health at Northwell’s North Shore University Hospital, said opioids like oxycodone and hydrocodone may be prescribed in pregnancy if the mother has undergone surgical procedures such as an appendectomy or mastectomy.
But there are significant risks to these drugs, such as the baby’s dependence on opioids, preterm birth, birth defects and poor fetal growth.
“Safe dosing depends on the individual and is always a case-by-case medical decision,” McLean said.
Other options
“Non-drug options (heat packs, massage, prenatal yoga) are encouraged as first-line whenever possible,” McLean said.
Lidocaine patches and some topical NSAIDs may be helpful, she added, “but safety data in pregnancy is limited, so only under medical guidance.”
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