This sheet is about exposure to acetaminophen in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is acetaminophen (paracetamol)?
Acetaminophen (paracetamol) has been used to treat fever and mild to moderate pain. Acetaminophen is available alone and in combination with other medications that have been used to treat symptoms of colds, flu, headache and osteoarthritis. Acetaminophen comes in different forms, including liquids, tablets, capsules, and suppositories. A common brand name is Tylenol®.
Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
I take acetaminophen. Can it make it harder for me to get pregnant?
It is not known if acetaminophen can make it harder to get pregnant.
Does taking acetaminophen increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. Based on the studies reviewed, taking acetaminophen at the recommended doses is not expected to increase the chance for miscarriage.
Does taking acetaminophen increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the studies reviewed, when used at recommended dosages, acetaminophen has not been shown to increase the chance for birth defects.
Does taking acetaminophen in pregnancy increase the chance of other pregnancy-related problems?
Acetaminophen is considered by most healthcare providers to be the pain reliever of choice during pregnancy. It suggested to use only as needed and at the lowest effective dose, unless otherwise directed by your healthcare provider. Your healthcare providers may have a recommendation of how much they want you to take.
Acetaminophen is also in many combination medications. Carefully check the ingredients of any other medications that you take to see if they also have acetaminophen. Adding up the amount of acetaminophen in medications can help make sure you are not taking more than what is recommended by your healthcare provider in one day. Taking too much acetaminophen can cause liver damage, kidney damage, and anemia (low iron in the blood) in a person who is pregnant. It has also been reported to cause the same problems in the baby.
Does taking acetaminophen in pregnancy affect future behavior or learning for the child?
Some studies have suggested that taking acetaminophen daily or most days during the second half of pregnancy could slightly increase the chance of wheezing or asthma in children. However, other factors may be the reason for the development of asthma in the child, such as the illness the parent has, or why the parent needs to use acetaminophen during their pregnancy, and not the acetaminophen itself.
There have been studies that noted a possible link between the use of acetaminophen in pregnancy and mild developmental delay (including language delay) and hyperactivity. This link was stronger when acetaminophen was used for 28 days or more during pregnancy. Another study showed a weak link between acetaminophen use between 18-32 weeks of pregnancy and hyperactivity and attention problems. However, this link was only seen in children under the age of 7. It is not clear if these findings are related to acetaminophen or to other factors.
One study looked at the reported use of acetaminophen during pregnancy and then evaluated the exposed children at four years of age. This study did not find an increased chance for harmful effects on the children’s I.Q., learning, or development.
Breastfeeding while taking acetaminophen:
Acetaminophen is found in low levels in breast milk. When needed, it is given to infants at higher doses than they would get from breast milk. Negative effects in exposed newborns are rare. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a male takes acetaminophen, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?
Studies have not been done to see if acetaminophen could affect fertility or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.