This sheet is about exposure to acetaminophen in pregnancy and while breastfeeding. This information is based on available published literature. It 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®.
Acetaminophen is considered by most healthcare providers to be the pain reliever of choice during pregnancy. It has been suggested to use this medication only as needed and to take the lowest effective dose, unless your healthcare provider has given other instructions.
Acetaminophen is also found in many combination medications. Carefully check the ingredients of any other medication 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 providers in 1 day.
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 your 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 is common and can occur in any pregnancy for many different reasons. Taking acetaminophen at the recommended dose 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. 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?
One study of over 24,000 pregnancies with self-reported acetaminophen use reported an increased chance for pregnancy-related complications, including preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, there were flaws in the design of this study, including the reason a person was taking a pain medication was not accounted for. These pregnancy-related problems were not found in a report that reviewed the medical literature with acetaminophen use in over 39,000 pregnancies.
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 might be the reason for the development of asthma in the child, such as the illness the parent has, or the reason why the parent needs to use acetaminophen during their pregnancy, and not the acetaminophen itself.
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?
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 years. 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 4 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 or increase the chance of birth defects?
Studies have not been done to see if acetaminophen could affect fertility (ability to get partner pregnant) 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.