This sheet is about exposure to acetaminophen in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is acetaminophen? 

Acetaminophen (also known as 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 in many combination products. Always check the labels to see if they contain acetaminophen. Adding up the amount of acetaminophen in medications can help make sure you are not taking more than is recommended by your healthcare providers within 24 hours.   

Sometimes when women 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. 

Acetaminophen is still considered by many healthcare providers and organizations to be the pain reliever and fever-reducer of choice during pregnancy. It has been suggested to use acetaminophen only as needed and take the lowest effective dose, unless your healthcare provider has given other instructions.  

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 of 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 of miscarriage. One study found that using acetaminophen during pregnancy did not increase the chance of miscarriage, no matter when it was taken during pregnancy or for how long.  

Does taking acetaminophen increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like acetaminophen, might increase the chance of birth defects in a pregnancy. When used at recommended dosages, acetaminophen has not been shown to increase the chance of birth defects. 

Does taking acetaminophen in pregnancy increase the chance of other pregnancy-related problems? 

Pregnancy-related problems including preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) were not found in a report that reviewed medical literature with acetaminophen use in over 36,000 pregnancies.  

A study of over 24,000 pregnancies found that women who reported using acetaminophen had a higher risk of pregnancy problems. However, the study did not consider why the women were taking acetaminophen, which could have affected the results. 

Taking too much acetaminophen can cause liver damage, kidney damage, and anemia (less oxygen in the blood) in adults. It has also been reported to cause the same problems in the fetus. 

Does taking acetaminophen in pregnancy affect future behavior or learning for the child? 

There has been concern about a possible link between the use of acetaminophen in pregnancy and an increased chance of developmental delay, autism and attention deficit hyperactivity disorder (ADHD).  

One study reported 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. However, this study had some important limitations. It did not measure how serious the illness was that led to acetaminophen use, making it unclear if the reported increased risk was related to acetaminophen use, the condition being treated, or a combination of factors. Also, the ADHD diagnoses were based on health records and not confirmed by researchers. 

Another study showed a weak link between acetaminophen use between 18-32 weeks of pregnancy and hyperactivity and attention problems. 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. 

There are also studies that have not found an increased chance of behavior or learning issues for the child. 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 of harmful effects on children’s I.Q., learning, or development. Another study looking at 185,909 children who were exposed to acetaminophen in pregnancy found no increased chance of autism, ADHD, or intellectual disability.  

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 newborns exposed to acetaminophen through breast milk are rare. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes acetaminophen, could it affect fertility or increase the chance of birth defects? 

There are limited studies on the use of acetaminophen and men’s fertility (ability to get a woman pregnant). One study found that men with higher levels of acetaminophen in their urine took longer to get their partner pregnant, and another showed that men who took more than 4,000 mg per month also took longer to conceive a pregnancy. 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/.  

Please click here for references. 

This sheet is about exposure to diazepam 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 diazepam?

Diazepam is a medication that has been used to treat anxiety, sleeplessness, muscle spasms, and alcohol withdrawal. It is sometimes used with other medications to treat seizures. Diazepam is in the class of medication called benzodiazepines. It is sold under the brand name Valium®.

Sometimes when women 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. Some women may have a return of their symptoms (relapse) if they stop this medication during pregnancy.

If you plan to stop this medication, your healthcare provider may suggest that you slowly lower the dose instead of stopping all at once. Stopping this medication suddenly can cause some people to have withdrawal symptoms. It is not known what effects, if any, withdrawal could have on a pregnancy.

I take diazepam. Can it make it harder for me to get pregnant?

It is not known if taking diazepam can make it harder to get pregnant.

Does taking diazepam increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if diazepam increases the chance of miscarriage.

Does taking diazepam 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, using diazepam is not expected to increase the chance of birth defects above the background risk. Older studies suggested a less than 1 in 100 (less than 1%) increased chance of cleft lip and/or cleft palate if a woman uses diazepam in the first trimester of pregnancy. A cleft lip or cleft palate is when the lip and/or roof of mouth formed with a split and can need surgery to correct. More recent studies that are larger and better-designed have not found an increased chance of oral clefts or other birth defects with diazepam use in pregnancy.

Does taking diazepam in pregnancy increase the chance of other pregnancy-related problems?

Some, but not all, studies reported that taking diazepam or other benzodiazepines in pregnancy might increase the chance for pregnancy complications such as preterm delivery (delivery before 37 weeks of pregnancy), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), and/or smaller head size. As there can be many causes of pregnancy-related complications, it is hard to know if a medication, the medical condition, or other factors are the cause of the reported complications.

I need to take diazepam throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of diazepam during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms might include breathing problems, jitteriness, excessive crying, and trouble keeping their body temperature. Some newborns may have loose muscle tone, sluggishness, and trouble latching on to feed (called “floppy infant syndrome”). Some babies might need to spend more time in the hospital to help manage these symptoms. The symptoms are expected to go away within a few weeks. Not all babies exposed to diazepam will have these symptoms. It is important that your healthcare providers know you are taking diazepam so that if symptoms occur your baby can get the care that is best for them.

Does taking diazepam in pregnancy affect future behavior or learning for the child?

It is not known if taking diazepam increases the chance for behavior or learning issues. Two studies have followed children who were exposed to diazepam during pregnancy until the children were up to 18 months or 3 years of age. These studies reported that the children were more likely to show certain behaviors, such as anxiety, sadness, and fearfulness. One study, on benzodiazepines in general, found that using a benzodiazepine medication, including diazepam, in pregnancy might make it slightly more likely for someone to have autism or ADHD. However, when the study compared siblings who were exposed to a benzodiazepine with siblings who were not exposed, they no longer found an increased chance for ADHD or autism. This study suggests that the chance for ADHD or autism is more likely associated with genetic factors. In addition, another study on benzodiazepines, including diazepam, did not report a higher chance for ADHD and autism.

Breastfeeding while taking diazepam:

Diazepam gets into breast milk in small amounts. Diazepam can stay in the body longer than some other benzodiazepine medications. If you use diazepam regularly while breastfeeding, there is a chance it could build up in the baby’s system. This might cause sleepiness or affect your child’s weight gain. If you suspect the baby has any symptoms like trouble feeding, breathing, gaining weight or being too sleepy, contact the child’s healthcare provider.

The product label for diazepam recommends women who are breastfeeding not use this medication. But, the benefit of using diazepam may outweigh possible risks. Your healthcare providers can talk with you about using diazepam and what treatment is best for you. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a man takes diazepam, could it affect fertility or increase the chance of birth defects?

It is not known if diazepam could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects . In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about exposure to clonazepam in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is clonazepam? 

Clonazepam is a medication that has been used to treat seizures, anxiety, panic attacks, and insomnia (trouble sleeping). It belongs to a class of medications called benzodiazepines. Clonazepam is sold under the brand name Klonopin®. 

Sometimes when women 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. For more information on anxiety, see our fact sheet here: https://mothertobaby.org/fact-sheets/anxiety-fact/.  

I take clonazepam. Can it make it harder for me to get pregnant?  

Studies have not been done to see if taking clonazepam can make it harder to get pregnant.  

Does taking clonazepam increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if clonazepam can increase the chance of miscarriage. One study found that women who were taking more than 4 mg/day of clonazepam had a slightly higher chance of miscarriage. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition, or other factors are the cause of a miscarriage.  

Does taking clonazepam 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. Data on the use of clonazepam only in pregnancy is limited. Information from a small number of studies of women taking clonazepam only during pregnancy has not found an increased chance of birth defects. There may be different risks for women who take clonazepam in combination with other medications.  

Does taking clonazepam in pregnancy increase the chance of other pregnancy-related problems? 

Two prescription record studies suggested that babies exposed to clonazepam during pregnancy might be more likely to be born preterm (birth before week 37) or with low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Studies based on filled prescription records cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors. An additional study reported that babies exposed to clonazepam during pregnancy were more likely to be born small for gestational age (SGA) among women with and without epilepsy. 

I need to take clonazepam throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?  

The use of clonazepam during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Some babies exposed to clonazepam at the end of pregnancy may have trouble breathing, cyanosis (blue skin from low oxygen in the blood), poor circulation, and low muscle tone (floppy baby syndrome). Some babies may need to spend some time in the neonatal intensive care unit (NICU). Not all babies exposed to clonazepam will have these symptoms. It is important that your healthcare providers know you are taking clonazepam so that if symptoms occur your baby can get the care that is best for them.  

Does taking clonazepam in pregnancy affect future behavior or learning for the child?   

It is not known if clonazepam increases the chance for behavior or learning issues. A study of 314 children exposed to clonazepam during pregnancy found an increased chance of intellectual disability and delayed developmental milestones.  

One study of 269 children exposed to clonazepam during pregnancy did not find an increased chance of autism. A prescription record study found no increased chance for autism or intellectual disability when clonazepam was used in the first trimester of pregnancy to treat seizures. This report did find an increased chance for intellectual disability in those exposed to clonazepam for something other than seizures. Studies based on filled prescription records cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors. 

Breastfeeding while taking clonazepam: 

Clonazepam gets into breastmilk in small amounts. It can cause sedation (sleepiness) and levels might build up in the infant’s body. Other medications with a shorter half-life (amount of time the medication stays in the body) might be preferred while breastfeeding a newborn or an exclusively breastfed infant. If you suspect the baby has any symptoms (sleepiness, not gaining weight, delayed milestones) contact the child’s healthcare provider.  

The product label for clonazepam recommends women who are breastfeeding not use this medication. However, the benefit of using clonazepam along with the benefits of breastfeeding your baby may outweigh the possible risks. Your healthcare provider can talk with you about using clonazepam and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a male takes clonazepam, could it affect his fertility or increase the chance of birth defects? 

A study in male rats found that clonazepam might affect male sperm. Human studies have not been done to see if clonazepam could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.

This sheet is about exposure to mycophenolate 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 mycophenolate?

Mycophenolate is a medication that has been used to treat some autoimmune conditions like rheumatoid arthritis and lupus. Mycophenolate may also be taken to help prevent the body from rejecting an organ, such as a kidney, after a transplant. Mycophenolate works by lowering the immune system (the body’s defense system against substances and germs that could be harmful). Mycophenolate is sold under the brand name Cellcept®. A similar medication called mycophenolic acid is sold under the brand name Myfortic®.

For more information about rheumatoid arthritis and lupus, please see the MotherToBaby fact sheets at https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/ and https://mothertobaby.org/fact-sheets/lupus-pregnancy/.

Sometimes when women 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 am taking mycophenolate, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

People eliminate medication at different rates. In healthy adults, it takes up to one week, on average, for most of the mycophenolate to be gone from the body.

I take mycophenolate. Can it make it harder for me to get pregnant?

It is not known if mycophenolate can make it harder to get pregnant.

The U.S. Food and Drug Administration (FDA) requires that women who may become pregnant participate in a mycophenolate education program before they start taking the medication. Healthcare providers who prescribe mycophenolate must also participate in the program. The program requires having a negative pregnancy test before starting mycophenolate and another negative pregnancy test eight to ten days after treatment begins. The program also recommends using effective birth control to prevent pregnancy while taking mycophenolate. Birth control should continue for 6 weeks after stopping mycophenolate. It is important to know that mycophenolate might make hormonal birth control methods, like birth control pills, not work as well to prevent pregnancy.

Does taking mycophenolate increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Taking mycophenolate in pregnancy can increase the chance of miscarriage. One report suggests the chance for miscarriage with mycophenolate use during pregnancy may be close to 50% (1 in every 2 pregnancies). Since some of the conditions that mycophenolate is used to treat can also increase the chance of miscarriage, it is hard to know if the medication, the medical condition, or other factors are the cause of a miscarriage.

Does taking mycophenolate 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. Taking mycophenolate during pregnancy might increase the chance of birth defects. A pattern of birth defects has been reported that includes unusually small or absent ears, eyes, and/or jaw; heart defects, cleft lip and/or palate (openings in the lip or the roof of the mouth), and others. Affected children might have only one birth defect or a combination of these birth defects. Not all children exposed to mycophenolate during pregnancy will have a birth defect.

Does taking mycophenolate in pregnancy increase the chance of other pregnancy-related problems?

It is not known if mycophenolate can cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking mycophenolate in pregnancy affect future behavior or learning for the child?

It is not known if mycophenolate increases the chance for behavior or learning issues.

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects, such as defects of the ears, eyes, jaw, heart, lip, and palate. Ultrasound can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.

Breastfeeding while taking mycophenolate:

It is not clear how much mycophenolate gets into breast milk. Limited reports of infants that have been exposed to mycophenolate through breastmilk have not reported harmful effects. Be sure talk to your healthcare provider about all of your breastfeeding questions.

If a man takes mycophenolate, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if mycophenolate could affect a man’s fertility (ability to get a woman pregnant). Three studies looking at 356 infants born to men taking mycophenolate around the time of conception found no increase in birth defects. Another report including 255 children born to men taking mycophenolate also showed no increase in miscarriage or birth defects.

Due to theoretical concern (and not proven risks), some healthcare providers may recommend that men taking mycophenolate wait at least three months after stopping treatment before trying to conceive a pregnancy. In general, exposures that men 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/.

MotherToBaby is currently conducting a study looking at lupus and medications used to treat lupus in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at https://mothertobaby.org/join-study.

Please click here for references.

This sheet is about exposure to methylphenidate in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is methylphenidate? 

Methylphenidate is a stimulant medication that has been used to treat attention deficit hyperactivity disorder (ADHD) and sleep disorders (narcolepsy). It has also been used to lower appetite. Methylphenidate is sold under brand names including Ritalin®, Metadate®, Cotempla®, and Concerta®. A transdermal (skin) patch called Daytrana® is approved for children and adolescents.  

Sometimes when women 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 methylphenidate. Can it make it harder for me to get pregnant? 

Studies have not been done in humans to see if the use of methylphenidate could affect fertility (ability to get pregnant). Animal studies did not show any harmful effects on fertility, even at doses up to 200 times higher than the maximum dose used in humans. 

Does taking methylphenidate increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. One small study suggested a slight increased chance, but most studies have not found a higher chance of miscarriage. Because miscarriage can happen for many reasons, it is hard to know whether a medication, the condition being treated, or other factors such as age or health are the cause. 

Does taking methylphenidate increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like methylphenidate, might increase the chance of birth defects in a pregnancy. 

One large database study suggested a possible increase in heart defects, but other studies did not find this. Most studies, including one large study of about 3,000 pregnancies, have not found an increased chance of birth defects with methylphenidate use during pregnancy. The skin patch form of methylphenidate has not been studied in pregnancy. 

Does taking methylphenidate in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if taking methylphenidate can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces at birth) when methylphenidate is taken as prescribed during pregnancy.  

One study found a higher chance of high blood pressure and preeclampsia during pregnancy. Preeclampsia can cause serious problems, including seizures, early delivery, stillbirth, or babies smaller than expected. Another study did not find a higher risk of stillbirth or small babies, but it did report more preterm labor and preeclampsia. The authors noted that their results were limited and should not be used to recommend stopping ADHD treatment during pregnancy. A third study did not find an increased risk of pregnancy-related problems. Because many factors can affect pregnancy outcomes, it is hard to know whether the medication, the condition being treated, or other factors such as age or health explain these findings. 

I need to take methylphenidate throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?  

Some exposures during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Withdrawal symptoms have not been reported when methylphenidate was taken as directed by a healthcare provider.  

One small study reported withdrawal symptoms in children exposed to methylphenidate and an opioid called pentazocine before birth. Many of the reports also included other factors, such as exposure to cocaine and lysergic acid diethylamide (LSD). Also, pentazocine and other opioid exposures during pregnancy can increase the chance of withdrawal symptoms after exposure in pregnancy.  

Does taking methylphenidate in pregnancy affect future behavior or learning for the child?   

Methylphenidate is not expected to increase the chance of behavior or learning issues for the child. Limited studies have shown typical growth in children up to one year of age and no changes in neurodevelopment in children after exposure to methylphenidate during pregnancy.   

Breastfeeding while taking methylphenidate: 

Methylphenidate passes into breast milk in small amounts. When taken as prescribed, methylphenidate is not expected to cause problems for a nursing infant. There are reports of infants exposed to methylphenidate through breast milk who did not have any side effects. 

In some women, taking methylphenidate can lower the levels of a hormone called prolactin. Low levels of prolactin might lower the amount of milk that the body makes, especially at the start of breastfeeding. Studies have not been done to see if taking methylphenidate during breastfeeding will affect milk production. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes methylphenidate, could it affect his fertility or increase the chance of birth defects? 

A study with 50 participants found that males who had been taking methylphenidate for at least 1 year had a decrease in motility (movement) of sperm and a decrease in the amount of sperm produced. This could affect fertility (ability to make healthy sperm). Studies have not been done to see if men taking methylphenidate can increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.