President Trump’s news briefing on Monday suggesting that acetaminophen use in pregnant women—especially late in pregnancy—may have a causal link to autism is continuing to stir up controversy among medical experts. Pointing to select studies listed on the White House website, Trump advised pregnant women not to take Tylenol. Medical experts and organizations have swiftly pushed back.
For starters, FDA Commissioner Marty Makary, M.D., M.P.H., said causation has not been proven. Makary advised clinicians to minimize Tylenol use for routine low-grade fevers when possible, but also added: “This consideration should also be balanced with the fact that acetaminophen is the safest over-the-counter alternative in pregnancy among all analgesics and antipyretics; aspirin and ibuprofen have well-documented adverse impacts on the fetus.”
Major groups strongly rejected any suggested connection. The Society for Maternal-Fetal Medicine (SMFM) said that acetaminophen remains appropriate for treating pain and fever during pregnancy and that existing research has not established causation between prenatal acetaminophen and autism or ADHD. “To be clear, SMFM stands behind our recommendation that acetaminophen use during pregnancy has not been shown to cause or increase the risk of autism or other neurobehavioral problems in children,” according to an SMFM statement.
The Autism Science Foundation (ASF) called the claims premature, warning that selective and limited research poses a risk of being misleading. “The Autism Science Foundation strongly supports research into autism’s causes,” said Autism Science Foundation Chief Science Officer Dr. Alycia Halladay in a statment. “More research needs to be done before alarming families or suggesting steps that may not actually reduce risk, when we know that not treating a fever during pregnancy creates risk.”
The American Psychiatric Association (APA) said autism is complex, and decisions around medications in pregnancy should be made by patients and their physicians using evidence-based guidance.
Kenvue, Tylenol’s manufacturer based in Summit, also pushed back. “We believe independent, sound science clearly shows that taking acetaminophen does not cause autism,” Kenvue said in a statement. “We strongly disagree with any suggestion otherwise and are deeply concerned with the health risk this poses for expecting mothers.”
New Jersey Family asked two doctors for their take.
Dr. Amir Miodovnik, M.D., M.P.H., is a developmental-behavioral pediatrician in private practice and formerly an Assistant Professor in the Department of Pediatrics at Johns Hopkins University School of Medicine. He also previously worked as an Attending Physician in the Center for Development and Learning at Kennedy Krieger Institute in Baltimore.
Dr. Nechama Sorscher is a licensed child neuropsychologist, psychotherapist and author of Your Neurodiverse Child: How to Help Kids with Learning, Attention, and Neurocognitive Challenges Thrive.
New Jersey Family: From your perspective, how strong—or weak—is the current scientific evidence suggesting a link between acetaminophen use during pregnancy and autism?
Dr. Miodovnik: “The largest and most rigorous study to date, involving nearly 2.5 million children in Sweden, found that children exposed to acetaminophen during pregnancy had a less than one-tenth of one percent higher actual risk of developing autism by age 10. Imagine a school with 1,000 children. Without acetaminophen exposure, about 20 might develop autism by age 10. With acetaminophen exposure, that number rises to about 21. In other words, one additional child in a thousand. However, when the researchers controlled for siblings in the analyses to account for genetic factors, the small risk disappeared.”
Dr. Sorscher: “An analysis by a Mount Sinai-led team called for caution and need for further study in regards to acetaminophen use during pregnancy. If it’s one thing we know, it’s that autism absolutely needs further study and pregnant women should be cautious in general about what they are exposed to, from environmental exposures, which includes everything from highly processed foods to pollutants.”
New Jersey Family: As someone who treats patients daily, what do we actually know about the causes of autism, and what are the biggest misconceptions that come up when studies like this make headlines?
Dr. Miodovnik: “Autism is first and foremost a condition affecting social communication. The way it is often presented in the media can give people the mistaken impression that autism is mainly about flapping, stimming, and behavior challenges. But these visible behaviors are neither necessary nor sufficient for diagnosing autism. The core features of autism include difficulties with nonverbal social communication, such as using and interpreting eye contact, gestures, and facial expressions to share information, direct attention, initiate or respond to interactions, and read social cues.
Autism is a complex condition that involves many parts of the brain working together. It does not have a single cause, and saying it does oversimplifies the science. To the best of our knowledge, autism develops when many common genes, and sometimes rare mutations, combine to influence early brain development. Environmental factors may play a minor role, but what we know for sure is that parenting styles and vaccines do not cause autism.”
Dr. Sorscher: “As a psychologist practicing for over three decades, I now find myself treating the children of former patients. Over the years, one consistent observation has been clear: autism has a genetic component but there are biologic and environmental factors at play as well. We don’t know exactly what causes autism, but some factors can raise the chances. These include having a sibling with autism, certain genetic conditions, complications during birth, or being born to older parents. Ultimately there is more that we don’t know about autism, than what we do know, that’s why it’s important not to spread misinformation and fear.”
New Jersey Family: How should we interpret a suggested Tylenol-autism link in light of the fact that acetaminophen is often used to treat fever, which itself carries risks for pregnancy?
Dr. Miodovnik: “It’s understandable that parents feel worried or even guilty when they hear an alarming announcement taken out of context. But focusing on Tylenol diverts attention away from where it really matters, such as improving prenatal care, preventing premature birth, treating fevers and infections during pregnancy, and avoiding known environmental toxins. In fact, untreated high fevers in pregnancy are much more strongly linked to complications such as neural tube defects. Pregnant women already have enough to worry about, and Tylenol should not be high on the list, especially when limited to single or short-term use at recommended doses.”
New Jersey Family: How should doctors, researchers, and the media communicate these kinds of findings to pregnant women and families—balancing transparency without creating unnecessary fear or anxiety?
Dr. Sorscher: “It’s vital to share information and facts, not speculation and fear. Doctors, researchers, and the media should communicate autism research with clarity and context. Highlighting that risk factors don’t equal certainty, as no single cause for autism has been identified. The focus should be on actionable guidance, reassurance, and encouraging families to discuss any concerns with their healthcare providers. Transparency is important, but it should be paired with perspective to avoid unnecessary fear or anxiety.”
In the end, it’s always best to discuss your concerns with your doctor.
Get the latest on the best things to do with your family in and around New Jersey by signing up for our newsletter and following us on Pinterest, Facebook and Instagram!
Read More:
How an NJ Mom of a Neurodiverse Child Found Her Community
Ways to Help Your Neurodiverse Child Navigate Success at School
Nurturing the Talents of Children With Autism
