Tylenol, Pregnancy, and ADHD

The Canadian Family Physician recently published a review article on the topic of whether acetaminophen during pregnancy causes ADHD.

Before I go further, I want to say that I realize that this a sensitive issue.   When your kid doesn't act the same as other kids, you get blamed day and night that it's your fault and that you're a bad parent.  This is not what this research is about.

This research is not about how morally deficient you are if your child has ADHD after you took Tylenol during pregnancy.  Its not the same a fetal alcohol syndrome.  People who drink during pregnancy know how it can hurt their child and they choose to do it anyway.  People who took Tylenol during pregnancy 3 or more years ago for the most part were told it was safe.  This research is about finding a cause so that we can prevent ADHD from developing in kids in the future.   If you have a child with ADHD, chances are you would want to prevent other children from going through the stuff your kid has gone through.  That's why getting the word out about acetaminophen being a potential problem is so important.

There are two large studies of children with ADHD who were followed from pregnancy onward, that is, before they were diagnosed with ADHD.  Both studies showed an association between use of acetaminophen during pregnancy and ADHD years later.  The association was stronger for children whose mothers used acetaminophen for more days during pregnancy and for those who used it later in pregnancy.

Unfortunately, association does not necessarily mean that ADHD is caused by Tylenol.   It could be that women with ADHD take more acetaminophen, or it could be that women who have some other risk factor for ADHD take more acetaminophen.

The other issue is that acetaminophen, aside from this issue with ADHD, is a very safe drug during pregnancy.  Its generally safer than almost all other medications for pain, and 65% of pregnant women take it.  However, knowing the evidence, would you want to risk taking Tylenol during pregnancy?

That depends on the condition, the stage of pregnancy, and the risk for ADHD.

There are other alternatives for treating pain during pregnancy.  Sometimes a good physical therapist, massage therapist, or chiropracter can work wonders, especially for musculoskeletal pains.   However if you have something like kidney stones or disabling migraines, its not fair to expect yourself to not use medication.

As noted before, treatment later in pregnancy is associated with the highest risk.  The later you are in pregnancy, the more you may want to avoid acetaminophen.

Also, women who have ADHD, or who have a spouse or child with ADHD, may have a higher genetic risk for having a child with ADHD and may be more likely to want to avoid anything that might add to that risk.


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