Is it safe to use Tylenol (acetaminophen) while pregnant or breastfeeding? 

Are you confused by the latest guidelines put out by the CDC (U.S. Centers for Disease Control and Prevention) on whether it is safe to take Tylenol (acetaminophen) during pregnancy or while breastfeeding?

Dr. Kaytlin Krutsch is a leading lactation pharmacology expert and Director of the InfantRisk Center of Excellence, Associate Professor of Obstetrics and Gynecology at Texas Tech University Health Sciences Center, and coauthor of Hale’s Medications and Mother’s Milk 2025-2026.

She has been fielding questions from concerned expectant and breastfeeding mothers.

“Mothers should not be expected to endure fever or pain simply in the name of avoiding risk—because fever or pain itself carries infant risk,” said Dr. Krutsch, when asked about the safety of Tylenol (acetaminophen) for pregnant or nursing mothers:

Guidance from the CDC reports, “Some studies of acetaminophen during pregnancy have shown an association with neurological conditions such as autism and ADHD, particularly when taken chronically throughout pregnancy. Although a direct causal relationship between acetaminophen and autism or ADHD has not been established, pregnant women should consider avoiding acetaminophen use during pregnancy as a precaution.”

However, several leading medical associations and professionals disagreed with this recommendation.  ACOG (American College of Obstetricians and Gynecologists) posted:

“Suggestions that acetaminophen use in pregnancy causes autism are not only highly concerning to clinicians but also irresponsible when considering the harmful and confusing message they send to pregnant patients, including those who may need to rely on this beneficial medicine during pregnancy.”

The AAP (American Academy of Pediatrics) stated, “Acetaminophen is safe for children when taken as directed, No link to autism.”

Dr. Krutsch stressed that, treatment decisions should always be guided by an individualized risk-benefit assessment, grounded in the best available evidence, and reached through shared decision-making with the patient’s healthcare team.

She went on to add that Tylenol is the best over-the-counter option for fever and pain for pregnant women. Alternatives, like ibuprofen, have known infant risks in late pregnancy and she doesn’t want moms reaching for NSAIDs instead thinking they would be better off. Acetaminophen and ibuprofen are both compatible with breastfeeding.

Key Takeaways

• Acetaminophen (Tylenol) is considered safe for use during pregnancy and breastfeeding when used as directed (correct dose, shortest necessary duration).
  • Alternatives like ibuprofen have known fetal risk, especially later in pregnancy.  Ibuprofen is compatible with breastfeeding in most cases.
• Correlated risks seem to be associated with chronic, high-dose, or long-duration use; the evidence for causal links (e.g. to autism or ADHD) is mixed, observational in many cases, and not definitive.
• Fever and untreated pain themselves can be harmful during pregnancy, so the risk vs. benefit calculation often favors use of acetaminophen.
• For breastfeeding, acetaminophen is among the medications more safely tolerated; its levels in breast milk are low, and adverse effects in infants are uncommon when used appropriately.

Finally, ACOG stresses that it is important to consider the risks and benefits associated with all medication and reassure pregnant and breastfeeding patients with the following: “The data from numerous studies have shown that acetaminophen plays an important—and safe—role in the well-being of pregnant women.”

References:

1. Centers for Disease Control and Prevention. (2025, September 22). Medicine and pregnancy: An overview. U.S. Department of Health & Human Services. https://www.cdc.gov/medicine-and-pregnancy/about/index.html
2. American College of Obstetricians and Gynecologists. (2025, September 22). ACOG affirms safety and benefits of acetaminophen during pregnancy. https://www.acog.org/news/news-releases/2025/09/acog-affirms-safety-benefits-acetaminophen-pregnancy
3. American Academy of Pediatrics. (2025, September 22). Acetaminophen is safe for children when taken as directed; no link to autism. https://www.aap.org/en/news-room/fact-checked/acetaminophen-is-safe-for-children-when-taken-as-directed-no-link-to-autism

For more helpful guidance on safe medication practices while breastfeeding, visit www.springerpub.com/hale