Study: Could Tylenol taken during pregnancy cause ADHD in children?

More research needed about how much Tylenol is too much.

Moms have all done it. We have a headache, a backache or a fever, and we take Tylenol while pregnant. But a new study suggests a link between a woman’s use of Tylenol — acetaminophen — during pregnancy and her child’s risk of having behavioral difficulties including attention deficit hyperactivity disorder later in life.

The study looked at 7,796 mothers and their children who had been enrolled in the Avon Longitudinal Study of Parents and Children from 1991 to 1992. It analyzed data from the Avon study taken from when the mothers were at 18 weeks and 32 weeks of pregnancy and when their child was 5. The questionnaires the mothers were given asked about acetaminophen use at those times. The mothers also answered the Strengths and Difficulties Questionnaire about their children when their children were 7.

Researchers found that 53 percent of the mothers in the study used acetaminophen at 18 weeks of pregnancy and 42 percent used it at 32 weeks. Of those that did use acetaminophen, their children were at 42 percent more risk for having conduct problems and 31 percent more risk for hyperactivity symptoms. Moms who used acetaminophen at 32 weeks also had children with a 29 percent greater risk of having emotional symptoms and 49 percent total behavioral difficulties.

Researchers also looked at the mother’s use of acetaminophen post-pregnancy and their partner’s use of acetaminophen and found no relation to their child’s behavior problems.

This is not the first study to suggest a possible link. A study of Danish women published in 2014 found that mothers who used acetaminophen during pregnancy had a 40 percent higher risk of having a child diagnosed with ADHD than moms who did not.

What’s not clear from either study is how much Tylenol you would need to ingest for your child to be affected.

Dr. John Gianopoulos, a maternal-fetal medicine specialist at Seton Healthcare and a professor of women’s health at the University of Texas Dell Medical School as well as an obstetrician and gynecologist, also wonders if there might be a link between why the mother was taking Tylenol and the ADHD. What if it was the headache or the fever that was the reason for the Tylenol that was actually the factor and not the Tylenol itself, Gianopoulos wonders.

Dr. Sonia Krishna, a child and adolescent psychiatrist at the Seton Mind Institute, agrees that more research is needed. “There’s no way to prove that it was the Tylenol that did it,” she says.

What we do know about ADHD is that there is a strong genetic link between kids who have it and parents who grew up with it, though they might not have been officially diagnosed with it as children, she says.

What is different about this study and the one before it is that they’re not looking at just the fetus and the infant. They’re looking long-term.

“For almost 40 years, I’ve been recommending Tylenol for fever and pain,” Gianopoulos says. “We have lots and lots of fetal studies that it’s safe and doesn’t cause birth defects.”

This new study, he says, “is concerning to me, but we have to take it with the right perspective.”

So, what’s a pregnant mother in pain to do?

The reality is the other alternatives to acetaminophen are worse. Advil or ibuprofen can cause kidney problems as well as a duct in the heart to close prematurely. Aspirin also can lead to structural defects and infant mortality.

When it comes to fever, the possible effects of the fever on a baby could be worse than possible ADHD. Fever, especially 102 or higher, can cause brain damage and problems with growth in fetuses. For that reason, Gianopoulos is still recommending that a pregnant woman with a fever of 101 or 102 take the Tylenol to get the fever down and, of course, call her doctor to see what is causing the fever.

What about symptoms that don’t include fever? That’s where it gets a little tricky. Perhaps you try non-pharmaceutical options such as yoga, massage and meditation.

In all things pregnancy and health, of course, consult with your doctor.

And for those of us mothers who took the occasional Tylenol while pregnant and now have a kid who has ADHD, do we now have one more thing to feel guilty about?

No. You didn’t know and you still don’t know. Krishna and Gianopoulos remind us that more research is needed.

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