Healthy pregnancy hub

Acetaminophen (Tylenol®)

Last Update: 07 Mar 2025

Welcome to our fact sheet on acetaminophen (Tylenol®) during pregnancy and breastfeeding. The information given is based on recent research and may change as science progresses. Please remember that this content does not replace personalized advice from your healthcare team.

The HEALTHY PREGNANCY HUB team is collaborating with MotherToBaby to share information on this topic. The original version is available here (dated from September 2023).

Serene, our chatbot, can also answer your questions about medications during pregnancy.

Please note that this fact sheet is based on United States information and has been adapted for Canada, with a review by our Canadian experts. Minor differences may exist between the two countries. Always consult your healthcare professional for information tailored to your situation.

1. What is acetaminophen (paracetamol)? 

Acetaminophen (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 considered by most healthcare providers to be the pain reliever of choice during pregnancy. It has been suggested to use this medication only as needed and to take the lowest effective dose, unless your healthcare provider has given other instructions. 

Acetaminophen is also found in many combination medications. Carefully check the ingredients of any other medication that you take to see if they also have acetaminophen. Adding up the amount of acetaminophen in medications can help make sure you are not taking more than what is recommended by your healthcare providers in 1 day. 

Sometimes when people 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. 

2. What does research say about the risks during pregnancy?

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 for 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 for miscarriage. 

Does taking acetaminophen 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. When used at recommended dosages, acetaminophen has not been shown to increase the chance for birth defects. 

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

One study of over 24,000 pregnancies with self-reported acetaminophen use reported an increased chance for pregnancy-related complications, including preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, there were flaws in the design of this study, including the reason a person was taking a pain medication was not accounted for. These pregnancy-related problems were not found in a report that reviewed the medical literature with acetaminophen use in over 39,000 pregnancies. 

Some studies have suggested that taking acetaminophen daily or most days during the second half of pregnancy could slightly increase the chance of wheezing or asthma in children. However, other factors might be the reason for the development of asthma in the child, such as the illness the parent has, or the reason why the parent needs to use acetaminophen during their pregnancy, and not the acetaminophen itself. 

Taking too much acetaminophen can cause liver damage, kidney damage, and anemia (low iron in the blood) in a pregnant individual. It has also been reported to cause the same problems in the baby. 

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

There have been studies that noted 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. Another study showed a weak link between acetaminophen use between 18-32 weeks of pregnancy and hyperactivity and attention problems. However, 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. 

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 for harmful effects on the children’s I.Q., learning, or development. 

3. 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 exposed newborns are rare. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

4. What about fathers and sperm donors?

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

Studies have not been done to see if acetaminophen could affect fertility (ability to get a partner pregnant) or increase the chance of birth defects above the background risk. In general, exposures that fathers and sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures here

Key points

  • Acetaminophen or paracetamol (Tylenol®) is the first-choice medication for treating pain and fever during pregnancy.
  • It is recommended to take this medication only when necessary and at the lowest effective dose.
  • When taken at recommended doses, it does not increase the risk of miscarriage or birth defects. Research is mix about other risks.
  • Acetaminophen passes into breast milk in small amounts, and side effects in babies are rare.
  • Always consult your healthcare professional before making any changes to your treatment.

References

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Disclaimer

HEALTHY PREGNANCY HUB provides a source of information validated by health professionals; however, this information is provided for informational purposes only and should not replace professional advice. Medical standards and practices evolve as new data becomes available, so it is imperative to consult your doctor or a qualified health professional for any questions or concerns regarding your health without delay or omission. It is the responsibility of your treating physician or any other health professional, based on their independent experience and knowledge of the patient, to determine the best way to evaluate and treat you.

HEALTHY PREGNANCY HUB does not specifically recommend or endorse any test, practitioner, treatment, product, or opinion mentioned on our platform. HEALTHY PREGNANCY HUB also does not replace the individual patient assessment based on the examination by the healthcare provider of each patient and the consideration of laboratory data and other patient-specific factors.

The use of the information available on our site is at your own risk. No person involved in the creation, production, promotion, or marketing of HEALTHY PREGNANCY HUB guarantees or represents, expressly or implicitly, anything regarding the information available on the platform, which is provided “as it is”. All warranties are expressly excluded and disclaimed, including but not limited to implied warranties of merchantability or fitness for a particular purpose, as well as any warranties arising by law or otherwise in law or from trade or usage. Any statements or representations made by any other person or entity are void.

While consulting symptoms or other medical information on our platform may guide your discussions with your healthcare professional, this information should not be used to make a medical diagnosis or determine treatment. Before making changes to your supplement or medication regimen, please discuss with your medical team or contact 811 (Canada) to ensure the relevance of these changes to your individual situation.

Credits
MotherToBaby
Organization of Teratology Information Specialists (OTIS)
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Émy Roberge
Centre hospitalier universitaire Sainte-Justine
Brigitte Martin
Centre Hospitalier Universitaire Sainte-Justine

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