Dr. Heidi Leftwich, a maternal-fetal medicine specialist at UMass Memorial Health, said she has gotten many more questions about acetaminophen from some of her pregnant patients in recent weeks.<\/p>\n
The safety of the fever and pain reliever \u201ccomes up periodically,\u201d especially when there\u2019s a news story about it, said Dr. Allison Bryant, a maternal-fetal medicine specialist at Mass General Brigham.<\/p>\n
Rather than scare them or dictate what they should do, Bryant said, she favors \u201cshared decision-making\u201d with her patients, with them \u201cat the center\u201d of her guidance.<\/p>\n
At a news briefing Monday, President Donald Trump promoted unproven claims that taking acetaminophen during pregnancy was linked to a risk of autism in children. The Food and Drug Administration has sent a letter telling doctors<\/a> to \u201cconsider minimizing the use of acetaminophen,\u201d the active ingredient in Tylenol and a wide range of other over-the-counter medications, for routine low-grade fevers in pregnant women.<\/p>\n Trump\u2019s announcement came after several weeks of reports about the warning. Pregnant women experiencing pain or fever should \u201ctough it out,\u201d Trump said.<\/p>\n Dr. Laura Riley, chief of obstetrics and gynecology at Weill Cornell Medicine in New York, said patients have come in since Trump\u2019s briefing anxious and unsure what to do. \u201cThere was a lot of head-shaking,\u201d Riley said. <\/p>\n Are doctors changing their guidance about acetaminophen? <\/p>\n More than half of women worldwide use acetaminophen during pregnancy<\/a>. It is used in hundreds of products<\/a>, including cough and cold treatments. Doctors said in interview that their advice hasn\u2019t changed, in spite of the Trump administration\u2019s concerns.<\/p>\n \u201cWe normally advise women with pain or fever to take acetaminophen, unless there is some other reason why we think it might be unsafe,\u201d such as when women have allergies or pre-existing liver disease, Bryant said. <\/p>\n Riley said the most common reasons pregnant women take acetaminophen are fever, headache and low back pain. <\/p>\n \u201cI\u2019m telling women not to do anything differently than what we started with, which was Tylenol is one of the best pain relievers that we have in pregnancy,\u201d she said.<\/p>\n Untreated fever<\/a>, especially in the first three months of pregnancy, increases the risk of miscarriage<\/a>, birth defects and premature birth, according to the Society for Maternal-Fetal Medicine. <\/p>\n Fever in the second and third trimesters can trigger contractions and may be associated with early labor, Riley said, so \u201cit\u2019s important to treat.\u201d<\/p>\n Emily Heumann, 31, was 10 or 12 weeks pregnant when she spiked a fever of 104 degrees because of a viral infection. She\u2019d developed hand, foot and mouth disease<\/a> \u2014 a highly contagious virus that typically spreads among children \u2014 after she was infected by her 4-year-old son. The infection causes sores in the mouth and a rash on the hands and feet.<\/p>\n Heumann said that although her son experienced only minor symptoms that went away quickly, she experienced severe pain for 10 days, especially because of sores in her throat and inside her ears.<\/p>\n Her doctor told her that it was important to bring her temperature down and suggested she take acetaminophen, often sold under the brand name Tylenol.<\/p>\n \u201cIf the Tylenol didn\u2019t work, they said to go to the emergency room,\u201d said Heumann, who is now 36 weeks pregnant.<\/p>\n Bryant suggests that women with questions about any medication during pregnancy talk to doctors they trust and who know them well.<\/p>\n Both the American College of Obstetrics and Gynecology<\/a> and the Society of Maternal Fetal Medicine<\/a> continue to recommend acetaminophen as safe for pregnant women and say the bulk of medical evidence doesn\u2019t show a link to autism. Bryant noted that the groups base their advice on the total body of evidence about acetaminophen and neurodevelopment disorders, not just one study.<\/p>\n \u201cThat guidance is not likely to change anytime soon,\u201d Bryant said.<\/p>\n Leftwich said she feels comfortable talking with her patients about the treatment of fever and pain with acetaminophen during pregnancy. \u201cThis is a very important conversation to have with a trusted physician.\u201d<\/p>\n Untreated pain in pregnancy can be risky, too<\/p>\n Riley said that after Trump warned about acetaminophen use during pregnancy, she’s had patients asking, \u201c\u2018the next time I get a headache, what should I do?\u2019\u201d <\/p>\n Her response: \u201cTake Tylenol.\u201d <\/p>\n \u201cThere\u2019s no reason for you to tough it out,\u201d Riley said. \u201cThat\u2019s not an appropriate way of managing pain.\u201d <\/p>\n If women ask Bryant about research suggesting a link between acetaminophen and autism, she tells them that the strongest, most rigorous study to examine the question found no association between acetaminophen use during pregnancy and autism, attention-deficit\/hyperactivity disorder or intellectual disability.<\/p>\n