Readers of Real Answers with Dr. Lavin have known that the innocent looking Tylenol we all like to use has been associated with the development of asthma, so we at Advanced Pediatrics have advised against the use of Tylenol pending further information.

Now comes a new association.  This time instead of Tylenol having an impact on the lung, the concern is now with the brain.

A group has looked at the chance a child will develop ADHD in relation to how much Tylenol the mother took during pregnancy. The study was published in November of 2017 in the flagship journal of the American Academy of Pediatrics Pediatrics.  http://pediatrics.aappublications.org/content/140/5/e20163840

What the study did was look at the outcome in over 100,000 births, a very large number, across all of Norway. The one outcome looked for was the diagnosis of hyperactive-type ADHD and looked to see if the level of use of Tylenol during pregnancy could be linked to the chance of the child developing ADHD.

To make sure no other reason could explain why these children developed ADHD, the authors looked at a wide range of possibilities, including maternal use of alcohol, parental history of ADHD, maternal smoking, maternal anxiety or depression, level of mother’s education, level of mother’s income, and the presence or absence of 128 specific medical conditions.

Overall, about 4% of the 112,000 children born developed ADHD by the age of 13.

For mothers who used Tylenol during the first trimester, about 17% of their children developed ADHD.  If Tylenol was used during the first and second trimester, about 39% of their children developed ADHD.  If Tylenol was used during all 3 trimesters, about 46% of their children developed ADHD.

Now, if various issues were taken into account, the risk from Tylenol dropped, but only slightly.

Risks for a child developing ADHD after their mother took Tylenol during pregnancy did not vary much if the use was for fever or pain in the mother.

It was also found that if a mother used Tylenol prior to conceiving, but not during pregnancy, those children did not have an increased risk of developing ADHD.

BOTTOM LINES

1.  Tylenol, or acetaminophen, is commonly used for fever and pain by hundreds of millions of men and women, including women who are pregnant and those who will later become pregnant.
2. In this study, a good one and a large one, taking Tylenol before pregnancy did not lead to those children being more likely to develop ADHD.
3. But taking Tylenol during pregnancy did lead to those children being more likely to develop ADHD.  And, the more days mothers took Tylenol during pregnancy, the more likely those children born would have ADHD by age 13.
4. The increase risk of developing ADHD after being exposed during pregnancy did not go away by trying to explain it by mother’s smoking, or having ADHD, or over 128 various medical conditions.

This study does not prove taking Tylenol during pregnancy causes ADHD, but it raised the question fairly seriously.   Again, until we know more, we will be advising mothers to not take or use Tylenol during pregnancy.  And, it means yet one more question about the impact of Tylenol on developing children.

To your health,
Dr. Arthur Lavin