Health professionals pushed back on President Donald Trump’s assertion that pregnant women should avoid taking Tylenol or risk having an autistic baby.
“So, taking Tylenol is, uh, not good. All right, I’ll say it. It’s not good,” Trump said during Monday’s White House event on autism. “For this reason, they are strongly recommending that women limit Tylenol use during pregnancy unless medically necessary.”
Flanked by Health Secretary Robert F. Kennedy Jr., Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, and other health officials in his administration, Trump announced that the Food and Drug Administration will be notifying physicians that the use of acetaminophen during pregnancy can be associated with an increased risk of autism.
Trump announced the National Institutes of Health will be granting awards from the .
And Dr. Marty Makary, the FDA commissioner, said the administration is initiating the approval of leucovorin, which he called an “exciting” treatment for children with autism.
“You know, autism may also be due to a autoimmune reaction to a folate receptor on the brain, not allowing that important vitamin to get into the brain cells,” Makary said at the event. “It’s an fairly established mature pathway. Again, we have a duty to let doctors and the public know. We are going to change the label to make it available. Hundreds of thousands of kids, in my opinion, will benefit. One study found that with kids with autism and chronic folate deficiency, two-thirds of kids with autism symptoms had improvement and some marked improvement.”
Trump decried the “crisis of autism” while referencing increasing rates in the U.S.
has been identified with autism spectrum disorder, according to the Centers for Disease Control and Prevention.
That’s an increase from 1 in 150 children as of 2000, according to the CDC.
“And now we’re at the level of 1 in 12 in some cases for boys. One in 31 overall,” Trump said. “So, since 2000, autism rates have surged by much more than 400%. Instead of attacking those who ask questions, everyone should be grateful for those who are trying to get the answers to this complex situation. And the first day, all of these great doctors behind me were there, I told them this is what we got to – we have to find out, because when you go from 20,000 to 10,000 and then you go to 12, you know, there’s something artificial. They’re taking something. And by the way, I think I can say that there are certain groups of people that don’t take vaccines and don’t take any pills that have no autism.”
Christine Ladd-Acosta, an autism researcher at Johns Hopkins Bloomberg School of Public Health, recently said broadened diagnostic definitions, better screening and increased awareness.
The said it was deeply concerned by the White House autism announcement.
“Premature claims like the association with acetaminophen risk retraumatizing autistic individuals and families, stigmatizing mothers, and diverting attention from what truly matters: ensuring Autistic people have access to the supports they need across their lifespan,” the Autism Society of America said in a news release.
The organization said autism is “a diverse, life-long disability with a complex spectrum, shaped by a combination of genetic, biological, and environmental factors. To date, no single cause or cure has been identified after decades of rigorous research.”
And it said the treatment touted by the FDA commissioner, leucovorin, needs more testing.
Research on high-dose leucovorin is very preliminary, the Autism Society of America said.
Another group, , acknowledged some observational studies that have suggested possible associations between Tylenol and autism. But the group said studies have not proven causation.
Autism Speaks said leucovorin shows promise in improving speech in minimally verbal children.
But it, too, called for more study.
Larger, well-controlled clinical trials are still needed to confirm its efficacy and safety, Autism Speaks said.
“At Autism Speaks, we have been encouraged by the recent, increased focus on autism and have consistently advocated for substantive spending on the research and services needed to improve the lives of autistic people,” the organization said in a statement. “We acknowledge today’s commitment and the investment being directed toward further research and resources, and express our sincere hope that these efforts will translate into true, improved quality of life for those with autism.”
Dr. Steven Fleischman, the president of the , stood up for the safety and benefits of acetaminophen during pregnancy.
Fleischman said in a statement that suggestions that Tylenol, or 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.”
And Fleischman said the White House announcement “dangerously simplifies the many and complex causes of neurologic challenges in children.”
, an obstetrician and gynecologist at Houston Methodist, also said Tylenol is safe for pregnant women.
“I want pregnant women to feel comfortable taking Tylenol if they need it, and if they have any questions or they have concerns, to talk to their doctor,” Borchardt told The National News Desk.
Borchardt said she listened to the White House announcement and didn’t hear any new studies or changes in data.
A woman must weigh the risks and benefits of any medication in pregnancy, including Tylenol, Borchardt said.
“And women should never take a medication if there’s not a benefit to it,” she said. “But especially with Tylenol, the risk of untreated fever can lead to miscarriage and birth defects, neural tube defects.”
There’s harm with untreated fever in pregnancy, Borchardt said.
And ibuprofen isn’t a safe alternative to acetaminophen, she said.
Borchardt said she was worried the White House announcement would “create fear in pregnant women and lead to unintended consequences.”
Borchardt, too, said there’s no simple cause for autism.
She said it can be associated with certain neurodevelopmental and genetic conditions.
And she mentioned the “two-hit hypothesis,” where an underlying genetic predisposition paired with environmental factors or exposures can increase the risk.
Such environmental factors for mothers can include diabetes, high blood pressure in pregnancy, and preeclampsia, she said.
What things are pregnant women asked to avoid?
Borchardt said pregnant women are immunocompromised. They’re at higher risk for infections.
“So, we asked women to avoid undercooked raw meat, poultry, fish, unpasteurized milk or juices, soft cheeses and lunch meats,” Borchardt said. “A lot of these things have a higher risk of … listeria.”
Doctors ask pregnant women to avoid fish with higher mercury levels, such as shark, swordfish and king mackerel. They ask expectant mothers to limit tuna.
Borchardt said they ask pregnant women to avoid green tea and other folate inhibitors, because folic acid is important in fetal neural tube development.
They warn pregnant women about herbal supplements that are not studied in pregnancy and might affect folic acid.
Borchardt said pregnant women should limit caffeine – the upper limit is about 300 milligrams a day – and avoid alcohol.
Pregnant women should avoid hot baths and hot tubs, which risk raising the core body temperature and could increase the risk of neural tube defects, she said.
Pregnant women are advised to limit travel after 28 weeks because of the increased risk of blood clots with prolonged immobility.
And Borchardt said pregnant women should avoid people with chickenpox or shingles to reduce risks of congenital varicella to infants.
“There’s a lot of things that pregnant women have to worry about and have to avoid,” Borchardt said.
Tylenol to treat a fever is not one of those things, Borchardt said.