Emily Oster

3 min Read Emily Oster

Emily Oster

Can I Take Tylenol While Pregnant?

Q&A on headaches

Emily Oster

3 min Read

I’ve seen a lot of scary panic headlines — maybe even a lawsuit? — about exposure to Tylenol during pregnancy. Is it okay to treat my headache? 

—Head pain and Pregnant

This question has been coming up for years. I’ve written about it before, and it’s the subject of an active lawsuit. The problem with most of the evidence on this is that it is very difficult to separate correlation from causality. Women who take Tylenol tend to be different from those who do not — on top of the concern that whatever is necessitating the Tylenol might be responsible. In all prior writing on this, the conclusions are a little unsatisfying, because we suspect these are just correlations but cannot say with certainty.

This has changed. Just this week a new paper on it was released, with better-quality evidence. The paper, published in JAMA, uses a sibling analysis to address this question. We all know that the “gold standard” for causality is a randomized controlled trial. But that is not going to happen in this case, for many reasons. A sibling analysis isn’t as good as a randomized trial, but it’s a huge improvement over just comparing across kids. In short, this paper compares kids born to the same mother, where she took Tylenol in one pregnancy and not the other. Because this analysis holds the mother constant, it is able to adjust for all of the characteristics of the mom — the ones we can measure and the ones we do not. This is able to effectively turn off many of our most significant concerns about a relationship being just correlation.

The paper uses an enormous sample of people — 2.5 million births in Sweden; that’s all singleton births in Sweden between 1995 and 2019. Women were asked about acetaminophen use several times during pregnancy, and diagnoses of children are measured in medical records (Scandinavian data is extremely complete). 

The results: When the authors do a naive analysis, where they do not compare within siblings — this is similar to the existing literature — what they find is consistent with what has been found before: a modest increase in ADHD and autism rates among children whose mothers were exposed to acetaminophen during pregnancy. However, when they do their sibling analysis, they find this result completely goes away. This is their most compelling analysis, and the result is: there is no relationship between acetaminophen exposure and these diagnoses.

This is true when they measure any exposure and when they measure higher exposure amounts. Without sibling controls, higher exposure looks like it leads to more diagnoses. With sibling controls, higher exposure has no impact.

This is extremely good news for pregnant people. In the best data we have, which is now quite good, there is no link between Tylenol exposure and these behavioral outcomes for kids. If you have a headache, please treat it. 

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Prevention is key! I suggest:
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⭐ Using bug sprays with DEET 
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray
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#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster

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OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

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Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76. 

#emilyoster #pregnancy #pregnancytips #sleepingposition #pregnantlife

Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

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