President Trump is being ripped apart by Big Pharma and mainstream physician societies for issuing an advisory on Tylenol during pregnancy. It’s hard to believe that they even read the update before issuing reactions. If Trump came out in favor of drinking more water, I’m afraid they might promote dehydration.
President Trump was characteristically off script in his presentation and seemed to want to push his HHS team to say more than they were comfortable regarding possible connections and root causes of autism. This caused a little confusion and fueled a strong reaction from his political opponents, but the reaction from medical societies and Big Pharma was indecipherable from them.
Because acetaminophen is one of the only options for pregnant women to take for low grade fever or pain, the advisory promotes discretion (lowest dose for shortest course) not abstinence from the medication. Kennedy cited studies showing a possible connection between acetaminophen and neurodevelopmental risks for babies as well as conflicting findings.
Trump, for his part correctly points out that a “little common sense” is necessary to right the ship at the nation’s health bureaus. What a doctor tells a patient should not depend on who that doctor’s medical society supported in the last election.
Secretary Kennedy pointed out in his Monday White House press conference, that in the lifetime of the typical first-time mother in the US, the autism rate has gone from one-in-10,000 to 31-in-10,000. For boys in California, Kennedy cites studies showing one-in-12.5. Any normal person can tell you that even if the increase was one tenth as dramatic, this could not simply be due to an increase in screening and diagnosis. It is unfortunate that industry insiders and medical societies are responding with the defiance of political resistance, rather than thoughtful, patient-centered entities.
Kennedy’s response to this epidemic and the data around a possible link between acetaminophen and autism seems far more prudent than continuing to say it cannot exist. CDC and the FDA now say there are no safe levels of alcohol consumption during pregnancy. Ibuprofen is also not recommended at all during most of a pregnancy, but the guidance given by Kennedy was extremely measured. This is what it actually says:
Given the conflicting literature and lack of clear causal evidence, HHS wants to encourage clinicians to exercise their best judgment in use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest duration when treatment is required. Furthermore, FDA recognizes that acetaminophen is often the only tool for fevers and pain in pregnancy, as other alternatives (e.g., NSAIDs) have well documented adverse effects. FDA is partnering with manufacturers to update labeling and drive new research to safeguard mothers, children, and families.
The American College of Obstetricians and Gynecologists (ACOG) blasted the advisory, saying “Suggestions that 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..” The same folks who refuse to say, “pregnant women” (because they contend, they now treat pregnant men) are now lecturing President Trump for not following basic science. Is it any wonder that the public has lost faith in the recently politicized physician groups and Big Pharma? Wouldn’t it make sense to advise women to take “the lowest dose for the shortest time” as possible even if the data are unconclusive?
Tylenol’s maker, Kenvue issued a statement saying, “independent, sound science clearly shows that taking acetaminophen does not cause autism.”
For additional information on this briefing, please refer to Secretary Kennedy’s fact sheet
* What it is: Acetaminophen (Tylenol) is an over-the-counter analgesic and antipyretic widely used during pregnancy. Concerns have arisen regarding possible neurodevelopmental risks associated with chronic prenatal exposure and potential overuse for low-grade fevers in pregnant women.
* Who it affects: Chronic acetaminophen use in pregnant women, especially late in pregnancy, may cause long-term neurological effects in their children.
* Evidence base: Large-scale cohort studies, including the Nurses’ Health Study II and the Boston Birth Cohort, report associations between in utero exposure and later diagnoses of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Scientists have proposed biological mechanisms linking prenatal acetaminophen exposure to altered brain development.
* Conflicting findings: Family-based Scandinavian studies, comparing exposed and unexposed siblings, have not shown significant associations. Critics from Icahn School of Medicine at Mt. Sinai and Harvard argue that statistical adjustments in these analyses may mask true effects.
