Generic Name: Acetaminophen
Indications: Fever, mild pain and moderate pain. 
FDA Drug Category: B
 
Acetaminophen is one of the most commonly used medications for fever and mild to moderate pain. For many pregnant and breastfeeding women, it’s often the go-to choice when relief is needed — and when used correctly, it has a strong track record of safety. Still, new research is helping us understand where extra caution may be wise, especially with frequent or long-term use.

Safe Use During Pregnancy and Breastfeeding

When taken according to package instructions, acetaminophen is generally considered safe during pregnancy. Studies have found no increased risk of miscarriage or fetal/maternal death when the medication is used as directed. This is why many healthcare providers recommend acetaminophen as a preferred option for pain or fever during pregnancy.

The dose and frequency matter. Pregnant women are advised to take the lowest effective dose for the shortest necessary time. The maximum recommended dose is 4,000 mg per day. Exceeding this limit can increase the risk of liver damage, kidney problems, or anemia.

For those who are trying to conceive, the same rule applies: acetaminophen should only be used when needed and always according to medical guidance.

During breastfeeding, acetaminophen passes into breast milk in very small amounts, well within the levels considered safe for infants. No birth defects have been associated with recommended use. Both the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) support its use while breastfeeding.

People with liver disease, kidney disease, or anemia should consult a healthcare provider before taking acetaminophen at any stage, including pregnancy.

Emerging Research and Potential Risks

While acetaminophen remains one of the safest options available, a growing number of studies are exploring its long-term effects on child development when used frequently during pregnancy.

A well-known study, Association of Acetaminophen Use During Pregnancy With Behavioral Problems in Childhood: Evidence Against Confounding said: "Children exposed to acetaminophen prenatally are at increased risk of multiple behavioral difficulties," but also that further studies need to be performed.

A Norwegian study went a step further, noting that daily use of acetaminophen for more than 28 days during pregnancy was associated with “substantially adverse developmental outcomes at 3 years of age.” Because of these findings, long-term use of acetaminophen in pregnancy is not currently recommended.

There’s also some evidence of a minimal increase in the risk of wheezing or asthma in children whose mothers took acetaminophen daily during the second trimester. However, many doctors believe that the risks of untreated pain or fever may outweigh the potential lung-related effects, especially since fever itself can be harmful to the fetus.

The Bottom Line

For short-term relief of pain or fever, acetaminophen remains a trusted and effective option during pregnancy and breastfeeding. The key is responsible use:

• Take the lowest effective dose
• Use it for the shortest time necessary
• Avoid exceeding 4,000 mg per day
• Talk to your healthcare provider before prolonged use or if you have underlying health conditions

As research continues to evolve, these precautions can help balance comfort and safety for both you and your baby.