Paracetamol in pregnancy - is it safe?
There have been some scary headlines about possible links between taking paracetamol during pregnancy and health issues in babies. Is there something to worry about? Is it really OK to take paracetamol when you’re pregnant – and how much can you take? Our expert GP advises
In a nutshell: Yes. Paracetamol (also known as acetaminophen) has been taken by pregnant women for many years without any obvious harmful effects on their developing baby. But because it's not possible to say that any medicine is absolutely safe to take in pregnancy, it's also recommended that you don't take it for a prolonged period, and that you only take the minimum amount you need to ease your pain.
How much paracetamol is safe in pregnancy?
Paracetamol is the painkiller the NHS recommends as a first choice for pregnant or breastfeeding women who have a fever or pain. That's because other painkillers have not been shown to be any safer – and some are not suitable for use during certain stages of pregnancy.
For a pregnant woman, current NHS advice is to take the lowest dose of paracetamol that works for you – and to take it for the shortest possible time.
The dosage for (non-pregnant) adults is a maximum of 2 500mg tablets or capsules no more than 4 times in 24 hours– so up to 8 500mg tablets in total – leaving at least 4 hours between dose.
Can I take paracetamol at the same time as other medicines?
Other over-the-counter remedies, such as cold and flu medicines, may also contain paracetamol, so check their ingredients to make sure you're not going over the daily paracetamol limit. If you're unsure, check with a pharmacist, doctor or midwife.
Always check with your pharmacist that what you are buying is just simple paracetamol and is safe in pregnancy
If I take paracetamol while I'm pregnant, will it harm me or my baby?
There have been various scientific studies that have looked at possible links between taking paracetamol in pregnancy and various potentially adverse effects on your own health or your baby’s health.
Some of these include:
- A Finnish study (2021) looked at an association between pregnant women taking paracetamol and developing pre-eclampsia (a potential serious high-blood-pressure condition). 1
- A UK study (2019) looked at an association between pregnant women taking paracetamol and their children developing behavioural, memory and IQ problems.2
- A UK/Swedish study (2019) looked at a possible link between pregnant women taking paracetamol and their children developing asthma.3
- A US study (2021) looked at a possible link between pregnant women taking pregnancy and neurodevelopmental and reproductive disorders.4
Many of these studies have been reported in the media, and, if you are currently pregnant or were pregnant at the time, they may seem to make for worrying reading. But it's important to note that none of these studies have shown that it's the paracetamol that actually causes the problems; only that there may be some association. It could be, for example, that the illness the pregnant woman in the study took the paracetamol to treat could have caused the problem.
Most experts are agreed that the current evidence is not good enough to draw any conclusions about the safety of taking paracetamol in pregnancy and that research is needed to gather that evidence.
Until then, the expert advice remains that it is safe to take paracetamol when it's needed but to take it at the lowest dose and for the shortest time.
Please don't suffer in silence because you're too worried to take any painkillers during pregnancy. If you're in pain or have a fever and you're not sure what medicine to take, talk to your GP or midwife for reassurance.
About our expert Dr Philippa Kaye
Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.
1. Increased risk of preeclampsia after use of paracetamol during pregnancy – causal or coincidence? Von Hellens, H et al. BMC Pregnancy and Childbirth, 2021;21:article 24.
2. Associations between paracetamol (acetaminophen) intake between 18 and 32 weeks gestation and neurocognitive outcomes in the child: A longitudinal cohort study. Golding, J et al. Paediatric and Perinatal Epidemiology, 2019;33(3):257-266.
3. Prescribed analgesics in pregnancy and risk of childhood asthma. Shaheen, SO et al. Eur Respir Journal, 2019;53(5):1801090. doi:10.1183/13993003.01090-2018.
4. Paracetamol use during pregnancy – a call for precautionary action. Bauer, A et al. Nature Reviews Endocrinology 17 757-766 (2021) https://doi.org/10.1038/s41574-021-00553-7
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