Fear and guilt after Tylenol remarks, but Pakistan paediatricians say the science hasn’t changed
US President Donald Trump links autism to Tylenol use during pregnancy and childhood. —Photo(s) [Reuters/Author]
When the president of the United States stands on a podium and proclaims that Tylenol—locally known as Panadol—causes autism in children, parents listen. His statements unleashed a wave of fear, anxiety and anguish at least in Karachi, where we report from.
An autism expert at Aga Khan University was “flooded” with calls and emails from anxious mothers over the weekend after Trump’s briefing.
“Many mothers feel guilty, thinking their child’s autism might be linked to medications taken during pregnancy,” said Associate Professor Dr Sidra Kaleem, one of Pakistan’s few developmental paediatricians, and the director of the Child Development and Rehabilitation Centre at Aga Khan University Hospital.
“It’s important to understand the difference between causation and association,” she stressed. Some studies have observed children developing autism after their mothers took Panadol during pregnancy, others did not. “This proves that taking Panadol does not guarantee a child will develop autism,” she said.
Autism is largely a condition, with genetic and environmental factors contributing. “Vaccines do not cause autism,” she added by way of comparison. “We’ve seen children with autism from areas where vaccination programs do not exist.”
Autism manifests as social communication difficulties, repetitive behaviors, and challenges in understanding societal norms, especially when these signs appear in early childhood.
“Tylenol remains one of the safest painkillers for pregnant women, and using it when necessary is not a risk factor for autism,” Dr Sidra said.
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What did Trump say?
Panadol, widely prescribed to pregnant women for fevers and minor pain, is considered one of the “safest” options during pregnancy. Acetaminophen—known globally as ‘Tylenol’ or ‘Panadol’—is the same medication used to treat pain and fever.
Speaking at a White House briefing on autism research, President Donald Trump said the Food and Drug Administration would notify physicians that the prenatal use of acetaminophen “can be associated with a very increased risk of autism”.
Scientists react to Trump
A major US-based non-profit organization focused on autism, Autism Speaks, issued this statement, “We urge the Administration’s resources be dedicated toward advancing new and innovative areas of research, so the community benefits from fresh insights, rather than revisiting questions that have been well studied, including vaccines and autism.”
The WHO and European regulators have also weighed in. “Neither acetaminophen (Tylenol/Panadol) nor vaccines have been shown to cause autism,” WHO spokesperson Tarik Jasarevic said, noting that some observational studies suggested a possible association but that evidence remains inconsistent.
Medical experts and Tylenol’s parent company, Kenvue, dismissed Trump’s claims. “Independent science clearly shows acetaminophen does not cause autism,” a spokesperson told PEOPLE magazine.
Dr. Karam Radwan, the director of the UChicago Medicine Neurodevelopmental Clinic, added, “Tylenol has been safely used for decades and remains one of the safest options for treating fever and pain during pregnancy.”
The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) echoed this reassurance, stating, “Patient safety is our top priority. There is no evidence that taking paracetamol during pregnancy causes autism in children.”
WHO and MHRA further clarified that autism occurs even in areas without vaccination programs, reinforcing that vaccines do not cause the condition — and similarly, there is no evidence that Panadol (acetaminophen) taken during pregnancy causes autism.
‘We cannot draw sweeping conclusions’
The head of the Sindh Institute of Child Health & Neonatology, Professor Dr. Syed Jamal Raza, told The Express Tribune, it is difficult to establish a clear linkage between the painkiller and Autism.
“If we particularly talk about Panadol, we must ask why mothers are taking it during pregnancy in the first place. Often, it’s due to an underlying viral infection or body pain. So, indirectly, there was already another factor present. You cannot isolate the effect. We call this a confounding effect — when two effects appear together.”
He stressed that when all factors are considered, there is still no evidence to suggest Panadol causes autism. “Other factors, such as environmental influences or excessive screen time, can also play a role. We cannot draw sweeping conclusions the way Trump did. In pregnancy, even the slightest risk can cause complications, which is why we generally avoid medicines altogether. So yes, it’s better to avoid taking Panadol unnecessarily for something minor like a sneeze or headache.”
When asked what actually causes autism, Dr Raza said there is no single reason. “Autism is a multi-factor disorder. There is no one gene directly linked to it. What we know is that there can be a genetic predisposition, which is then triggered by environmental factors.”
Clarifying further, he added that autism has a very high heritability rate, and around 5–10% of cases result from single-gene disorders. Abnormalities in brain development also play a role, alongside environmental influences.
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Drawing a comparison with Type 1 diabetes, he added, “The gene may be present, but it only gets activated later in life.”
Dr Raza explained that autism develops over a period of time, and early detection signs vary case to case, such as difficulty in maintaining eye contact. “Autism is not a single, uniform disorder. It exists on a wide spectrum, which is why we call it ‘ASD’ (Autism Spectrum Disorder). It can range from mild to severe.”
Summing up, Dr Raza emphasized that current scientific evidence strongly rejects a causal link between Panadol and autism.
At most, there is a very slim possibility. The main takeaway, he said, is that while it remains ‘safe when necessary’, Panadol—like all medicines—should not be taken unnecessarily during pregnancy.
Parents react
Some parents sought urgent consultations, while others dismissed the claims.
One mother told The Express Tribune, “I don’t think it will happen because of taking Tylenol (Panadol) during pregnancy. Yes, it’s possible if we take it excessively or routinely, but I don’t think so.”
She added, “I feel that excessive mobile use and exposure to harmful rays can also contribute to autism, as far as I know.”
With additional reporting by Noor ul Huda Bhurgri.
