Tylenol and Autism: Separating Science from the Headlines – PediaCast 608
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Show Notes
Description
Dr Dane Snyder visits the studio as we consider Tylenol and autism. Parents may hear mixed messages… with the headlines saying one thing and medical providers saying something different. So, what are moms and dads to do? Tune in for a thoughtful discussion on this important topic!
Topics
Tylenol and Autism
Guest
Dr Dane Snyder
Primary Care Pediatrics
Nationwide Children’s Hospital
Links
New Research Bolsters Evidence that Tylenol Does NOT Raise the Risk of Autism Despite Trump’s Claims (Associated Press)
Acetaminophen is Safe for Children When Taken as Directed, No Link to Autism (AAP)
Guidance for Parents About Acetaminophen Use (NCH)
Acetaminophen: Frequently Asked Questions (NCH)
Vaccines: Frequently Asked Questions (NCH)
Episode Transcript
[Dr Mike Patrick]
This episode of PediaCast is brought to you by Primary Care Pediatrics at Nationwide Children’s Hospital.
[MUSIC]
[Dr Mike Patrick]
Hello, everyone, and welcome to another episode of PediaCast. We are a pediatric podcast for moms and dads.
This is Dr. Mike coming to you from the campus of Nationwide Children’s Hospital. We’re in Columbus, Ohio. It’s episode 608.
We’re calling this one Tylenol and Autism, Separating Science from the Headlines. I want to welcome all of you to the program. We are so happy to have you with us.
You know, there are lots of mixed messages out there related to health and science, which can be confusing for moms and dads. An example of this is autism, especially as we consider its cause. There are the headlines linking autism first to vaccines and more recently to acetaminophen or Tylenol, as it’s called in the United States.
That’s the brand name. But what is true? What should families do when their medical providers share advice that conflicts with governmental agencies and news headlines?
We will answer this question today and many more related questions. Of course, in our usual PediaCast fashion, we have a terrific guest joining us in the studio to discuss the topic. Our guest today is Dr. Dane Snyder. He is Associate Chief Medical Officer for Ambulatory Pediatrics at Nationwide Children’s Hospital, also a professor of pediatrics at the Ohio State University College of Medicine. Before we get to him, I do want to remind you that the information presented in our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.
If you’re concerned about your child’s health, be sure to call your health care provider. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org. So, let’s take a quick break.
We’ll get Dr. Dane Snyder settled into the studio, and then we will be back to talk about Tylenol and autism. It’s coming up right after this.
[MUSIC]
[Dr Mike Patrick]
Dr. Dane Snyder is Associate Chief Medical Officer for Ambulatory Pediatrics at Nationwide Children’s Hospital. He is also a professor of pediatrics at the Ohio State University College of Medicine. He has a passion for supporting children and families in their wellness journey, and that includes taking an evidence-based approach to patient care, helping parents think critically, and promoting shared decision-making based on science. All of these things come together as we consider autism and acetaminophen, also known as Tylenol, here in the United States, and paracetamol and Panadol, and there’s lots of other names for it in other parts of the world.
Before we dive into the conversation, though, let’s offer a warm PediaCast welcome to our guest, Dr. Dane Snyder. Thank you so much for stopping by the studio today.
[Dr Dane Snyder]
Thank you, Dr. Mike. Happy to be here. Thank you for the invite.
[Dr Mike Patrick]
Yeah, we’re really excited to talk about autism and acetaminophen. I know we’ve been planning this episode for quite a while. Why don’t we start off with just sort of what we know about the causes of autism?
You know, in the minds of parents, we see so many things in the news, and some sources are reliable, others are not so reliable. What do we know from a science standpoint of what causes autism?
[Dr Dane Snyder]
Yeah, so there’s been a lot of research in this area, and there still isn’t a complete answer here, and that’s because the causes of autism are very complex. And can be from many factors. And so, there’s not a single answer here.
One thing we do know is that genetics plays a big role. There have been a lot of gene variants that have been identified that have been associated with autism, either inherited from parents or spontaneous changes that happen during development. But we also know that the environment interacts with those genes to possibly increase the likelihood.
A lot of research has been done to figure out what environmental causes could be there or what could be impacting this. But we know more about what does not cause autism versus what actually does cause it. And that’s why the research continues and why it’s such an important topic.
[Dr Mike Patrick]
Yeah. And not only important for researchers and folks who take care of kids in the health care system, but also just for parents. Really, that confusion, like if doctors aren’t sure about something, it can definitely cause anxiety for parents, especially in your clinical practice.
What do you see in terms of autism and fear and just the unknown of it all?
[Dr Dane Snyder]
Yeah, I think you just hit the nail on the head. We’re humans. We don’t like uncertainty.
We want to know why things happen and we want to know why the world is the way it is and why things are happening. And so, if there’s a lot of uncertainty or conflicting information out there, I think that feeds into anxiety about the world and about their children. And I think that’s, you know, as a general pediatrician, it’s our job to explain what we do know and be OK with a little bit of ambiguity and uncertainty and explain the options that are out there to move forward.
And I think once you can establish that rapport with families, you know, the general pediatrician is someone who knows those children the best and they see those children’s develop from being a new baby all the way up through teenage years, including that area when autism is typically diagnosed. And so, establishing that relationship is a huge key to helping quell some of that anxiety and following the steps that that are needed to. One screen for autism, but then also once the risk of autism is known to be higher because of those screening, then what do you do about it and how do you move forward?
[Dr Mike Patrick]
Yeah. Let’s shift gears and talk about Tylenol for a moment. What exactly is Tylenol or again, the drug names acetaminophen?
What is this medicine and how long has it been used? What do we know about it?
[Dr Dane Snyder]
Yeah, so Tylenol is the brand name of acetaminophen. That’s what most of us know acetaminophen as Tylenol here in the United States. It’s been around for more than 100 years.
It’s well known. It’s typically used for pain or fever, and most people can take Tylenol. It’s really the first anti-fever medication we have for babies.
It’s the safest in young infants and pregnant women. And so, it’s a very common medication that if used properly is extremely safe for the vast majority of individuals. And that’s why it’s very commonly used in these age groups.
[Dr Mike Patrick]
Yeah. And I think it’s important to note, you know, folks look up like dangers of Tylenol or acetaminophen. You know, one of the things you’re going to see is liver problems.
But we want to point out that that is with excess doses and that at the recommended doses. And it is important for parents to make sure that you’re given the right dose to your child based on their weight in particular. But in those normal doses, liver issues are really not a concern, correct?
[Dr Dane Snyder]
You’re exactly right. And, you know, there has been a lot of talk about Tylenol in the past six to nine months and about the recommendation to give it in the lowest effective dose and only when needed. And honestly, that’s how pediatricians practice in general.
We don’t recommend that families give doses above what the recommended doses, the safe doses that have been studied to be safe are. We don’t recommend that we give Tylenol around the clock for no reason. And we want to give it only when it’s needed and at the right dose.
And if you do that, then you avoid those levels that cause liver problems and other side effects.
[Dr Mike Patrick]
And then why is it that Tylenol is so commonly used, especially during pregnancy and infancy? As we think about the options that are out there for fever and pain, you know, the ibuprofens of the world and all the other what we would call non-steroidal anti-inflammatory drugs or NSAIDs. I just want to get all those words out there because they’re ones that people may have heard of.
Why do we choose Tylenol over other options, especially during pregnancy and infancy?
[Dr Dane Snyder]
Really, because it’s the safest. So, the other options, one that you just mentioned, ibuprofen, we know and if taken during pregnancy or if given early in the baby’s life can cause significant problems. So, it can affect the kidneys and young infants.
It can affect the baby’s heart if taken during pregnancy and development of the heart. And aspirin is another one people use for fever and pain, and that’s rarely ever safe to give to kids. It’s used very rarely for certain medical conditions, but that should only ever be given at the direction of a clinician.
And so, Tylenol is the safest choice. We know it’s safe and it can work to alleviate pain and fever in both pregnant women and in those little infants. When ibuprofen and aspirin, we know are not safe at those ages.
[Dr Mike Patrick]
Now, some would say, then, why not just sort of suffer through your fever, especially for pregnant moms, you know, when you’re carrying your baby? We have to look at the risk and benefit of all our choices. And fevers can be an issue in pregnant women, right?
[Dr Dane Snyder]
Oh, exactly. And everything in medicine is about risk benefit. How much benefit is the patient going to receive and how much risk is there to that patient?
And fever during pregnancy, we know, causes there to be an increased risk of serious issues for the mommy and the baby. It can be very high. Fever can be very dangerous to the developing baby.
It increases the risk of being born early when they aren’t ready to be out in the real world yet. And it can increase the risk of neurologic conditions in the future. So, it’s really important to treat fever in pregnant women.
Treating fever in infants also can be an important thing. But very young infants, you also need to let your physician know that your baby’s having these issues. But there are good reasons that fever needs treated in young infants as well.
But again, it needs to be only when necessary and when the dosing is at the proper dose. And it’s really important to do these things because we know the alternatives aren’t good.
[Dr Mike Patrick]
Yeah. Yeah. Yeah.
So, we really do want to treat fever in pregnant women and young babies. And Tylenol is the safest option of all the options that are available. So then where did this idea that Tylenol might be linked to autism, where did this come from?
[Dr Dane Snyder]
Yeah, I think it has mostly to do with a focus on a review of studies done in 2025 that we then heard about in the media, propagated on social media. That study included over 40 studies, some of which showed that Tylenol and autism and ADHD were possibly associated. So based on that, there were individuals and groups recommending limiting Tylenol to only when needed, which honestly, like I said previously, is what we’ve already practiced, you know, in general.
That’s how pediatric providers practice. So that wasn’t a big change for us. But I think the focus on that one study, and we’ll talk we can talk more in detail about that study and some others that have come out since then.
But I think the focus on that study and how that spread has really caused this that this question to be asked.
[Dr Mike Patrick]
Yeah. Yeah, absolutely. One, a couple of terms that we’re going to need to understand as we move forward with our conversation is the difference between correlation and causation in a way that that everybody can understand.
Can you do that for us?
[Dr Dane Snyder]
Yeah, this is one of my favorite things because there are so many real-world examples to explain the differences here. So, correlation means that two things you see two things happen more often together. But that doesn’t mean that one causes another.
It just means that you see them happen at the same time. So, there are examples from medical research that I think a lot of people can relate to. One involves research, early research a long time ago about lung cancer.
At first, the researchers who were looking at what causes lung cancer, they saw a correlation between lung cancer and drinking coffee. And so, individuals who drank coffee got lung cancer more often. And so, they had to ask the question, does that mean that coffee causes lung cancer?
I really hope not, because I rely on coffee every single day. So, they had to look at other factors and smoking was what they found was that other factor. Once they looked at those groups based on who smoked and who didn’t, they were able to determine that it wasn’t actually the coffee that caused the lung cancer, it was the smoking.
It just meant that people who smoke also tended to drink coffee more often. And you see this; there’s great websites out there that look at these correlations that really have nothing to do with each other. And you could spend hours on these websites and laugh.
And one of my favorite one is that the graphs for sales of ice cream and shark attacks mirror each other exactly. But I don’t think anyone out there believes that eating or buying ice cream causes sharks to attack us more. It just means there’s other factors and warm weather, hot weather, sunny days.
That’s what that’s what the cause is more so than ice cream.
[Dr Mike Patrick]
Yes. Yeah, no, I love that example. And then so what does the overall body of literature really show about Tylenol and autism?
Like if we look at the big picture and not necessarily just one study over another, because we do know that studies, you know, they have strengths and they also have weaknesses. They are peer reviewed, but that doesn’t mean that that it’s always correct. And that is why oftentimes if there’s a small study, we’ll have a much larger study to sort of confirm that the results of that are correct.
So, as we think about all the different studies that are out there, you know, what assumptions can we come up with based on all of those together?
[Dr Dane Snyder]
Yeah, this is really hard to navigate. And what you said is exactly right. Maybe you’ll have a small study that gives you a hint of something you need to look at more closely.
You have a larger study to follow up. But then you also have to repeat those larger studies and replicate the findings. And that’s what makes this so difficult.
So, there’s been a lot of this over the past few years, and the interest has increased in this area. So, there’s one of the studies that a lot of people talk about is from 2024 out of Sweden. It was a very large study.
It involved two million children. They were siblings. They looked at Tylenol and if it was associated with autism, ADHD, other intellectual disorders.
And they observed that the association between Tylenol and autism, once they adjusted things for all the other factors that, you know, think about the smoking, coffee, lung cancer example. Once they started to look at other factors, they concluded that the association between Tylenol and autism was due to other factors and not the actually the Tylenol.
[Dr Mike Patrick]
Yeah, yeah. And this can be so difficult because we’re I mean, to do a study like this, you’d have to take either sort of control for which babies got Tylenol and which ones didn’t and then follow them up, you know, through elementary school and find out who has autism and who doesn’t. And that would be a very long prospective study and challenging in other ways.
But on the other hand, if we take the kids who have autism and have a control group with kids who don’t have autism and then look back and say, did they get Tylenol or not? Now you’re relying on parent memory of how often did they get Tylenol? Is that really what they use?
Did they use the correct doses? So, all of these things make this particular topic a challenge, right?
[Dr Dane Snyder]
Yeah, and you wouldn’t want necessarily to restrict the safest option for pain and fever in young childhood and infancy to be able to study those children long term and say, this group is going to get Tylenol and this isn’t because we know not treating those things like we already talked about can be really bad. And so, it’s really difficult to design this. And that’s why you have to look at the overall body of evidence.
You ask, what does the overall body of evidence show? And it really shows that Tylenol doesn’t have anything to do with autism. We have this 2024 study out of Sweden that we just talked about.
The one study that we mentioned previously in 2025 that looked at those 40 studies, they found very conflicting information. Some of the studies showed no association at all. Some had a small increase in risk that was associated with Tylenol.
Again, not a cause-and-effect type of relationship, but an association or a correlation. And when that happens, like we’ve talked about, you have to look at the studies and how they were designed. And many of the studies in that package of 40 some studies didn’t have complete data.
The designs were not great. They didn’t control for things like family history, genetics, those other factors. And so, then you have to start to look further into what else could be causing this.
Could it be fever? Could it be pain? Could it be other environmental factors that are contributing?
[Dr Mike Patrick]
Yeah. Yeah. And I don’t want to go too deep into politics here, but you do wonder what is the motive for coming out with this on such shaky ground?
And the fact that we really haven’t heard a lot about it since a particular press conference. If you felt passionately that Tylenol is dangerous for pregnant women and babies, you think we would continue to hear more about it. But we haven’t.
And I think that says something.
[Dr Dane Snyder]
Yeah. And a lot of those statements have been walked back from that initial press conference. It didn’t get as much news as the press conference itself.
But I think that’s good. There’s been some newer studies in 2026 that have maybe led to that because, again, there’s conflicting information out there. We want to keep studying it.
We want to know the answers. We’re humans. We’re curious, naturally.
And so, we haven’t heard as much about it. And I think that’s because the evidence just hasn’t been there. And I think the motivation, I can’t speak to motivation at the beginning, but, you know, people want answers.
People want to deliver answers. They want to make people happy. And so that’s all of us want to figure this out.
Everyone should be on the same team here to figure out how we can help every child in our community.
[Dr Mike Patrick]
Yeah. Yeah. Very important.
Where do sibling studies come into play? What are those? And why might that be helpful in a situation like this?
[Dr Dane Snyder]
Yeah, so there have been several studies involving siblings in this area. And sibling studies are really important because it takes out so many of the variables that could influence the study. So, the environment for siblings is really likely to be very similar.
So maybe not identical, but similar. And so, they look at siblings and they divided them into groups that received Tylenol, again, based on parent report and those who did not. And that really increases the strength and the validity of the findings because it, again, takes out many, many of the factors that maybe we weren’t even considering.
[Dr Mike Patrick]
Yeah. Yeah. So, at the end of the day, you really still recommend Tylenol for pregnant women.
I mean, I know as a pediatrician, you don’t necessarily for them. I mean, obviously, if you have a fever and you are pregnant, please call your OBGYN and talk to them about it. But at least in young infants, you still feel comfortable recommending Tylenol for appropriate reasons and at appropriate doses.
[Dr Dane Snyder]
Yeah, in the right amounts, like we’ve talked about. Pediatricians have always tried to use this medication, any medication, even over-the-counter ones like Tylenol, only when it’s necessary, only when it’s needed. But we would still recommend this for infants when used appropriately.
It’s not a new thing, and you should only give Tylenol or really any other medication to a baby, child, adult when it’s really necessary and only in the recommended amount.
[Dr Mike Patrick]
Yeah, yeah, absolutely. There’s going to be listeners who are like, OK, OK, we understand Tylenol is a good thing, but vaccines, that’s, you know, another conversation that we could easily talk, you know, an hour on. But really, there’s a lot of the same thing here with a causation and correlation being two different things when it comes to vaccines and autism.
Can you speak to that briefly?
[Dr Dane Snyder]
Yeah, vaccines have a natural correlation with the diagnosis of autism because of when we give vaccines. We give vaccines during infancy at the same time or just before we start to notice symptoms, the first symptoms of autism. And so, there’s that natural correlation that then we need to look at, is there a causation to it, too?
And because of that, vaccines have been studied in relationship in its relationship to autism extensively over decades. There have been dozens of studies about this, and the entire body of that research shows that vaccines don’t cause autism. Giving vaccines is correlated with diagnosing autism, again, because of the timing of both.
But the literature out there, the research out there shows that it doesn’t have a cause-and-effect relationship.
[Dr Mike Patrick]
Yeah, yeah. And you feel very comfortable recommending all the vaccines that the American Academy of Pediatrics would recommend for families.
[Dr Dane Snyder]
Definitely. And I have three children, all under the age of 10, and I recommend them for them as well. And they receive them all, too.
I think that’s one of the strongest statements I can say. Yeah, yeah, absolutely.
[Dr Mike Patrick]
So, what is your advice as we close for parents who are just feeling overwhelmed? You know, you get lots of different information from lots of different sources. It oftentimes doesn’t match up.
What’s a parent to do in deciding what’s best for their family?
[Dr Dane Snyder]
It is really tough on parents right now. Social media has a big role in that. I think we if we if we watch a video on any social media platform and we and we watch the entire thing, then there are algorithms and that we see that information more.
And we see it again and we see it and it reinforces that. And you could say that for either side of any argument that you’re on. And so, it’s really tough to navigate what is the truth and what is not.
And the reality is parents want to do what’s best for their kids. Pediatricians want what’s best for those kids as well. But parents want to do the right thing.
They love their children. And so, the best advice I can give is talk to your pediatrician, talk to those trusted health care providers. When parents are surveyed, pediatricians are still very, very, very highly trusted with these conversations and with their time.
And so, talking to that, you know, care provider for your child can help you sort through all the conflicting information out there because it’s difficult as a health care provider with all the information out there to sort through it. And for those parents who aren’t in the health care field, I can’t imagine. I don’t envy the decisions that they have to make and what they try to what they try to get through.
And they shouldn’t have to do it alone.
[Dr Mike Patrick]
Yeah. Yeah. I love that you say that parents just want what’s best for their kids and pediatricians want what’s best for those kids.
And we’re all a team working together, thinking about the risks and benefits of everything, looking at all of the studies and really trying to come up with the right answer. And when there’s some gray zone, you know, what is the right answer for a particular family given other situations? And that’s where shared decision making comes in.
Also, very important. We really appreciate you taking the time to talk with us about this. For folks who want to learn more about Tylenol and autism, we are going to have a lot of links for you in the show notes.
So, if you head over to PediaCast.org, click on the show notes for this episode and you will find all of those resources there. So once again, Dr. Dane Snyder, Associate Chief Medical Officer for Ambulatory Services at Nationwide Children’s Hospital. Thank you so much for stopping by the studio today.
[Dr Dane Snyder]
Thank you, Dr. Mike.
[MUSIC]
[Dr Mike Patrick]
We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. We really do appreciate your support. Also, thanks again to our guests this week.
Dr. Dane Snyder, Associate Chief Medical Officer for Ambulatory Services at Nationwide Children’s Hospital and Professor of Pediatrics at the Ohio State University College of Medicine. Don’t forget, you can find us wherever podcasts are found. We’re in the Apple podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube, and most other podcast apps for iOS and Android.
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And until next time, this is Dr. Mike saying, stay safe, stay healthy, and stay involved with your kids. So long, everybody.
[MUSIC]
