Concerns about whether cold and flu medications may affect developmental health, especially in children and during pregnancy, have been a topic of ongoing scientific investigation and public discussion. The core of these concerns often centers on the potential impact of certain common ingredients, such as acetaminophen (also known as paracetamol or Tylenol), on neurodevelopmental outcomes like autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).
Acetaminophen is widely used to reduce fever and relieve pain, including during pregnancy and in young children. Some recent comprehensive reviews of multiple studies have suggested a possible association between prenatal exposure to acetaminophen and an increased risk of neurodevelopmental disorders in children. These studies analyzed data from many previous investigations and found evidence that prenatal acetaminophen use might be linked to higher rates of autism and ADHD. However, the researchers emphasize that acetaminophen remains important for managing fever and pain during pregnancy, as untreated high fever itself can pose risks to fetal development, such as neural tube defects and preterm birth. Therefore, they recommend cautious use—using the lowest effective dose for the shortest possible time under medical supervision—rather than avoiding the drug altogether.
On the other hand, this association is not universally accepted. Large-scale studies following millions of children over decades have found no clear increase in neurodevelopmental disorders linked to acetaminophen use during pregnancy. Regulatory agencies and health experts from various countries have stated that current evidence does not justify changing recommendations for acetaminophen use in pregnant women. They continue to regard acetaminophen as a safer option compared to other over-the-counter pain relievers like aspirin or ibuprofen during pregnancy. The scientific community acknowledges that while some studies suggest a link, a definitive causal relationship has not been established, and the topic remains an active area of research and debate.
Beyond acetaminophen, other common ingredients in cold and flu medications, such as antihistamines (diphenhydramine, chlorpheniramine), dextromethorphan, and decongestants (pseudoephedrine, phenylephrine), have been associated with adverse events in children, particularly when medications are misused or accidentally ingested. Reports show that young children, especially those under four years old, are at risk of side effects like rapid heartbeat, drowsiness, hallucinations, coordination problems, pupil dilation, and agitation. Serious outcomes, including fatalities
