Donald Trump claims to have ‘found the answer to autism’, which has sparked backlash among scientists and medical regulators around the world
Donald Trump’s claim that paracetamol causes babies to develop autism has sparked backlash among scientists and medical regulators.
President Trump’s US administration has advised women in the early stages of pregnancy to avoid taking paracetamol as he suggested “pills and vaccines” are behind a rise in cases. NHS guidelines insist it is the safest treatment for pain and high fever which if untreated, increase the risk of birth defects. The NHS states: “Paracetamol is the first choice of painkiller if you’re pregnant. It’s commonly taken during pregnancy and does not harm your baby.”
Here the Mirror examines the claims being made by the US administration, and whether the science backs them up…
What is Trump claiming?
Trump’s bombshell press conference in the Oval Office has caused shock among the global scientific community after he claimed to have “found the answer to autism”.
He made the announcement alongside his Health Secretary Robert F Kennedy Jr, who had a long history of spreading anti-vaxxer conspiracy theories before taking up his post.
Trump described it as “one of the biggest announcements medically” in US history and doctors there will now be advised not to prescribe the drug – which has the brand name Tylenol in the US – to pregnant women. The President said the common painkiller “is no good” and that pregnant women should “fight like hell” to only take it in cases of extreme fever.
Trump began by thanking RFK Jr for bringing the issue to the “forefront of American politics”. He has pledged to find the cause of the complex neurological disorder in just five months. Experts had warned that finding the causes of autism – a complex syndrome that has been researched for decades – would not be simple.
What is autism?
The widely held view of researchers is that there is no single cause of autism, which is thought to be the result of a complex mix of genetic and environmental factors.
Autism diagnoses have increased by almost 800% in the last two decades, according to research in the Journal of Child Psychology and Psychiatry. It is not a disease and people with it can lead full lives.
Those with the neurological condition have brains that work differently to other people and it occurs on a wide spectrum of severity. Autistic people can have any level of intelligence. However many can find it hard to communicate and interact with other people or may find it hard to understand how other people think or feel.
Surging rates of diagnoses are thought to be in part a genuine increase in cases and partly due to children with symptoms who might once have gone undiagnosed now being spotted at an early age.
What does the science say?
Scientists have been investigating possible environmental factors which could contribute to autism for years – but without notable success. The problem is that most research into this is so-called observational studies from which it is very difficult to establish a cause.
For example some studies have indicated pregnant women who take paracetamol are slightly more likely to have an autistic child – but this does not prove that one causes the other. There may be a third, unknown, health factor which is making both more likely.
A study earlier this year by Harvard University’s Chan School of Public Health found that children may be more likely to develop autism and other neurodevelopmental disorders when exposed to paracetamol during pregnancy.
However the best evidence to date comes from a landmark Swedish study which looked at 2.4 million children born in Sweden between 1995 to 2019. Around 7.5% of them were exposed to paracetamol during pregnancy.
By comparing autism rates between those exposed versus those who were not, the study concluded that there was no increased risk of autism, ADHD or intellectual disability.
Crucially, this study also included siblings where one had been exposed to the painkiller in the womb and the other had not – and concluded that paracetamol use “was not associated with children’s risk of autism”.
What do the experts say?
Dr Steven Fleischman, president of the American College of Obstetricians and Gynecologists, said Monday’s announcement “is not backed by the full body of scientific evidence and dangerously simplifies the many and complex causes of neurologic challenges in children”.
He continued: “Studies that have been conducted in the past, show no clear evidence that proves a direct relationship between the prudent use of acetaminophen during any trimester and fetal developmental issues.”
Dr Monique Botha, associate professor in social and developmental psychology at Durham University, said: “I am confident in saying that no relationship exists. Pain relief for pregnant women is woefully lacking and paracetamol is a much safer option during pregnancy than any alternative. The fearmongering will prevent women from accessing the appropriate care.”
Experts stressed that all medication comes with a risk of side effects but paracetamol has been used for decades and with well established safety.
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Associate Professor Kevin Yap, Senior Principal Pharmacist at Singapore General Hospital said: “Benefits vs risk of foetal harm from medical condition (e.g. maternal fever and pain) versus the use of paracetamol in pregnancy should be weighed by the healthcare team. If paracetamol is taken, it is recommended to take the lowest effective dose for the shortest duration under medical guidance. Pregnant women should discuss any persistent or recurrent symptoms with their healthcare team.”
Professor Andrew Whitehouse, Professor of Autism Research at The Kids Research Institute Australia, said: “Autism is a complex condition influenced by many genetic and environmental factors. Any small associations in this area need to be weighed against the risk of untreated high fever in pregnancy for the woman and the developing baby.”
Dimitrios Siassakos, professor in obstetrics and gynaecology at University College London, said: “Undue focus on paracetamol would risk preventing families from using one of the safest medications to use in pregnancy when needed.”
Are Trump’s claims dangerous?
Tylenol contains the active ingredient acetaminophen, which is sold over the counter in the UK as paracetamol. Paracetamol is the NHS’s first choice treatment for pain and high fever. If untreated, fever can cause complications and birth defects.
Scientists warn Trump’s edict will prevent women accessing pain relief and could cause harm to unborn babies. The Medicines and Healthcare products Regulatory Agency, the UK medicines watchdog, said: “There is no evidence that taking paracetamol during pregnancy causes autism in children.”
Dr Monique Botha, of Durham University, added: “Paracetamol is a much safer pain relief option during pregnancy than basically any other alternative. The fearmongering will prevent women from accessing the appropriate care during pregnancy. Further, it risks stigmatising families who have autistic children as having brought it on themselves, and reinvigorates the long pattern of maternal shame and blame we’ve seen re-emerge repeatedly over the last 70 years, where we try to pay the fault of autism at the mother’s door one way or another.”
The intervention has sparked fears that ideology in the Trump administration is being allowed to lead the science.
What else did Trump say?
Trump also claimed certain groups who don’t take vaccines or pills do not get autism. He said: “I think I can say that there are certain groups of people that don’t take vaccines and don’t take any pills, that have no autism.”
When Trump was asked about a possible link between autism and vaccines, he said: “Vaccines are very interesting. They can be great but when you put the wrong stuff in them… and children get these massive vaccines like you give to a horse.”
The statement on vaccines has reignited unsubstantiated claims linked to a published paper by disgraced anti-vaxxer Andrew Wakefield.
In 1998 his research wrongly linked the MMR (measles, mumps and rubella) jab to autism. Childhood vaccination rates fell off a cliff, from 92% to 72% after the paper’s publication. His results were later found to be defective and he was struck off the medical register in 2010 for serious professional misconduct.