Essential workers need childcare, so grandparents are filling the gap

America is in the middle of a pandemic but it is also in the middle of an unprecedented childcare crisis. With schools and day cares closed and babysitters, nannies and grandparents out of reach parents are overworked and overwhelmed.

In some nations parents who must stay home without pay due to the closures of schools and daycares qualify for income supports, but the United States does not have such a program and so many parents who cannot work from home—those working in retail, food service, janitorial and health care—are facing a desperate dilemma.

Do parents break quarantine by having someone watch their children while they go to work, or do they lose their job?

As Nicole Rodgers, founder and executive director of Family Story, a think tank dedicated to understanding how individuals are forming and reforming families in America, told CNBC, this is an unimaginably impossible situation for many working parents.

"This is when we would ideally lean on our communities and share the burden of filling in and caring for each others' kids," Rodgers explains. "But when we're being asked to practice social distancing, that might not be feasible. It's a truly impossible situation."

These are desperate times and for some parents these times are going to call for desperate measures. The very people in occupations we now deem heroic are having to weigh the risks: Keep the kids quarantined and lose the family's income or break social distancing guidelines so that someone can watch the children while parents work.

That's why, even though older adults are more at risk for COVID-19 and that kids can often be asymptomatic carriers, grandparents are stepping in to fill the gap (and are potentially risking their health to do so.

"We're the day care now," 64-year-old grandmother Terri Barhite told the Boston Globe after her toddler grandson's daycare closed. "We're reading Sesame Street."

It's easy to see why in some states childcare centers have reopened for all workers despite risks to the children enrolled—because as Barhite's situation proves, they are such a vital service and parents cannot work without them. Some local governments have recognized that, but more needs to be done nationally.

In some states, frontline workers can access subsidies and help finding childcare. In Connecticut, for example, workers can access $500 a week in childcare subsidies and help finding a childcare provider that is still open. In Virginia, the state is spending federal grant money to keep childcare centers open for vital workers like doctors and sanitation workers.

But across the country, many centers that have closed will never reopen as they will never recover from this loss of income. A new report from the Center for American Progress estimates that without public funding, the nation could lose 49% of licenced childcare spots during the pandemic.

"Families were struggling to find and afford child care before the new coronavirus, but our estimates make clear that if Congress fails to act, this pandemic could have a catastrophic toll on America's childcare system," says Simon Workman, director of Early Childhood Policy at CAP. "This will have profound implications for working families as states begin to ease social distancing guidance; for the nation's ability to mount a robust economic recovery; and for women, who shoulder a disproportionate share of in-home family caregiving responsibilities."

That's why childcare advocates and some politicians, including Sen. Elizabeth Warren, are calling on Congress to help this industry as it has helped others.

Even before the pandemic, finding affordable, quality childcare was a huge challenge for working parents with 2 out of 3 families struggling to find care that meets their standards. Childcare needs to be part of America's plan for economic recovery because the system was broken before and now it is shattered.

In This Article

    Kristen Bell and Jackie Tohn on how they’re ‘sneak teaching’ kids with their new show "Do, Re & Mi"

    The best friends created a musical animated show that's just as educational as it is entertaining

    Amazon Studios

    This episode is sponsored by Tonies. Thank you for supporting the brands that support Motherly and mamas.

    Kristen Bell and Jackie Tohn have been best friends since they met as young singers and actors more than 15 years ago, and now they're collaborating on a new Amazon Original animated kids series called Do, Re & Mi. The show, which follows best birds Do, Re and Mi as they navigate the world around them while also belting out catchy tunes, is just as educational as it is entertaining.

    On the latest episode of The Motherly Podcast, Bell and Tohn talk to Motherly co-founder Liz Tenety about how they're "sneak teaching" kids with their new show and why music is such an important focal point.

    "It was basically our mission from the very beginning to 'sneak music education' into kids' lives, hands, brains, all of it," Tohn admits.

    "There's so much science and data to support that [music] helps kids, their brains grow with math, with social skills. It literally can change your neuroplasticity. You can put music of their favorite genre or timeframe on, in an Alzheimer's ward, and they will come back online for a couple minutes. I mean, it's crazy," Bell, who has two daughters of her own, adds. "You know, music can bind a lot of families together. It can bind friendships together. And it's just a show that you can feel really good about. We want to get it in front of as many kids as possible, because I don't like the fact that some kids won't have exposure to music. Their brains deserve to grow just as much as everyone else's."

    The first season of Do, Re & Mi premiered on September 17th and its creators recorded 52 different songs for the show that range from reggae and pop to country, blues and jazz.

    "That's what's so exciting about this show," Tohn gushes. "Not only are the lessons we're teaching for everyone, but every episode has a musical genre, a musical lesson and an emotional lesson. And so there really is so much to learn."

    Elsewhere in the episode, Bell tells Tenety about how she made literal toolboxes that carry different regulation tools to help her kids calm down (one is "find a song you love and sing out loud") and why having a village is crucial to surviving motherhood, especially in a pandemic, while Tohn details her special friendship not only with Bell, but with her daughters, too.

    To hear more about the show, Bell's experiences in motherhood, and her enduring friendship with Tohn, listen to The Motherly Podcast for the full interview.


    12 baby registry essentials for family adventures

    Eager to get out and go? Start here

    Ashley Robertson / @ashleyrobertson

    Parenthood: It's the greatest adventure of all. From those first few outings around the block to family trips at international destinations, there are new experiences to discover around every corner. As you begin the journey, an adventurous spirit can take you far—and the best baby travel gear can help you go even farther.

    With car seats, strollers and travel systems designed to help you confidently get out and go on family adventures, Maxi-Cosi gives you the support you need to make the memories you want.

    As a mom of two, Ashley Robertson says she appreciates how Maxi-Cosi products can grow with her growing family. "For baby gear, safety and ease are always at the top of our list, but I also love how aesthetically pleasing the Maxi Cosi products are," she says. "The Pria Car Seat was our first purchase and it's been so nice to have a car seat that 'grows' with your child. It's also easy to clean—major bonus!"

    If you have big dreams for family adventures, start by exploring these 12 baby registry essentials.

    Tayla™️ XP Travel System

    Flexibility is key for successful family adventures. This reversible, adjustable, all-terrain travel system delivers great versatility. With the included Coral XP Infant Car Seat that fits securely in the nesting system, you can use this stroller from birth.

    Add to Babylist


    Iora Bedside Bassinet

    Great for use at home or for adventures that involve a night away, the collapsible Iora Bedside Bassinet gives your baby a comfortable, safe place to snooze. With five different height positions and three slide positions, this bassinet can fit right by your bedside. The travel bag also makes it easy to take on the go.

    Add to Babylist


    Kori 2-in-1 Rocker

    Made with high-quality, soft materials, the foldable Kori Rocker offers 2-in-1 action by being a rocker or stationary seat. It's easy to move around the home, so you can keep your baby comfortable wherever you go. With a slim folded profile, it's also easy to take along on adventures so your baby always has a seat of their own.

    Add to Babylist


    Minla 6-in-1 High Chair

    A high chair may not come to mind when you're planning ahead for family adventures. But, as the safest spot for your growing baby to eat meals, it's worth bringing along for the ride. With compact folding ability and multiple modes of use that will grow with your little one, it makes for easy cargo.

    Add to Babylist


    Coral XP Infant Car Seat

    With the inner carrier weighing in at just 5 lbs., this incredibly lightweight infant car seat means every outing isn't also an arm workout for you. Another feature you won't find with other infant car seats? In addition to the standard carry bar, the Coral XP can be carried with a flexible handle or cross-body strap.

    Add to Babylist


    Pria™️ All-in-One Convertible Car Seat

    From birth through 10 years, this is the one and only car seat you need. It works in rear-facing, forward-facing and, finally, booster mode. Comfortable and secure for every mile of the journey ahead, you can feel good about hitting the road for family fun.

    Add to Babylist


    Pria™️ Max All-in-One Convertible Car Seat

    Want to skip the wrestling match with car seat buckles? The brilliant Out-of-the-Way harness system and magnetic chest clip make getting your child in and out of their buckles as cinch. This fully convertible car seat is suitable for babies from 4 lbs. through big kids up to 100 lbs. With washer-and-dryer safe cushions and dishwasher safe cup holders, you don't need to stress the mess either.

    Add to Babylist


    Tayla Modular Lightweight Stroller

    With four reclining positions, your little ones can stay content—whether they want to lay back for a little shut-eye or sit up and take in the view. Also reversible, the seat can be turned outward or inward if you want to keep an eye on your adventure buddy. Need to pop it in the trunk or take it on the plane? The stroller easily and compactly folds shut.

    Add to Babylist

    Tayla Travel System

    This car seat and stroller combo is the baby travel system that will help make your travel dreams possible from Day 1. The Mico XP infant seat is quick and easy to install into the stroller or car. Skipping the car seat? The reversible stroller seat is a comfortable way to take in the scenery.

    Add to Babylist

    Modern Diaper Bag

    When you need to change a diaper during an outing, the last thing you'll want to do is scramble to find one. The Modern Diaper Bag will help you stay organized for brief outings or week-long family vacations. In addition to the pockets and easy-carry strap, we love the wipeable diaper changing pad, insulated diaper bag and hanging toiletry bag.

    Add to Babylist


    Mico XP Max Infant Car Seat

    Designed for maximum safety and comfort from the very first day, this infant car seat securely locks into the car seat base or compatible strollers. With a comfy infant pillow and luxe materials, it also feels as good for your baby as it looks to you. Not to mention the cushions are all machine washable and dryable, which is a major win for you.

    Add to Babylist

    Adorra™️ 5-in-1 Modular Travel System

    From carriage mode for newborn through world-view seated mode for bigger kids, this 5-in-1 children's travel system truly will help make travel possible. We appreciate the adjustable handlebar, extended canopy with UV protection and locking abilities when it's folded. Your child will appreciate the plush cushions, reclining seat and smooth ride.

    Add to Babylist

    Ready for some family adventures? Start by exploring Maxi-Cosi.

    This article was sponsored by Maxi-Cosi. Thank you for supporting the brands that support Motherly and mamas.

    Boost 1

    This incredibly soft comforter from Sunday Citizen is like sleeping on a cloud

    My only complaint? I've slept through my alarm twice.

    When it comes to getting a good night's sleep, there are many factors that, as a mama, are hard to control. Who's going to wet the bed at 3 am, how many times a small person is going to need a sip of water, or the volume of your partner's snoring are total wildcards.

    One thing you can control? Tricking out your bed to make it as downright cozy as possible. (And in these times, is there anywhere you want to be than your bed like 75% of the time?)

    I've always been a down comforter sort of girl, but after a week of testing the ridiculously plush and aptly named Snug Comforter from Sunday Citizen, a brand that's run by "curators of soft, seekers of chill" who "believe in comfort over everything," it's safe to say I've been converted.

    Honestly, it's no wonder. Originally designed as a better blanket for luxury hotels and engineered with textile experts to create this uniquely soft fabric, it has made my bed into the vacation I so desperately want these days.

    The comforter is made up of two layers. On one side is their signature knit "snug" fabric which out-cozies even my most beloved (bought on sale) cashmere sweater. The other, a soft quilted microfiber. Together, it creates a weighty blanket that's as soothing to be under as it is to flop face-first into at the end of an exhausting day. Or at lunch. No judgement.

    Miraculously, given the weight and construction, it stays totally breathable and hasn't left me feeling overheated even on these warm summer nights with just a fan in the window.

    Beyond being the absolute most comfortable comforter I've found, it's also answered my minimalist bed making desires. Whether you opt to use it knit or quilted side up, it cleanly pulls the room together and doesn't wrinkle or look unkempt even if you steal a quick nap on top of it.

    Also worth noting, while all that sounds super luxe and totally indulgent, the best part is, it's equally durable. It's made to be easily machine washed and come out the other side as radically soft as ever, forever, which totally helps take the sting out of the price tag.

    My only complaint? I've slept through my alarm twice.

    Here is my top pick from Sunday Citizen, along with the super-soft goods I'm coveting for future purchases.

    Woodland Snug comforter


    The bedroom anchor I've been looking for— the Snug Comforter.


    Braided Pom Pom Throw

    Because this degree of coziness needs portability, I'm totally putting the throw version on my list. It's washable, which is a must-have given my shedding dog and two spill-prone kiddos who are bound to fight over it during family movie night.


    Lumbar pillow


    What's a cozy bed without a pile of pillows?


    Crystal infused sleep mask

    sunday citizen sleep mask

    Promoting sleep by creating total darkness and relaxation, I've bookmarked as my go-to gift for fellow mamas.


    We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.


    10 Montessori phrases for kids who are struggling with back to school

    The first day of school can be hard for everyone, mama. Here's how to use the Montessori method to help your child adjust.

    No matter how excited your child was to pick out a new lunchbox and backpack this year, there will likely be days when they just don't want to go to school. Whether they're saying "I don't like school" when you're home playing together or having a meltdown on the way to the classroom, there are things you can say to help ease their back-to-school nerves.

    More than the exact words you use, the most important thing is your attitude, which your child is most definitely aware of. It's important to validate their feelings while conveying a calm confidence that school is the right place for them to be and that they can handle it.

    Here are some phrases that will encourage your child to go to school.

    1. "You're safe here."

    If you have a young child, they may be genuinely frightened of leaving you and going to school. Tell them that school is a safe place full of people who care about them. If you say this with calm confidence, they'll believe you. No matter what words you say, if your child senses your hesitation, your own fear of leaving them, they will not feel safe. How can they be safe if you're clearly scared of leaving them? Try to work through your own feelings about dropping them off before the actual day so you can be a calm presence and support.

    2. "I love you and I know you can do this."

    It's best to keep your goodbye short, even if your child is crying or clinging to you, and trust that you have chosen a good place for them to be. Most children recover from hard goodbyes quickly after the parent leaves.

    If your child is having a hard time saying goodbye, give one good strong hug and tell them that you love them and know they can do this. Saying something like, "It's just school, you'll be fine" belittles their feelings. Instead, acknowledge that this is hard, but that you're confident they're up to the task. This validates the anxiety they're feeling while ending on a positive note.

    After a quick reassurance, make your exit, take a deep breath and trust that they will be okay.

    3. "First you'll have circle time, then work time, and then you'll play on the playground."

    Talk your child through the daily schedule at school, including as many details as possible. Talk about what will happen when you drop them off, what kinds of work they will do, when they will eat lunch and play outside, and who will come to get them in the afternoon.

    It can help to do this many times so that they become comfortable with the new daily rhythm.

    4. "I'll pick you up after playground time."

    Give your child a frame of reference for when you will be returning.

    If your child can tell time, you can tell them you'll see them at 3:30pm. If they're younger, tell them what will happen right before you pick them up. Perhaps you'll come get them right after lunch, or maybe it's after math class.

    Giving this reference point can help reassure them you are indeed coming back and that there is a specific plan for when they will see you again. As the days pass, they'll realize that you come consistently every day when you said you would and their anxieties will ease.

    5. "What book do you think your teacher will read when you get to school this morning?"

    Find out what happens first in your child's school day and help them mentally transition to that task. In a Montessori school, the children choose their own work, so you might ask about which work your child plans to do first.

    If they're in a more traditional school, find an aspect of the school morning they enjoy and talk about that.

    Thinking about the whole school day can seem daunting, but helping your child focus on a specific thing that will happen can make it seem more manageable.

    6. "Do you think Johnny will be there today?"

    Remind your child of the friends they will see when they get to school.

    If you're not sure who your child is bonding with, ask the teacher. On the way to school, talk about the children they can expect to see and try asking what they might do together.

    If your child is new to the school, it might help to arrange a playdate with a child in their class to help them form strong relationships.

    7. "That's a hard feeling. Tell me about it."

    While school drop-off is not the time to wallow in the hard feelings of not wanting to go to school, if your child brings up concerns after school or on the weekend, take some time to listen to them.

    Children can very easily be swayed by our leading questions, so keep your questions very general and neutral so that your child can tell you what they're really feeling.

    They may reveal that they just miss you while they're gone, or may tell you that a certain person or kind of work is giving them anxiety.

    Let them know that you empathize with how they feel, but try not to react too dramatically. If you think there is an issue of real concern, talk to the teacher about it, but your reaction can certainly impact the already tentative feelings about going to school.

    8. "What can we do to help you feel better?"

    Help your child brainstorm some solutions to make them more comfortable with going to school.

    Choose a time at home when they are calm. Get out a pen and paper to show that you are serious about this.

    If they miss you, would a special note in their pocket each morning help? If another child is bothering them, what could they say or who could they ask for help? If they're too tired in the morning, could an earlier bedtime make them feel better?

    Make it a collaborative process, rather than a situation where you're rescuing them, to build their confidence.

    9. "What was the best part of your school day?"

    Choose a time when your child is not talking about school and start talking about your day. Tell them the best part of your day, then try asking about the best part of their day. Practice this every day.

    It's easy to focus on the hardest parts of an experience because they tend to stick out in our minds. Help your child recognize that, even if they don't always want to go, there are likely parts of school they really enjoy.

    10. "I can't wait to go to the park together when we get home."

    If your child is having a hard time saying goodbye, remind them of what you will do together after you pick them up from school.

    Even if this is just going home and making dinner, what your child likely craves is time together with you, so help them remember that it's coming.

    It is totally normal for children to go through phases when they don't want to go to school. If you're concerned, talk to your child's teacher and ask if they seem happy and engaged once they're in the classroom.

    To your child, be there to listen, to help when you can, and to reassure them that their feelings are natural and that they are so capable of facing the challenges of the school day, even when it seems hard.

    Back to School

    How to have "the talk" about sex with your kids

    Talking to your kids about sex can feel awkward, but it's a crucial part of growing up.

    Gravity Images/Getty Images

    As a parent, you may be dreading the day you have to have "the talk." But it doesn't have to be that way! Even if you're feeling anxious or awkward around conversations about sex, those conversations provide an opportunity to empower both yourself and your child, and to grow trust and understanding between you.

    We've come a long way since the time that we called sex "the birds and the bees," and thank goodness. These days, parents can talk about sex with their kids without using euphemisms or instilling a sense of fear or shame about sexuality in their kids. But if your parents didn't know how to handle these topics, chances are you don't, either. Fear not, mama—we have guidance for you.

    Here are some of the best tips for having age-appropriate conversations about sex with your child.

    Make sure your kids know that sex—and curiosity about it—is totally normal.

    In any conversation you have with your child about sex, sexuality, and bodies, it's important for them to understand that these things are normal and natural parts of life. Some parents (maybe including your own, in the past!) worry that having conversations about sex will encourage their child to engage in it sooner, and avoid these conversations entirely or frame sex as forbidden as a result.

    The good news is that the opposite is actually true. According to the Centers for Disease Control, teens who reported that they could have open, honest conversations with their parents about sex also delayed having sex longer and had safer sex than their peers. Normalizing age-appropriate, nonjudgmental conversations should start early so that by the time your children are making decisions about sex, they know they can come to you.

    Start early with conversations about bodily autonomy.

    If you have little kids, the best way to start having conversations about bodies is to talk to them about bodily autonomy. While the phrase might be too much for them to understand when they're really young, they can certainly grasp the concept: Everybody gets to decide what happens to their own body.

    Parenting presents plenty of great opportunities to talk about autonomy and consent. For instance, bathtime is a good time to talk about appropriate and inappropriate touching. If your child doesn't like hugging, or doesn't want to give someone a hug, it's important to let them know that they don't have to hug or be affectionate to anyone they don't want to—and to help them find ways to express love and affection that they are comfortable with. Throughout their life, you'll want to help your child understand they have the autonomy to decide when and how their body is touched and by who.

    Even getting dressed in the morning presents an opportunity to talk to your child about autonomy. Give them the opportunity to choose from a few different options of outfits for the day. That way, they gain a sense of independence and know that what goes on their body is their choice too (within appropriate boundaries).

    Be careful which words you use.

    While it may feel uncomfortable to some parents at first, it's important to use the correct anatomical terms for your child's body so they understand that they aren't "dirty" words, they're just factual names. Likewise, parents can sometimes give children the wrong impression by using language like "dirty" or "gross" about body parts and bodily functions. Avoid that kind of language when discussing your own parts and pieces, as well as your child's.

    This also applies to the way they touch their own body. Especially as your child enters the toddler stage, they may begin to play with themselves or touch their private parts. this is actually a great way to organically begin a conversation about consent and autonomy. You'll need to use simple language your child will understand to explain that while there's nothing wrong or bad about touching themselves, there is an appropriate time and place for masturbation. This helps reinforce appropriate social boundaries around masturbation without causing shame or embarrassment to your child. Instead of shaming a child for exploring their bodies, parents should be redirecting them and reinforcing boundaries around when it's appropriate.

    Give your child age-appropriate books about sex and hygiene—and read them yourself.

    As your child gets older, your approach to conversations about sex should adapt. While talking about autonomy and consent is appropriate at a young age, it's also the groundwork for later conversations about sex, relationships, and hygiene. Most schools begin sex education and genital hygiene lessons around fifth or sixth grade, just as kids are about to start puberty. Feel free to align your conversations with your child with what they're learning in school.

    One way to help you ease into the conversation in a natural way is giving your child educational books. Around this age I would recommend you give your children a few books including one about where babies come from and one about hygiene (It's Perfectly Normal is a great classic standby, and The Care and Keeping of You is a great option for girls, specifically). You should also read these books! Whether you need a refresh or you just want to be prepared for any questions, reading these books will help prepare you for these conversations and reduce any nervous feelings.

    Let your child know it's safe to ask you any questions they have about sex and bodies.

    As your child grows into a young adult, it's important to provide a calm, safe and welcoming environment for them to come with any questions. Whether it's questions about birth control methods or accessing protection like condoms, you want to be sure you're prepared. It may feel jarring as a parent to answer these questions, but it'll help your child grow up to be a healthy, happy adult—and sexual relationships are a natural part of that. This also may be the time where your child is also discovering new aspects of their gender or sexuality and having that foundation of trust and understanding will help them feel comfortable and capable of having those discussions with you as a parent.

    Reflect on your own discomfort around talking about sex.

    What it comes down to is that we're often just scared. As parents, we want to make the right decisions and sometimes our own insecurity and discomfort with sexual topics gets in the way. This discomfort typically stems from having a lack of education or knowledge, which leads to fear and can (unintentionally!) lead your child to feel insecure with themself. Dig deep and reflect on where your own unease is coming from. By starting small and building your child's sense of self confidence and bodily autonomy you're helping them to become a flourishing adult capable of setting boundaries and having healthy relationships later in life.

    Health + Wellness

    Experts warn that acetaminophen is NOT considered safe in pregnancy

    An international group of experts warn that the risks to the developing fetus may include reproductive and behavioral disorders.

    Lordn/Getty Images

    If you're pregnant and you have a headache or a fever, Tylenol (acetaminophen) has long been at the top of the already short list of over-the-counter medications generally regarded as safe for both mothers and fetuses.

    However, according to a study published in September 2021 in the journal Nature Reviews Endocrinology, mounting research shows that "prenatal exposure to acetaminophen might alter fetal development, which could increase the risks of some neurodevelopmental, reproductive and urogenital disorders."

    Signed by 91 scientists from across the U.S., the U.K., Canada, Australia, Brazil, Scotland and Europe, a consensus statement published in the same journal draws a hard line, recommending that "pregnant women should forgo acetaminophen use unless medically indicated."

    I've taken Tylenol during both my pregnancies. Many of my mom friends have taken it during their pregnancies. I'm sure my own mother took it when she was pregnant with me.

    Doctors and midwives often fall back on Tylenol when pregnant women come to them looking for pain relief. But now, that's no longer a failsafe protocol.

    Potential risks to the fetus from Tylenol in pregnancy

    Performing a review of the most recent literature, the researchers found that acetaminophen exposure during pregnancy may be associated with reproductive and neurobehavioral abnormalities in both boys and girls.

    In boys, exposure may increase the risk of reproductive abnormalities, including a higher risk of undescended testicles, and a reduced distance between the anus and the base of the penis, (termed the anogenital distance). Both of these factors may indicate "altered masculinization" and the potential for other reproductive disorders later in life.

    In girls, prenatal acetaminophen exposure is associated with early puberty.

    In both sexes, studies suggest exposure might increase the risk of attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, language delay and decreased intelligence quotient (IQ).

    Figure 1 from Paracetamol use during pregnancy — a call for precautionary action.

    More research is needed to assess the timing, duration and dosage of acetaminophen usage, but numerous animal studies also back up these findings.

    In rats, fetal exposure to acetaminophen has been shown to also cause reproductive disorders, reduced fertility later in life and changes in cognitive function and behavior.

    Figure 2 from Paracetamol use during pregnancy — a call for precautionary action.

    It's unclear at what dosage Tylenol is harmful, but the strongest negative effects were observed with long-term use of acetaminophen (more than 2 weeks). If you happen to take it once or twice during your pregnancy at the minimum dose, you're much less likely to see such drastic repercussions.

    Tylenol use is widespread

    Acetaminophen is one of the most commonly used medications around the world—and it's often used in the general population without even a second thought. It's included in hundreds of other medications, including cough syrups, flu medicines, allergy medicines and sleep aids. It's often presumed benign, even though it's one of the major contributors to liver disease in the U.S. each year, writes doctor and midwife Aviva Romm, MD on a blog post about the safety of Tylenol in pregnancy.

    Approximately 65% of pregnant women in the U.S. are estimated to have used Tylenol, and globally, more than 50% of pregnant women are expected to have used it (where it's widely known as paracetamol). Those statistics are also probably underreported. "One study showed that when asked about pharmaceutical use, many pregnant women did not report [acetaminophen] unless specifically asked," note the researchers.

    The authors of the study acknowledge that acetaminophen "is widely considered to be the safest option for relief of pain and fever in pregnancy." And in fact, it's often the only option touted by healthcare professionals for their pregnant patients.

    The researchers cite acetaminophen as an endocrine disruptor, saying it is known to "readily cross the placenta and blood-brain barrier," making its way to the fetus—with potentially harmful effects.

    Now, given the growing body of evidence, it's time for increased awareness. The consensus statement calls on regulatory agencies, obstetrics and gynecological associations and healthcare providers to review the most recent research and reconsider their recommendations.

    But where does that leave pregnant women dealing with pain in the meantime?

    Pregnant women need pain management solutions

    Clinical trials on the pregnant population are notoriously lacking (not without reason—performing studies on pregnant women can be ethically fraught), and pain during pregnancy is especially understudied. However, we do know that severe pain during pregnancy, left untreated, could have dangerous consequences for the mother, including an increased risk of anxiety, depression and high blood pressure.

    And if you happen to get a fever above 100.4º during pregnancy, reducing it is your best course of action, as prenatal fever is associated with an increased risk of neural tube defects and cardiovascular disorders in the fetus.

    But other pain management options are limited—or nonexistent. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen come with an increased potential risk of miscarriage in the first half of pregnancy, as well as birth defects. Aspirin carries a risk of bleeding risks, and opioids come with serious risks of birth defects in the brain, spine or spinal cord.

    More research—and more options—are needed.

    Pregnant women should avoid acetaminophen

    The study's authors outlined a specific course of action, recommending that women be advised pre-pregnancy or early in pregnancy with the following guidance:

    • Pregnant women should forgo acetaminophen use unless medically indicated.
    • Pregnant women should consult with their physician or pharmacist if they are uncertain whether use is indicated and before using on a long-term basis.
    • Pregnant women should minimize risk by using the lowest effective acetaminophen dose for the shortest possible time.

    This is a major departure from the previous guidance of acetaminophen as generally accepted as safe. But if you've used Tylenol in a previous pregnancy, don't lambast yourself with mom guilt—you did the best you could with the information you had at the time.

    "The chances are, statistically speaking, still low that this will have any impact on your baby. And for fever and significant pain, it's still considered the safest prenatal option. But we can't just assume it's safe and it can have an impact, so the goal is to avoid it when you can and keep your duration of use as brief as possible," writes Dr. Romm on her blog.

    What to take instead of Tylenol during pregnancy

    If the idea of even taking one Tylenol pill gives you pause, know that there are a few alternative remedies safe for pregnancy that can be used for mild pain. For fever reduction, however, given the potentially dire consequences of high, prolonged fever itself during pregnancy, taking a Tylenol to reduce the fever is still probably your safest option—talk to your doctor to discuss details.

    Headache reduction alternatives:

    • Hydration: In some cases, a headache is the body's way of signaling that you're dehydrated. Try upping your water intake, or sipping some cold coconut water, which packs in electrolytes.
    • Protein and fat: You could be missing key nutrients in your diet—try rounding out your meals and snacks with more protein and plant-based fats to balance blood sugar.
    • Magnesium: Taking 400 to 800 mg/day of magnesium glycinate or citrate can help relieve tension headaches and improve the stress response.
    • Massage: Neck and shoulder massage can help release tension and reduce the resulting headaches.
    • Stress management: Deep-breathing techniques may help reduce stress-based headaches.

    Be sure to get your midwife or doctor's tips on headache management, too, and to discuss the frequency and duration of the headaches you're experiencing. If a headache comes on suddenly and severely, or you experience any vision changes, call your care provider right away.

    But ultimately, as the study's authors state, "A balance must be struck between potential harm to pregnant people and/or their fetuses from untreated pain and fever, and the increased risks of harm to the fetus from medications." When thinking about using Tylenol or any other medication during pregnancy, it's all about the risk-benefit analysis. But being more informed about the risks can make a significant difference when you're weighing the scales.


    Bauer AZ, Swan SH, Kriebel D et al. Paracetamol use during pregnancy—a call for precautionary action. Nat Rev Endocrinol. 2021. doi:10.1038/s41574-021-00553-7

    Caution needed: paracetamol use in pregnancy. Nat Rev Endocrinol. 2021. doi:10.1038/s41574-021-00567-1

    F.D.A. Safety Announcement: Drug Safety Communications. FDA has reviewed possible risks of pain medicine use during pregnancy. January 9, 2015.

    Womens Health