At the International Breastfeeding Institute, we emphasize the importance of clear scope of practice and evidence-based education. Many of us have heard a lot about Tylenol and autism in the media.
Whether you are working as a doula, Certified Breastfeeding Counselor (CBC), or other perinatal support professional, understanding your scope of practice is essential.
How do CBC’s address questions about Tylenol during pregnancy, given to infants, and autism?
Education vs. Medical Advice
First and foremost: we never provide direct medical advice.
Our role is to share accurate, evidence-based information and guide families back to their healthcare providers for individualized recommendations.
For example, if a parent asks whether a medication is safe during pregnancy or lactation, the proper response is to provide information from established guidelines and then refer them to their midwife, OB, or pediatrician for final guidance. The same goes for question about medication for infants.
What Counts as Evidence-Based Information?
Evidence-based information is more than personal experience or opinion—it is knowledge supported by:
- Reputable researchers
- Peer-reviewed studies
- Recommendations that have shaped clinical practice guidelines
Clinical practice guidelines are published by recognized professional bodies such as:
- ACOG – American College of Obstetricians and Gynecologists
- ACNM – American College of Nurse-Midwives
- WHO – World Health Organization
- Academy of Breastfeeding Medicine
- Infant Risk Center
These organizations review the best available evidence to issue safe and effective recommendations for information about medication during pregnancy, lactation, and infancy.
How to Talk About Conflicting Information
In breastfeeding and perinatal care, parents often encounter conflicting advice. Opinions from practitioners, case studies, and smaller research trials can be valuable. However, they don’t carry the same weight as clinical guidelines.
The key is to be transparent. You might say:
“The Infant Risk center recommends X. Another practitioner has suggested Y, based on smaller studies or their clinical opinion. If you’d like to know what this means for your care, I encourage you to ask your provider.”
This approach respects families’ need for context while ensuring you remain in scope.
Example: Acetaminophen During Pregnancy
When asked whether acetaminophen is safe, you could respond with something like:
“That’s a great question. ACOG and ACNM continue to recognize acetaminophen as a first-line safe option for treating fever and pain during pregnancy when used as directed. Some smaller studies suggested a possible correlation with certain outcomes, but when researchers adjusted for genetics and sibling factors, the correlation disappeared. For your care specifically, your midwife or doctor can give you the best guidance. If you’re wondering if it is safe to give an infant, current guidelines say it is when used as directed, but you should talk to your child’s doctor for individual guidelines and dosing.”
Notice the difference: you are not telling parents what to do. You provide reputable evidence and redirect the final decision to their provider.
Tylenol and Autism – How to Read a Paper
At IBI, we encourage our students and professionals to go beyond surface-level information. For instance, our Childbirth Educator students read How to Read a Paper—a resource that strengthens their ability to understand and evaluate research studies.
Knowing the difference between study types is also valuable. While double-blind randomized control trials are considered the “gold standard,” they are often not conducted in pregnancy or lactation due to ethical concerns. Instead, most research relies on retrospective studies, and large meta-analyses often provide the clearest understanding of actual risks.
Even if research interpretation feels overwhelming, it is always acceptable—and often most professional—to say:
“That’s outside my scope, but your provider can help you with that decision.”
Final Thoughts
As Certified Breastfeeding Counselors, we serve families best when we:
- Provide evidence-based education
- Stay within our professional scope
- Acknowledge limits in research and personal expertise
- Always refer clients back to their providers
By honoring these principles, we maintain professional integrity, build client trust, and strengthen the credibility of the entire breastfeeding support community.