ADHD Medications and Breastfeeding
- Jamie Sorenson
- Sep 2
- 2 min read
Here’s some helpful information on ADHD medications and breastfeeding, which is a topic of great importance for many birthing parents navigating the complexities of managing their health while nurturing their infants.
Methylphenidate: This medication is known for its effectiveness in managing ADHD symptoms and is characterized by its very low levels found in breast milk. No adverse events have been reported in infants.
Amphetamine salts: Similar to methylphenidate, amphetamine salts are detectable in breast milk, but at low amounts. No adverse events have been reported in infants who were exposed to this medication through breastfeeding.
We have far less data about the use of long acting formulations in breastfeeding. Typically, if mother has been stable on her medication for a very long time, it's lower risk to continue their medication because the risk of relapse, injury, job loss, and mood episodes is so high for women with ADHD.
Mama's dose matters significantly. For instance, a dosage of 5 mg daily poses a considerably lower risk compared to a higher dosage of 60 mg daily. In my experience, many birthing parents prefer to take short-acting options at lower doses, especially at the end of pregnancy and beginning of postpartum. This approach not only helps in effectively managing ADHD symptoms but also allows mothers the flexibility to lay down and take necessary naps when needed, which is crucial for their overall well-being. Additionally, many patients opt not to take the medication every day, which is perfectly acceptable with stimulant medications. However, I do encourage birthing parents to consider taking their medication when driving, as the risks of car accidents can increase due to ADHD symptoms and the potential for sleep deprivation.
Stimulants may also have an impact on prolactin levels, which is hormone that stimulates milk production. There is a notable degree of cross-tolerance between stimulant medications and Sudafed, a common over-the-counter medication often taken to reduce breast milk supply. For mamas that have their hearts set on chestfeeding, I usually recommend waiting until their supply (3-5 days postpartum) comes in before taking the stimulant medication due to risk of suppressing milk production. If mama is on the fence about breastfeeding, it’s better for her to do what she feels is best for her overall wellbeing.
The age of the baby is another critical factor to consider. Newborns are generally more sensitive to medication exposure compared to older infants, such as those who are 9 months old and are consuming both milk and solid foods. Moreover, if the baby is not exclusively breastfed, this can further reduce their exposure to any medication present in breast milk. It is important to reiterate that, so far, no adverse events have been reported, underscoring the need for personalized approaches based on individual circumstances.
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