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Adderoll for ADHD while breast feeding

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  • #16
    vlongley:

    I'd suggest you go ahead and try breastfeeding while taking the adderall. Most infants do just fine as the levels in milk are somewhat low. See all the posts above. I'd suggest you try it and simply observe your infant for signs of agitation, insomnia, and poor weight gain.

    Tom Hale Ph.D.

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    • #17
      I'm breastfeeding twice a day a 26pound 14 month old. (She's at daycare for 8-10hrs and not breastfeeding during that time). Is it safe for me to take 5-10mg of adderall 8hrs before breastfeeing? I also breastfeed her in the morning and that would be 22hrs after I took the 5mg of adderral. Is it life threatening if I where to take aderral and then breastfeed? How long should you wait after taking adderral before breastfeeding?

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      • #18
        Dear bellablu,

        Dextroamphetamine (Adderall) apparently transfers into milk avidly. Of the 6 infants studied thus far, no untoward effects have been reported in any infant. If this product is used in breastfeeding mothers, the dose should be kept low, and infants should be monitored for agitation, and poor weight gain.

        It has a half life of 6-8 hours, by that time half of the drug will be out of your system. The maximum plasma concentration (time when the medication is highest in your system) is achieved 1-2 hours after you take the medication. I think what you are doing is probably okay, just keep observing your child for agitation and poor weigh gain.

        Tassneem Abdel Karim, MD
        InfantRisk Center

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        • #19
          I was prescribed 10mg adderall xr today. I am still breastfeeding my 22 lb 13 month old about 2-4 times a day. Should I be okay to take this medication if I reduce the number of times I breastfeeding to bed time?

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          • #20
            Go ahead and try breastfeeding on your normal schedule. Toddlers get much less milk per day in relation to their body weight as compared with infants, and they are better able to tolerate incidental medication exposure. Just watch your child for signs of significant insomnia, agitation, or poor weight gain. If that happens, cut back on breastfeeding first before you consider changing medications. Most of the benefit of breastfeeding is achieved in the first 6 months, so by now the benefit of a stable and effective drug regimen is more likely to outweigh that of breastfeeding.

            -James Abbey, MD
            Last edited by admin-james; 07-17-2014, 01:08 PM. Reason: Typo

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            • #21
              Adderoll and Vyvanse while nursing

              Hi I am a Mom of a very demanding little boy who co sleeps with me and nurses 3 to 4 times a day and maybe 3 or 4 times at night. I need ADHD medicine. This is my first time ever taking any meds and I have had ADHD my whole life. They started me on the Kremers generic of Concerta extended release and within 3 days I broke out in hives. I was also taking 800 mg of Ibuprophin at the same time. The doctor says it must be the Concerta causing the rash since I've been using Ibuprophin before and never had a reaction. She prescribed Vyvanse but the pharmacy says its not safe. Can you help? I don't want to have to stop or limit breastfeeding. Is there anything else I can take if not this drug? Thank you. I haven't started it yet because not sure if its 100 percent safe.
              God Bless,
              littlemama07

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              • #22
                Hi Littlemama07, thank you for your question.

                There have been just a couple of clinical studies regarding Vyvanse and breastfeeding. They have shown that the infant gets about 2-6% of the mother's dose in the milk, assuming that she breastfeeds normally. There were no side effects reported in the infants that were exposed to that level of medication. However, those studies were small and may not apply to every baby. Here are a few things to consider:

                1. The risk of any medication exposure drops dramatically after the baby is older than about 6 months. As babies grow up, they consume much less breastmilk relative to their body weight than a neonate, and their ability to process medications approaches that of an adult.

                2. You may be able to take the Vyvanse less frequently than prescribed; however, if you find that your ADHD is not well controlled, you should take your meds more frequently. Remember that your quality of life is important too!

                3. We give Vyvanse an L3 (out of 5) ("probably compatible") with regards to it's lactation safety, largely due to the limited data available. Other medications in the same family, such as methyfenidate (Concerta, Ritalin) and dexmethylfenidate (Focalin) are better studied and we give them an L2 ("probably safe"). If any of these medications work for you, they may be better options while you are breast feeding. Talk to your doctor about it. Side effects for all of these drugs, including Vyvanse, are agitation, insomnia, and poor weight gain in an infant. In the absence of these symptoms, you can consider the medication safe for your situation. There are no "hidden" dangers of ADHD medications that we know of.

                Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

                -James Abbey, MD

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                • #23
                  Handling Adderall

                  My daughter is nursing. Her son is on adderall and she often holds it in her hand waiting for my grandson to come to her to take the medication. Can Adderall be absorbed through the skin and harm her baby she is breastfeeding?

                  Concerned grandma

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                  • #24
                    Hi, thanks for your post.

                    The question of whether Adderall can be absorbed through the skin has not been specifically studied. However, it is very unlikely that she would absorb enough to make any difference. Very few medicines are known to pass through the skin and most tablets have a thin coating on them to prevent the drug from getting all over you when you handle it. Many mothers who take Adderall themselves have successfully breastfed their children without problems. Your daughter should wash her hands before handling her child.

                    Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

                    -James Abbey, MD
                    Last edited by admin-james; 11-17-2014, 08:36 AM. Reason: Typo

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                    • #25
                      Thank you

                      To the doctors who have responded to all the previous questions and to the nursing mothers who have asked questions, thank you so much. I am so appreciative of this service.

                      I was diagnosed with ADHD 13 years ago and took Adderall IR for nine years successfully. After consulting with my psychiatrist and OB, I continued my dose (10 mg 1-2x/day) from weeks 16-36 while pregnant. I haven't taken it since my baby was born.

                      Now I am still nursing my 22-pound eight-month-old. He eats solids, but only 1-3T/day. I am having some trouble at work and so I was considering renewing my prescription. I got the go-ahead from my psych, OB, and pediatrician, consulted Hale's, and called Infant Risk, and I am now feeling confident that I can take nurse at 7:30 am, take my 10 mg at 8, pump at 10:30 and dump (to maintain supply), then pump at 2 and 4, and nurse at 6 and 8 pm with likely no ill effects (though of course watching my baby for poor weight gain, agitation, or insomnia).

                      Is there any research of how Adderall might cause a drop in supply?

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                      • #26
                        There is not published research examining Adderall or other amphetamines and its effect on milk supply.

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                        • #27
                          Anxiety meds and adhd meds

                          Hi I have a 9 week infant who I exclusively breastfeed. I also have adhd and anxiety which I did not medicate while pregnant or trying to conceive so it's been over a year without any medications. I think I need to restart them and will be talking to my physician. I've previously taken sertraline for anxiety and also concerta and adderal for adhd. Which of these ADHD meds would be safest while breastfeeding and is it safe to start anxiety and ADHD meds at same time or would it be better to start one and then add in the other one? Also would doing weight checks with baby be a good idea while starting medications?

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                          • #28
                            Hi, thanks for your post.

                            Concerta and Adderall are about the same in terms of breastfeeding safety. If the side effects are tolerable, there should be no problem with starting all of your meds at the same time. Monitoring your child's weight is a good idea; once every month or two should be enough.

                            Please post again or call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

                            -James Abbey, MD

                            Comment


                            • #29
                              My daughter is 9 months around 18 pounds. She gets half breastmilk and half formula through the day. I did not take my adderall while pregnant or the beginning of breastfeeding. Up to about 4 months I wasn't. I began taking it because I was sick of thinking about whether or not I could or should and even after l the research I did I couldn't get a straight answer. I was on 40 mg (20 mg 2x) before I found out I was pregnant. I immediately stopped. When I did start taking it it was only 10 mg sometimes 15 and I would pump and dump the next few feedings usually until next morning or if she nursed overnight. Gradually I would increase because I have a high tolerance for medication and 10-15 wasn't helping me. So I ended up taking 30-35 with the same pump and dump method I had been doing. I would take my adderall after pumping at 1030-11 at work then I wouldn't feed her until 8. I am aware of the 2-7% getting into breastmilk and I have monitored her and have shown no signs of insomnia (she sleeps 8 every night til 6-7 in the morning) and she eats just fine. Lately I've been feeling guilty because even though I don't notice signs, i don't know that I'm not doing more to my child's development so I've started dumping even the 8 o'clock feeding I pump because I'm concerned. Adderall improves my mood, my focus, my performance at work and I'd like to continue it. Is taking 30-40 mg too high of a dose? & if I take it at 11-12 in the morning, when would be the best time to keep her next feeding? (I exclusively pump)

                              Aside from that, my BIGGEST question that I can't seem to find an answer to is can the baby get serious side effects (behavior issues, mental issues, it mess with their brain development, etc) or is it not enough to effect the baby that seriously? I do know when adults take it that sometimes those are the side effects. I'm truly just trying to find a balance here. I feel selfish and I went as long as I could not taking it and I Don't want it to seem like I'm choosing the medication over breastfeeding my baby. I just want to be able to give her my best and with that I think the medicine does help in some ways.

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                              • #30
                                Adderall

                                Kjl1120, thanks for posting,

                                Adderall has a half-life of about 10-11 hours. A normal adult dose is 5-60mg a day. We do recommend with breastfeeding to try and keep the dose low at about 20mg or less a day if possible. In your case your infant is a little older and probably eating other foods at this point and would not be receiving as much breast milk as a newborn would be relative to their weight. Since you are exclusively pumping and are able to wait several hours to pump and save your milk reduces the amount of medication the infant will receive. The fact that you have not seen any side effects in your infant means they are probably not receiving enough of the medication to cause them any harm. We would suggest if your infant is gaining weight, sleeping well, and not overly excited it is probably ok to continue as you have been in regards to breastfeeding.

                                I hope this helps if you have any other questions please call the InfantRisk Center at 806-352-2519. Thanks,

                                Sandra Lovato R.N.
                                InfantRisk Center

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