Adderall

[APG]

I was on Adderall for 10 years prior to my pregnancy and I stopped taking it upon learning I was pregnant. My son is now 6 weeks old and I am considering resuming my treatment on an as-needed basis (for very specific projects at work that require me to be extremely focused and detail-oriented). If I take 20mg of Adderall (not XR) how long should I wait to breastfeed? I would like to be conservative to insure my son does not receive any of the medication. I am currently supplementing and my son does very well transitioning from bottle to breast and vice versa. Also, is it necessary to "pump and dump" in the meantime? Thank you for your feedback.

[admin]

APG:

With the limited data we presently have, I'd suggest you go ahead and breastfeed first starting at a low dose and ramping up over time. Just observe your infant for excitement, poor appetite and insomnia. If you note these, then you'll know what's causing it and you can withhold breastfeeding for maybe up to 6 hours or more. The amount that gets into milk ranges from 1.8% - 6.9% of mom's dose. This is still relatively low.

As with other stimulants, we advise to simply watch your infant closely for excitement and insomnia and anorexia. Any of these problems, you know what to do.

Tom Hale Ph.D.




Dextroamphetamine is a potent and long-acting amphetamine. Following a 20 mg daily dose of racemic amphetamine administered at 10:00, 12:00, 14:00, and 16:00 hours each day (total= 80 mg/day) to a breastfeeding mother, amphetamine concentrations were determined in milk at 10 days and 42 days postpartum. Samples were taken at 20 min prior to the 10:00 hour dose and immediately prior to the 14:00 hour dose. Milk levels were 55 and 118 ?g/L respectively.[1] Corresponding maternal plasma levels were 20 and 40 ng/mL at the same times. Milk/plasma ratios at these times were 2.8 and 3.0 respectively. At 42 days, breastmilk levels of amphetamine were 68 and 138 ?g/L while maternal plasma levels were 9 and 21 ng/mL respectively. Milk/plasma ratios in the 42-day samples were 7.5 and 6.6 respectively. Although the milk/plasma ratios appear high, using a daily milk intake of 150 mL/kg/day, the relative infant dose would be only 1.8% of the weight-normalized maternal dose, which probably accounts for the fact that the infant in this study was unaffected.

In another study of 4 mothers who received 15-45 mg/day dextroamphetamine, the average absolute infant dose was 21 (11-39) ?g/kg/day.[2] The authors suggest the relative infant dose was 5.7% (4-10.6). Plasma levels in the infants ranged from undetectable to 18 ?g/L. No untoward effects were noted in any of the 4 infants.