Breastfeeding and Adderall

[NewMommy]

I was recently advised by my PCP to restart Adderall 20mg IR BID and to stop breastfeeding my seven month old son. Since making this decision over a week ago, I have deeply regretted my choice and wish to breastfeed again. I spoke with a lactation consultant who explained that there wasn't much research on the situation but stated that the benefit of breastfeeding while taking this medication outweighed the risks. She also told me that I should try Ritalin instead of the Adderall. My milk supply is very low because I was giving my son formula over the course of the past week. I feel guilty for taking the medicine and don't want to harm my seven month old by breastfeeding him while taking the RX. I also have some Reglan to help boost my supply but was unsure of whether to take this with the adderall. Thank you in advance for your help.

[admin]

Dear NewMommy

Dextroamphetamine (Adderall) is compatible with breastfeeding in clinical doses. In the studies that have been done, none of the infants demonstrated untoward effects. However your infant should be monitored for agitation and poor weight gain. Please note, that if you are using the continuous release formulations (Adderall XR), plasma levels are virtually identical to the twice daily dosing system. Furthermore the XR formula has a Tmax (time when concentrations are highest) of 2.5 hours, so avoiding breastfeeding your infant for 2.5 hours after your dose will decrease the amounts he gets. Generally your infant will get 1.8-6.9% of your dose.

An alternative medication that has a lower relative infant dose in breastmilk is methylphenidate (Ritalin or Concerta). Methylphenidate is preferred during breastfeeding as the relative infant dose is less than one percent of maternal dose but certainly dextroamphetamine may be used if doses are kept low.

Metoclopramide (Reglan) effectively elevates plasma prolactin levels in breastfeeding patients, in those with predisposing lower levels, this increase may increase milk synthesis. In those patients with already high levels (>100 ng/mL), metoclopramide may not work. Therefore, i would suggest having your prolactin levels checked, before using Reglan. If your prolactin level is already high, Reglan will not help.

Please call us at the InfantRisk Center if you have further questions. Our phone number is 806-352-2519.

Tassneem Abdel Karim MD
InfantRisk Center

[johnwan980]

THanks, I was also searching for this.