Adderall IR timing and stability for exclusively pumping mom

[Afgood]

Hello,

I have contacted Infant Risk by phone and read Dr. Hale's book as well as LactMed. I am an NP, so I have some medical training. There are a few aspects of drug entry into milk and transfer to the infant that I do not understand, and I am hoping for clarification.

I am exclusively breastfeeding a 12 week old female infant who was born full term. I switched to methylphenidate knowing the RID is lower, but I was experiencing side effects that I did not with Adderall. I recently switched back to Adderall IR; I take 15 mg daily or 7.5 mg BID with doses 4 hours apart.

I am also an exclusive pumper and an overproducer. I make about 50 - 60 ounces of milk per day. I weight about 50 kg and have always been petite.

I know what to watch for in baby: agitation, insomnia, hyperactivity, restlessness, poor eating, etc. She may be a little fussier since the switch but I'm not sure. I've read Hale's statement this drug is transferred avidly into human milk, so I'm trying to minimize her dose.

My questions are:

If I take doses at 8am and 12p but only feed her milk I pumped between 7p and 7a, does that decrease the dose she receives and if so, by how much approximately?

If I feed her milk that has been pumped and then refrigerated for a few days, might the drug be less stable in that milk and therefore affect her less?

Or should I just avoid feeding her milk I have pumped within 3 - 4 hours of a dose?

Thank you for considering my inquiry,

Amanda

[admin]

Amanda:

If I take doses at 8am and 12p but only feed her milk I pumped between 7p and 7a, does that decrease the dose she receives and if so, by how much approximately?

--Yes, significantly, but I can't tell you how much. No one really knows.

If I feed her milk that has been pumped and then refrigerated for a few days, might the drug be less stable in that milk and therefore affect her less?

--No, refrigeration does nothing to this drug. This drug is quite stable.

Or should I just avoid feeding her milk I have pumped within 3 - 4 hours of a dose?

--This is a good suggestion in one respect. Works well with methylphenidate (Ritalin), less so with longer half-life Adderall which has a 11 hour half life. But even a 4 hour wait would reduce levels of Adderall.


Tom Hale Ph.D.