Adderral and breastfeeding 27 month old

[MD1]

Hi! I'd like information on any potential hazards in breastfeeding a 27 month old child while on Adderral. I'm contemplating going back on this drug, 10mg one or two times a day. I BF my daughter upon awakening (6-6:30), at a nap (around 11:30) and at bedtime (7:30-8). She also sleeps next to me so she feeds numerous times at night. Due to her age and my relatively low milk production, the night feedings probably only amount to 1-2 feedings.
I'm very concerned about any neurological damage the exposure to this drug may cause on a developing brain! Are there any studies that have been conducted? If i do choose to restart this drug, what is the best way to minimize her dose and what would her approximate dose be? Is it worth the risks?? I've tried other drugs (Ritalin) for my ADHD and they don't work well for me. Thank you as always for your professional help and insight!

[admin-james]

Hi, thanks for your post.

We have a statement about ADHD meds like Adderall on our MommyMeds site. The short version is that these meds are low-risk for breastfeeding mothers. Very little gets into the milk and there is no evidence in the literature that they cause any sort of long-term damage or developmental problems. In your situation, the risks are even lower because children that age get much less milk relative to their body weights than infants.

http://mommymeds.com/content/adhd

Give us a call if this hasn't completely answered your question.

-James Abbey, MD
InfantRisk center

[MD1]

Thank you very much for this information. I have one further question that was unresolved when I contacted Infantrisk. In an online article in ADDitude magazine entitled Women, Hormones and ADHD, it states that children who are breastfed by mothers taking stimulant medication are at higher risk for addiction problems later in life. This is very concerning. Can you please comment on this? Thank you!

[admin-james]

I looked up the ADDitude article and found that this statement is a single line without a citation. An extensive review of the medical literature has failed to turn up a single study which examines that specific situation. There are several studies of women who abuse illicit amphetamines either during pregnancy or breastfeeding, and whose children have adjustment issues and an increased risk of addiction behavior. These studies are unable to differentiate between the chemical effects of the drugs and the social effects of being a drug-addicted parent.

Having completed this review, we maintain our position that stimulant medications for ADHD, when taken as prescribed, are of low risk to a breastfeeding infant. Parental dysfunction from inadequately treated ADHD can have significant negative ramifications for a child's care and behavioral development. The benefits of breastfeeding are highly likely to exceed the risks of incidental stimulant exposure through the milk.

-James Abbey, MD
InfantRisk Center