Confused about Ritalin transfer into breast milk and breastfeeding timing

[Isabelle717]

I am currently nursing a 3 month old twice a day: once in the late morning and once in the evening before bedtime. The 2 nursing sessions end up being 8 to 10 hours apart, and I do not typically nurse or express any milk in between the two sessions. I take 40mg of Ritalin IR right after my morning nursing session and then do not nurse or express my milk until the evening session (8 to 10 hours later).

According to the data available, I understand that very little Ritalin actually makes it into breast milk, even at times of peak maternal plasma levels; however, I'd like to minimize infant exposure as much as possible. My question: is it known whether or not the drug accumulates in breast milk? So if I don't feed or express any milk for 8 hours after my dose, will there be significant drug in the breast milk that has been accumulating in my breasts for 8 hours?? Or is the drug filtered out of the milk that is accumulating in my breasts as it's metabolized by my body? Would you recommend expressing and discarding milk sometime during peak plasma levels or is it okay to wait and nurse about 8 hours after my dose? Thank you for your time!

[Sandra]

Isabelle717,

Ritalin peaks at 1-3 hours and has a half-life of 1.4-4.2 hours. The amount transferred into breast milk is only 0.2-0.4% of your dose. It is not necessary to pump and dump your milk between feedings with this medication. With most medications as the levels rise in the maternal plasma they also rise in the milk compartment then as the medication begins to fall out of the plasma compartment equilibrium forces the medication out of the milk compartment back into the maternal plasma compartment for elimination. Only ion trapping drugs need to be pumped out of the milk, and Ritalin is not an ion trapping medication.

Sandra Lovato R.N.
InfantRisk Center
806-352-2519