Confused?

[starluna]

hello!

Before I was pregnant I took 20mg Adderall daily and it would work great, some days i would crash really hard only because of the certain time i tok it, but soon i found out i was pregnant i had to stop....
I currently take ritalin 20mg 2-3x daily i do breastfeed. My son is 15 months old and he's in perfect health. i convinced my dr to put me on ritalin 10mg 3x a day when he was 8 months old due to the fact i was having issues in school, but it started to ware off instantly, no longer was 10mg every 4-5 hours lasting. So I asked to bump it up to 20mg and he advised me I had to quit breastfeeding to receive the script, so i said yes, BUT it has been hard for me to quit. I have been taking it and breastfeeding and nothing has changed for the past month. I usually only take about 40mg a day, but again its starting to wear off instantly. I know its because its not extended release. my question is, is it possible to get back onto adderall without it affecting my BF son? or what other options do i have? I just am going to school still and If I'm gong to crash as hard as i have been from the ritalin, i need to find new options. I have noticed that he has been breastfeeding less if that helps any advice.

[admin-james]

Hi, thanks for your post.

Adderall XR 40mg per day is reasonably safe while breastfeeding, as long as you are using it as prescribed. We give Adderall an L3(out of 5)("Probably Safe") with regards to its lactation safety. Toddlers get much less milk per day in relation to their body weight as compared with infants, and they are better able to tolerate incidental medication exposure. Just watch your child for signs of significant insomnia, agitation, or poor weight gain. In the absence of these symptoms, you can consider the medication safe for your situation. There are no "hidden" dangers of ADHD medications that we know of.

If your child does develop these symptoms, cut back on breastfeeding first before you consider changing medications. The benefits of breastfeeding, while still significant, begin to decline after the baby is about 6 months old. The benefits of an effective drug regimen, to both you AND your baby, will someday exceed that of breastfeeding. How early you get to that point depends on what meds you end up taking and how sensitive your baby is to the small amounts that he gets through the breastmilk. Talk to your doctor about a trial of Adderall to see how it fits into your situation.

Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

-James Abbey, MD
and
-Thomas W. Hale, Ph.D.

The following references may be useful to your physician if he or she needs more information:

1. Steiner E, Villen T, Hallberg M, Rane A. Amphetamine secretion in breast milk. Eur J Clin Pharmacol 1984; 27(1):123-124.
2. Ilett KF, Hackett LP, Kristensen JH, Kohan R. Transfer of dexamphetamine into breast milk during treatment for attention deficit hyperactivity disorder. Br J Clin Pharmacol 2006; 63(3): 371-375.