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Drug Info Maternal Matters

Can you take Adderall while breastfeeding?

Data is limited, but there is no evidence of adverse effects for infants
Wendy Wisner
By | Jun. 4, 2024 Medically reviewed by Kimberly Bowman, MD
baby bottle next to a capsule - Adderall and breastfeeding

Key takeaways

  • There is very little data about the safety of taking Adderall while breastfeeding.

  • Still, there have been no reports of adverse effects among mothers who take prescription ADHD stimulants.

  • You should never take Adderall while breastfeeding unless your healthcare provider prescribes it.

In this article:

Adderall (dextroamphetamine-amphetamine) is a central nervous system stimulant that’s primarily used to treat attention deficit hyperactivity disorder (ADHD) in children and adults. It’s also sometimes used to treat narcolepsy in adults and children ages 12 and older. Many expectant moms take medications for their mental health and physical well-being during pregnancy. If you’ve been prescribed this medication while pregnant or postpartum, you may be wondering: Can you take Adderall while breastfeeding?

The answer is complicated. There isn’t robust research about the safety of Adderall while breastfeeding. However, there’s evidence that when medications like Adderall are prescribed carefully by a healthcare provider, the risk to breastfed infants is low. Your provider can help you determine if the potential benefits outweigh any possible risks.

RELATED: Is it safe to take Adderall during pregnancy?

Can you take Adderall while breastfeeding?

Adderall is widely used to manage ADHD symptoms. One study found over 4% of female adults take a stimulant like Adderall. This type of medication is a pregnancy category C drug, meaning that animal studies have found that the drug negatively affects fetuses. Recent studies have found that taking ADHD medicine in pregnancy is linked to an increased risk of congenital disabilities.

But what about breastfeeding and postpartum? The research among breastfeeding mothers is somewhat less clear. “There is unfortunately not much research on the use of amphetamines, such as Adderall, during lactation and breastfeeding,” says Jessica Madden, MD, pediatrician, neonatologist, and international board-certified lactation consultant (IBCLC).

Based on the data currently available, when medications like Adderall are cautiously prescribed in normal dosages for ADHD, the amount that gets passed to breastfeeding babies is small and not likely to cause serious side effects, Dr. Madden says. “So if a breastfeeding parent is on prescription Adderall prior to breastfeeding, I think it’s okay to continue on it during lactation,” Dr. Madden says. “But I would hesitate to start it for the first time when a parent is breastfeeding and explore alternative treatment options for ADHD instead.”

In general, it’s important to be very cautious with Adderall while breastfeeding and to keep in mind that the drug does pass into breast milk. But, the amount that passes into breast milk is small, and no studies have shown adverse effects on infant growth and development, says Kelli Daugherty, ARPN, CNM, an advanced practice registered nurse and certified nurse midwife at OSF HealthCare.

Many people assume that taking prescription medication while breastfeeding is an automatic “no.” Yet, according to the CDC, most medications are safe to take while breastfeeding. This is because, although all medications pass into breast milk, most do so at low enough levels that they won’t cause harm in breastfed infants.

Most providers do a risk-benefit analysis with breastfeeding mothers to determine which medications to prescribe. They assess factors like the transfer of drugs into milk, how it might affect the baby, the baby’s age, and how necessary the medication is for the mother’s physical and mental health. “Mental health is also important, and medications like this should not be stopped abruptly without being monitored by a provider,” Daugherty says. “Parents who need Adderall may struggle with activity and emotions without it.”

How long should I wait to breastfeed after taking Adderall?

It’s not known exactly how long Adderall stays in your system after you take it, Dr. Madden says. It depends on your metabolism and which type of stimulant medication you are using—immediate release or extended release, according to the Massachusetts General Hospital Center for Women’s Health.

Immediate-release stimulants tend to peak in breast milk one to two hours after being taken. Extended-release preparations tend to increase incrementally and stay elevated for about six to eight hours.

To minimize your infant’s exposure, you can either breastfeed or pump right before taking your dose or after the peak concentration passes. That means waiting one to two hours for immediate release and six to eight hours for extended release.

Side effects of Adderall while breastfeeding

Anytime you are considering taking medication while breastfeeding, you need to consider how it might affect you and your breastfed infant. How will it impact your milk supply? Will it have negative side effects on the baby’s growth and development? Are there significant benefits for your physical and mental health?

Unfortunately, as with many medications, there are more questions than answers about the side effects of taking Adderall while breastfeeding. Some studies have found that taking amphetamines may decrease prolactin, the hormone involved in milk production. “But as far as we know, normally prescribed doses of Adderall should not affect breast milk supply or the quality of breast milk, and it is not metabolized differently while breastfeeding,” Dr. Madden says.

There aren’t any studies that look at the specific combination of ingredients that make up Adderall (amphetamine and dextroamphetamine) and how this affects breastfed infants, according to Mother to Baby. One very small study of four babies found no harmful effects when mothers took dextroamphetamine while breastfeeding. However, because the long-term effects of maternal amphetamine use on breastfed infants are unknown, the FDA advises against breastfeeding for mothers who take amphetamines.

Additionally, when mothers take stimulants without a prescription from a provider, adverse effects have been noted in babies, such as diarrhea, vomiting, elevated heartbeat, increased blood pressure, irritability, sleep issues, seizures, and weight loss. This may be because the dose is too high or the medication is not truly needed.

“If Adderall is taken in regular dosages as a prescribed medication for ADHD, it should not impact one’s ability to care for their baby,” Dr. Madden says. Still, she notes that Adderall (and other amphetamines) can be dangerous if taken in an abusive manner—meaning, taken in large doses or not prescribed by a healthcare provider.

How to take Adderall while breastfeeding

If you need to take Adderall and you’re nursing, make sure to follow certain safety precautions, such as:

  • Take Adderall or other ADHD meds under the supervision of a healthcare provider who knows you are breastfeeding. Your provider can help you decide the right dose and whether you need to time breastfeeding or pumping sessions around your dosage schedule. They will also discuss other ADHD treatment options that might be helpful to you, such as cognitive behavioral therapy or other medications.
  • Ask for the lowest possible dose of Adderall that is effective for you. “If a breastfeeding parent is having side effects while on the medication, such as agitation or insomnia, I worry that blood levels are too high and that this may affect one’s baby,” says Dr. Madden.
  • Keep an eye on your milk supply: “Breastfeeding parents should monitor their milk supply to ensure this does not decrease,” Daugherty says.
  • Watch out for side effects in your infant: Monitor your baby “for signs of insomnia, weight loss, jitteriness, or other concerning symptoms. If this is the case, they should contact their pediatrician,” says Daugherty.
  • Consider other medications: Dr. Madden also advises that if you are taking other psychiatric or neurological medications, such as antiepileptics, you monitor your baby especially closely for side effects like poor sleep and irritability.

The bottom line: Consult with your provider first

The data available on the safety of Adderall while breastfeeding is lacking. However, no indication exists that taking a conservative amount of Adderall adversely affects nursing babies. Some providers prescribe conservative doses of Adderall to breastfeeding women after a detailed discussion about potential risks and benefits. If you are interested in taking Adderall while breastfeeding, reach out to your healthcare provider.

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