Restarting Adderall While Breastfeeding at 1 Year Postpartum

Primary Recommendation

• The American College of Obstetricians and Gynecologists recommends that treatment with ADHD medications should not be stopped if they are required for the daily functioning of the breastfeeding person, as the magnitude of documented risks is very low 1, 2

Safety Profile During Breastfeeding

• The relative infant dose (RID) and actual exposure to amphetamines decrease as breastfeeding frequency naturally diminishes after 1 year of age 2

Infant Monitoring

• Monitor your infant for irritability or unusual fussiness, sleep disturbances, feeding difficulties, and appropriate weight gain and developmental milestones 1, 2

Practical Strategies to Minimize Infant Exposure

• Consider intermittent use of Adderall on an as-needed basis to maximize functioning while reducing overall infant exposure 1, 2
• Take Adderall immediately after a breastfeeding session and schedule the longest interval between dose and next feeding when possible 2
• Use the lowest effective dose that maintains daily functioning 1, 2

Alternative Considerations

• Methylphenidate may be preferred over amphetamines for breastfeeding, with a relative infant dose of less than 1% and no reported adverse effects in breastfed infants 2
• The American College of Obstetricians and Gynecologists recommends maintaining therapeutic doses of methylphenidate during breastfeeding 1

Risk-Benefit Context

• The functional impairment from untreated ADHD can significantly impact the ability to care for the child safely, quality of parent-child interactions, overall mental health, and management of co-occurring conditions 1
• Proceed with restarting Adderall if it is required for daily functioning, infant monitoring is possible, and strategies to minimize exposure are implemented 1, 2