Adderall While Breast Feeding: How Long Does It Stay In Breast Milk?

In our latest question and answer, the pharmacist discusses breastfeeding while taking Adderall and how long it stays in the breast milk.

Question

Hello, How long does 10mg of Adderall (IR) remain in breast milk? I am an exclusive pumper who has a diagnosis of ADHD. My psychiatrist told me it’s fine to take while nursing/breastfeeding, but I’m very nervous to try it.

Asked by Breastfeedingmom On Sep 22, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 22, 2022
Last updated Sep 22, 2022

Key points

  • Adderall and related amphetamines are excreted into the breast milk, with studies reporting around 2-13.8% of the maternal dosage may be present in the milk.
  • Sources vary on recommendations of whether or not it is safe to breastfeed while taking Adderall. Some, like the American Academy of Pediatrics, generally recommend against it due to the risk of side effects, such as irritability and decreased appetite.
  • Several studies, however, note that the risk of side effects in infants is low, even in mothers taking Adderall daily.
  • Talk to your doctor about what represents the best course of therapy for you and your infant.
  • If Adderall is used while breastfeeding, be sure to monitor the infant for possible effects.
  • Adderall is likely to be present in the breast milk for up to 48 hours or so after your last dose. After 24 hours though, the concentrations are thought to be exceedingly low and unlikely to cause any side effects in a breastfeeding infant.

Answer

Thanks for contacting us! Whether or not drugs are a particular drug is excreted in breast milk is of huge concern for breastfeeding mothers.

Not only do you want to avoid the potential negative side effects of exposing your infant to a drug not intended for them, but you also simply want to continue breastfeeding for its numerous health benefits. For example, studies show that breastfeeding infants have a lower rate of a variety of medical conditions, including ear and respiratory tract infections, asthma, and type 2 diabetes.

Additionally, studies also show that mothers who breastfeed are more likely to recover more quickly from childbirth and also have reduced rates of certain types of cancer (e.g. breast and ovarian).

So, it is extremely important to discuss your medication use with your doctor if you are breastfeeding, or are planning to breastfeed, to determine whether or not they are safe to continue taking.

As it concerns Adderall, it is excreted into breast milk in measurable amounts.

Most data suggests that a breastfeeding infant could potentially be exposed to between 2% and 13.8% of the maternal dosage of Adderall. The potential effects of this on the breastfeeding infant, however, aren't well known due to the lack of studies.

Making it a challenge to give a blanket recommendation, sources differ on recommendations. Some sources recommend against Adderall use while breastfeeding, while others suggest that regularly prescribed doses of Adderall will have negligible effects.

While I do discuss this topic in detail in the sections below, everyone's medical situation is unique, and I would highly recommend discussing the best course of therapy with your doctor.

Adderall Excretion Into The Breastmilk: Recommendations

Most sources generally do not recommend the use of Adderall in breastfeeding mothers due to the risk of side effects.

The FDA-approved prescribing information for Adderall states this succinctly:

"Amphetamines are excreted in human milk. Mothers taking amphetamines should be advised to refrain from nursing."
Adderall Prescribing Information

The American Academy of Pediatrics also states that amphetamines should not be used in breastfeeding mothers in most situations due to the potential side effects in infants, including:

  • Increased blood pressure
  • Increased heart rate
  • Insomnia
  • Hyperactivity
  • Decreased appetite
  • Irritability
  • Behavior changes

Also, amphetamines (particularly dextroamphetamine) have been shown to decrease milk production in breastfeeding mothers.

Having said all of the above, there is an overall lack of data regarding the potential negative effects of amphetamine use in breastfeeding mothers and it appears that the highest risk is in those who are abusing Adderall and taking higher than recommended doses.

Some sources state that when prescribed at recommended and indicated dosages, there may be next to no negative effects on nursing infants based on the low concentrations seen in breast milk at these dosages.

In fact, there have been several case studies reviewing the effects of prescribed Adderall use in breastfeeding women, up to doses of 35 mg per day. In most of these studies, there have been no observed negative effects in infants. The following excerpt is from one such study, 'Narcolepsy Treated with Racemic Amphetamine during Pregnancy and Breastfeeding':

"The breastfed infant had a low plasma concentration of rac-amphetamine (about 9% of the maternal plasma level) and the calculated relative infant dose was low (2%). No adverse effects were observed in the breastfed infant. The infant's somatic and psychomotor development up to 10 months of age was normal."
J Hum Lact. 2015 Aug;31(3):374-6.

Again, the above study was on a woman who was taken an indicated and prescribed dose of Adderall (35 mg per day) by their doctor. Studies that see side effects from Adderall use by breastfeeding mothers are often in cases of abuse or overdose.

How Long Does It Last In Breast Milk?

It isn't known exactly how long Adderall stays in the breast milk, but data suggests that Adderall will last in the breast milk for at least a few days after your last dose.

However, by 48 hours from the last dosing, concentrations in the breastmilk are minimal and the risk of side effects to a breastfeeding infant would be exceedingly low.

This time frame has been shown with multiple amphetamine-type drugs, including mixed amphetamine salts, dextroamphetamine, and methamphetamine.

Even as little as 24 hours after taking Adderall (at an FDA-approved dose), most studies suggest that the dose of Adderall an infant would ingest from breastmilk would not be likely to cause excess side effects due to low concentrations, and is generally well tolerated. Nevertheless, it is important to always monitor for potential adverse effects as they could happen and have been reported.

Talk To Your Doctor

Be sure to talk with your doctor about Adderall use while breastfeeding.

If it represents the best treatment option for you, it is important that the nursing infant is monitored for side effects, such as insomnia, irritability, hyperactivity, and decreased appetite.

If you are taking Adderall on a daily basis, it would be prudent to separate dosing from feeding as long as possible.

There will likely be measurable concentrations of Adderall in the breastmilk, but the longer you wait between dosing, the lower the concentrations will be, which will decrease the risk of potential side effects.

Final Words

Thanks so much for contacting us. I hope this answer helped.

References

  • American Academy of Pediatrics. Policy statement breastfeeding and the use of human milk, PubMed
  • New Mother's Guide to Breastfeeding, 2nd Edition, New Mother's Guide to Breastfeeding, 2nd Edition
  • Elsevier ClinicalKey: Adderall Monograph, ClinicalKey (Subscription Required)
  • Adderall, AccessFDA
  • The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics, American Academy of Pediatrics
  • Mydayis, AccessFDA
  • Drugs and Lactation Database., LactMed
  • Narcolepsy Treated with Racemic Amphetamine during Pregnancy and Breastfeeding, PubMed
  • Transfer of methylamphetamine and amphetamine into breast milk following recreational use of methylamphetamine, PubMed
  • Transfer of dexamphetamine into breast milk during treatment for attention deficit hyperactivity disorder, PubMed
  • Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy: Implications for Initiation of Breastfeeding, PubMed
  • Drugs of Abuse During Breastfeeding, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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