Adderall While Breast Feeding: How Long Does It Last?

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 Adderall (IR) remain in breastmilk? 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.

Asked by Breastfeedingmom On Apr 08, 2019

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Apr 08, 2019
Infant with mother on breast with text overlay - Adderall Article

Overview

Whether or not drugs are a particular drug is excreted in the 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.

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.[1]

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).[2]

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 the 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, however, aren't well known due to the lack of studies and some sources even suggest that regularly prescribed doses of Adderall will have negligible effects on a breastfeeding infant.[3]

Adderall In The Breastmilk

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

The prescribing information for Adderall states this succinctly:[4]

"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:[5]

  • 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.[6]

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.[7]

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'[8]:

"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 in 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.[9]

This time frame has been shown with multiple amphetamine-type drugs, including mixed amphetamine salts, dextroamphetamine, and methamphetamine.[10][11]

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.[12]

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 on 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.

Summary

Adderall (mixed amphetamine salts) is excreted in the breast milk. Use of amphetamines generally isn't recommended in those breastfeeding due to the risk of side effects in the infant. However, conflicting data exists on the overall severity of side effects and whether or not they are clinically significant (or likely to happen at all) if taking Adderall at recommended doses.

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

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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