Can You Take Adderall While Breastfeeding? ADHD Medicines and Nursing

If ADHD medicine helps you function, the thought of giving it up to breastfeed can be daunting, especially when you’re running on broken sleep. And if you look it up, you’ll find what looks like a contradiction: the Adderall label says not to breastfeed, while some lactation experts say prescribed doses can be compatible with nursing.

Both are true, and this page explains why. We cover what the label says, what the small studies found, how Adderall compares with Vyvanse, Ritalin and Strattera, and what to watch for in your baby. This is general information. Whether to take a stimulant while breastfeeding is a decision to make with your prescriber and your baby’s doctor. For other medicines, see our hub on what’s safe while breastfeeding.

Two answers: the label and the experts

The label. The Adderall XR prescribing information says that, because of the potential for serious adverse reactions in nursing infants, patients should be advised that breastfeeding is not recommended during treatment. The immediate-release Adderall label says amphetamines are excreted in human milk and that mothers taking them should refrain from nursing.

The experts. LactMed, the National Library of Medicine’s drugs and lactation database, says that in doses prescribed for medical reasons, some evidence indicates amphetamine does not affect nursing babies adversely. It notes that although most manufacturers advise against breastfeeding, some experts state that therapeutic doses can be used during nursing with monitoring of the baby for irritability, insomnia and feeding difficulty.

MotherToBaby puts it this way: the label recommends against use while breastfeeding, but the benefits of using the medicine may still outweigh possible risks, so talk with your healthcare providers about whether to use it and which treatment is best for you.

The gap exists because the label reflects a cautious reading of limited data, and the data really are limited. Nobody has run large studies of babies exposed to Adderall through breast milk.

What the studies actually found

The evidence on amphetamine in breast milk comes from case reports and very small studies.

What was measured	Finding	Source
Amount reaching the baby (amphetamine, case reports)	Relative infant dose 2% to 13.8% of the mother’s weight-adjusted dose; no reported adverse effects	Adderall XR label
Dexamphetamine study, 4 mothers (median dose 18 mg a day)	Median relative infant dose 5.7%; no adverse effects seen	Ilett et al., 2007
Drug in the babies’ blood (same study, 3 babies tested)	Undetectable in one; low levels in the other two	Ilett et al., 2007
Growth and health (4 babies)	No health or growth problems through 6 to 10 months	MotherToBaby
Development (13 babies exposed to amphetamine medicine)	No neurodevelopmental problems at an average age of about 18 months	MotherToBaby

The dexamphetamine study’s authors concluded that the drug readily transfers into milk, but that a relative infant dose under 10% is within a range generally accepted as safe in the short term. “Short term” is the important phrase. LactMed says the effect of amphetamine in milk on a baby’s neurological development hasn’t been well studied, and the Adderall XR label says long-term effects are unknown. LactMed also notes that in the 13-baby follow-up, mothers reported possible adverse reactions in 5 children (sleepiness, crying or restlessness, colic or constipation), mostly in babies who were only partly breastfed, although all 13 had normal developmental scores.

Adderall itself is a mix of amphetamine salts. MotherToBaby notes there are no studies of the amphetamine-dextroamphetamine combination in breastfeeding, so the figures above come from related drugs.

Can Adderall lower your milk supply?

Possibly, at high doses. LactMed says large doses of amphetamine might interfere with milk production, especially in women whose breastfeeding isn’t well established yet, and the Adderall XR label says the same. MotherToBaby adds that there are no clear reports showing this happens in patients.

If you take a stimulant, it’s reasonable to keep an eye on your baby’s feeds, weight gain and diapers in the early weeks. Our baby poop color chart shows typical diaper counts by age, and our guide to how to increase milk supply explains what helps if output drops.

Other ADHD medicines compared

Medicine (examples)	What LactMed says
Mixed amphetamine salts (Adderall)	Some evidence of no adverse effects at prescribed doses; monitor baby; large doses might affect supply
Dextroamphetamine (Dexedrine)	Same evidence and cautions as amphetamine
Lisdexamfetamine (Vyvanse)	A prodrug of dextroamphetamine; same evidence and cautions
Methylphenidate (Ritalin, Concerta)	Milk levels very low and not detectable in infant blood; not a reason to stop breastfeeding; large doses might affect supply
Atomoxetine (Strattera), non-stimulant	Very low milk levels; not expected to cause adverse effects; watch baby for excess sedation

Methylphenidate has the most reassuring LactMed summary of the stimulants, although LactMed describes the evidence as limited. If you’re starting treatment fresh, or your current medicine isn’t working well, it’s a fair question to ask your prescriber whether a different option would fit breastfeeding better. Don’t switch or stop on your own: MotherToBaby notes that stopping suddenly can cause withdrawal and that your providers may suggest lowering the dose slowly if you do stop.

Practical steps if you take a stimulant while nursing

• Tell everyone involved. Your prescriber, your OB or midwife, and your baby’s doctor should all know you’re breastfeeding and taking a stimulant.
• Use the lowest effective dose your prescriber recommends, since the supply concern is linked to large doses.
• Be extra careful in the newborn weeks. LactMed says large doses might interfere with supply, especially before breastfeeding is well established. If your baby was born early or has health problems, ask for individual advice.
• Watch your baby for the signs in the next section, especially after starting or raising a dose.
• Mind other stimulants. If you also drink coffee or energy drinks, our guide to caffeine while breastfeeding explains the limits for that one.
• Take only medicine prescribed to you. LactMed says breastfeeding is generally discouraged in mothers who are actively abusing amphetamines.

Broken sleep is hard on anyone. Our article on whether breastfeeding makes you tired has ideas for protecting your sleep.

When to call a doctor or lactation consultant

Call your baby’s doctor if your baby is irritable, sleeping poorly, having trouble feeding, unusually sleepy, or not gaining weight as expected. These are the signs LactMed and MotherToBaby list for stimulant exposure, and LactMed adds excess sedation for atomoxetine.

Talk to your prescriber before starting, stopping or changing an ADHD medicine while breastfeeding, and get help quickly if your mood, anxiety or sleep becomes hard to manage. If your supply seems to drop, an IBCLC can help you work out why; our breastfeeding support page lists where to find one.