Over the past two decades, the number of reproductive-aged women taking stimulant medications for attention-deficit/hyperactivity disorder (ADHD) has increased by almost 350%. Further, the number of pregnant women taking stimulants like Adderall for ADHD appears to be increasing as well. If you are pregnant or plan to be and take a stimulant medication like Adderall, you may wonder if it is safe for you and your baby. Adderall and Pregnancy Unfortunately, there is little data about the safety of stimulants during pregnancy and while breastfeeding. For this reason, it is common for women with ADHD to stop taking their stimulant medication until after the baby is born. However, the number of pregnant women staying on ADHD medications like Adderall appears to be increasing. Does Adderall Affect Birth Control? There are multiple medications that can actually decrease how effective some birth control methods will be. Adderall is not known to be one of these medications. Studies on Adderall and birth control medications in animals have not indicated that Adderall carries a risk of decreasing the effectiveness of birth control. Adderall While Trying To Get Pregnant Little information exists about the risks of taking Adderall while trying to conceive. However, a study on methylphenidate — a stimulant related to Adderall — showed no increased risk of birth defects in women who took the drug during early pregnancy. A study on dextroamphetamine (a component of Adderall) had similar results. It found no impact on the baby’s weight, head circumference, length or risk of birth defects when the drug was stopped before the 28th week of pregnancy. Adderall While Pregnant While many women decide to stop using stimulants like Adderall while pregnant, cases may exist where the benefits of staying on Adderall outweigh the risks to the baby. For example, some women with ADHD have functional impairments in activities like driving when they are off their ADHD medication. Stopping Adderall in that case could increase the risk of a car crash. In such cases, a doctor may advise the woman to continue taking Adderall. The FDA recommends weighing the risks and benefits carefully before deciding whether to stay on Adderall. Can Adderall Cause Miscarriage? Adderall is a pregnancy category C medication, meaning that good research in humans does not exist but that animal studies show it can cause birth defects. Adderall has been shown to increase the risk of miscarriage in lab mice. While data for humans is not readily available, there is a risk that Adderall could increase the chances of a miscarriage. Can Adderall Cause Birth Defects? Studies show that Adderall makes birth defects more likely during pregnancy. This does not necessarily mean that birth defects will definitely occur but that they are more likely. This should be a serious consideration for anyone who is considering becoming pregnant and uses Adderall. Adderall While Breastfeeding Little information is available about Adderall while breastfeeding. The main concern about taking Adderall while breastfeeding is that the drug may pass through the breastmilk, slow the baby’s growth and interfere with appetite and sleep. Another concern is that Adderall may interfere with the mother’s milk production. For these reasons, the FDA recommends not taking Adderall or Adderall XR while breastfeeding. One study on three mothers who took dextroamphetamine reported no side effects in the breastfed babies. The three babies were tested for exposure, and two showed low levels of dextroamphetamine in their bodies — less than 6% of the dose their mothers had taken. The third baby showed no trace of the drug. How Long Does Adderall Stay in Breastmilk? The amount of time that Adderall lasts in your breastmilk will depend on how much Adderall you use. Unless it is heavily misused, the amounts of Adderall present in breastmilk will normally be negligible within 48 hours. Adderall may still be detectable after this point, but its impact will be minimal. Potential Risks of Taking Adderall While Pregnant Many concerns about taking Adderall while pregnant have to do with a potential impact on the baby’s growth and premature delivery. One common side effect of Adderall is a decreased appetite, which may lead to growth problems with the baby. Additionally, a recent study observed a small but significant increase of certain birth defects in women taking stimulants while pregnant. Specifically, the study showed an increased risk of: Gastroschisis: The baby is born with its intestines outside the body, but this can be fixed with surgery. Omphalocele: The baby is born with part of its abdomen outside the body, but this can be repaired with surgery. Transverse limb deficiency: Part of a baby’s limb is smaller than expected or missing. Routine prenatal care is important for any pregnant woman, especially if they are taking a medication like Adderall. Prenatal exams tell the doctor whether the baby is growing at an appropriate rate while the mother is taking Adderall. Further, ultrasound exams may help the doctor find out if there are certain birth defects. Adderall XR vs. Adderall in Pregnancy The FDA has similar warnings about both Adderall and long-acting Adderall XR in pregnancy. The FDA recommends not taking Adderall or Adderall XR when breastfeeding due to unclear long-term risks to the baby’s development. Adderall Alternatives While Pregnant If you decide to stop Adderall use during pregnancy, it can be helpful to have other strategies to manage ADHD until your baby is born. One woman who chronicled her stimulant-free pregnancy reported having good results from: Carrying a journal and writing down reminders Taking long walks outside in the sunshine Having lots of healthy snacks and staying hydrated Setting phone alarms to keep on task Asking a trusted person to help keep yourself accountable If you are prescribed Adderall and become pregnant, you should speak with your doctor as soon as possible about Adderall alternatives. If you are dependent on Adderall and struggling with the idea of stopping, The Recovery Village at Baptist Health can help. Contact us today to learn more about treatment plans that can work well for your needs. SourcesCenters for Disease Control and Prevention. “Key Findings: A Growing Number of Reproductive-Aged Women are Filling Prescriptions for ADHD Medicine.” July 16, 2020. Accessed November 1, 2020. Freeman, Marlene P. “ADHD and Pregnancy.” The American Journal of Psychiatry, July 1, 2014. Accessed November 1, 2020. Centers for Disease Control and Prevention. “Use of ADHD Medicine is Increasing among Pregnant Women.” July 16, 2020. Accessed November 1, 2020. U.S. National Library of Medicine. “Adderall XR.” DailyMed, July 17, 2019. Accessed November 1, 2020. U.S. National Library of Medicine. “Adderall.” DailyMed, April 28, 2020. Accessed November 1, 2020. Davis, Jonita. “Surviving Pregnancy Without My ADHD Medication.” June 21, 2016. Accessed November 1, 2020. Barton, Jennifer. “Adderall and Pregnancy.” Parents, January 25, 2011. Accessed February 18, 2022. Feuer, G.; Sosa-Lucero, J. C.; & de la Iglesia, F. A. “Influence of oral contraceptives on the acute effect of amphetamine on the hepatic endoplasmic reticulum of the rat.” Toxicology, February 1977. Accessed February 18, 2022. Anderson, Kayla N., et al. “ADHD Medication Use During Pregnancy and Risk for Selected Birth Defects: National Birth Defects Prevention Study, 1998-2011.” Journal of Attention Disorders, March 9, 2018. Accessed February 18, 2022. Chomchai, Chulathida; Chomchai, Summon; Kitsommart, Ratchada. “Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy: Implications for Initiation of Breastfeeding.” Journal of Human Lactation, May 2016. Accessed February 18, 2022. Medical DisclaimerThe Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.