17. ADHD and pregnancy

Do not stop or reduce ADHD medicine without speaking to your prescriber. Stopping can bring symptoms back and may cause withdrawal effects. Your prescriber can help you decide what is safest for you before or during pregnancy.

bumps says therapeutic amfetamine use in pregnancy is not known to cause birth defects. Use later in pregnancy has been linked with poor growth, early birth and pregnancy complications in some studies. These studies cannot always separate the effect of the medicine from other factors. Discuss your own treatment with your prescriber.

Most babies exposed to methylphenidate in pregnancy are born without a birth defect. Some studies suggest a small increase in the chance of miscarriage or certain heart defects after early-pregnancy use. It is not clear whether methylphenidate causes these findings. Your maternity team may offer extra checks later in pregnancy if needed.

There is less pregnancy safety information for atomoxetine and guanfacine than for stimulant medicines. Available information has not shown that atomoxetine causes birth defects, but the evidence is limited. Guanfacine is not usually recommended in pregnancy. Ask your prescriber about the safest option for you.

If you take ADHD medicine near the end of pregnancy, tell your midwife and birth team. Your baby may be checked after birth for short-term symptoms such as being unsettled, feeding poorly or having sleep problems. The checks offered during pregnancy depend on your medicine and circumstances.

NHS advice says methylphenidate may be used while breastfeeding if your baby is healthy. Small amounts pass into breast milk. Ask your prescriber, midwife, health visitor or pharmacist to check your medicine. Get medical advice if your baby feeds poorly, is unusually sleepy or irritable, or is not gaining weight as expected.

bumps does not expect any increased risk to the baby if the father takes methylphenidate, an amfetamine or atomoxetine.