This sheet is about exposure to dextroamphetamine-amphetamine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is dextroamphetamine-amphetamine?
Dextroamphetamine-amphetamine (Adderall®) is a prescription medication combining mixed amphetamine salts. It has been used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy (a condition causing extreme daytime sleepiness).
Dextroamphetamine-amphetamine is different from methamphetamine. Please see our fact sheets on methamphetamine here: https://mothertobaby.org/fact-sheets/methamphetamine/ and dextroamphetamine here https://mothertobaby.org/fact-sheets/dextroamphetamine-pregnancy/.
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication.
Stopping this medication suddenly can cause withdrawal. It is not known if or how withdrawal may affect a pregnancy. If you are going to stop using this medication, your healthcare providers may talk with you about slowly reducing your dose over time. Your healthcare providers can also talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
I take dextroamphetamine-amphetamine. Can it make it harder for me to get pregnant?
Taking dextroamphetamine-amphetamine as prescribed by your healthcare provider does not make it harder to get pregnant.
Does taking dextroamphetamine-amphetamine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies that looked at pregnancies exposed to prescribed amphetamines, including dextroamphetamine-amphetamine, have not shown a consistent increase in the chance of miscarriage. Some studies report a small increase in the chance of miscarriage, while others find no clear difference after considering maternal ADHD and other factors.
Does taking dextroamphetamine-amphetamine increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like dextroamphetamine-amphetamine, might increase the chance of birth defects in a pregnancy. Studies looking at women who take dextroamphetamine-amphetamine as prescribed have not shown an increased chance of birth defects.
Does taking dextroamphetamine-amphetamine increase the chance of other pregnancy-related problems?
Some studies suggest that taking dextroamphetamine-amphetamine during pregnancy may increase the chance of pregnancy-related problems, such as poor growth (babies born small and/or with a small head size), low birth weight (weighing less than 5 pounds, 8 ounces [2,500 grams] at birth), or preterm delivery (birth before week 37). One study found a higher chance of preterm delivery, and two others did not.
Some studies have found a higher chance of high blood pressure and preeclampsia (high blood pressure and problems with organs, such as the kidneys) in pregnant women taking dextroamphetamine-amphetamine. It is important to remember that some conditions treated with amphetamines, such as ADHD, may themselves increase the chance of preterm delivery or high blood pressure conditions in pregnancy.
Using amphetamine medications at higher doses or more often than prescribed, or using them without a prescription, can increase the chance for poor growth (babies born small and/or with small head size), low birth weight, and preterm delivery. These studies, however, often included pregnancies that might have other risk factors that can also increase the chance of these pregnancy-related problems.
I need to take dextroamphetamine-amphetamine during my pregnancy. Will it cause withdrawal symptoms in my baby after birth?
Withdrawal has not been reported in the newborns of women who take dextroamphetamine-amphetamine as prescribed by their healthcare providers. Using amphetamine medications at higher doses or more often than prescribed, or using them without a prescription, can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. They can include jitteriness, sleepiness, and trouble breathing at the time of birth.
Does taking dextroamphetamine-amphetamine in pregnancy affect future behavior or learning for the child?
A study looking at over 7000 pregnancies in which the mother was prescribed dextroamphetamine-amphetamine in the second half of pregnancy showed no increased chance of neurodevelopmental conditions, including autism and ADHD. Another study looking at over 300 pregnancies prescribed amphetamines as a group showed no increased chance for neurodevelopmental conditions compared to those who stopped their medication before getting pregnant. Prescription-based studies cannot tell us if the women who filled the prescription took the medication during their pregnancy.
Breastfeeding while taking dextroamphetamine-amphetamine:
There are no studies on the combination of amphetamine-dextroamphetamine in breastfeeding. A small study of 4 infants who were breastfed by mothers taking dextroamphetamine for ADHD found no problems in the infant’s health and growth up to 6 to 10 months of age. Another study that included 13 infants breastfeed by mothers taking amphetamine medication found no problems with neurodevelopment at the average age of 18 months. If you suspect the baby has any symptoms such as trouble eating, trouble sleeping, extra sleepiness or irritability, contact the child’s healthcare provider.
The product label for dextroamphetamine-amphetamine recommends women who are breastfeeding not use this medication. But the benefit of using dextroamphetamine-amphetamine and breastfeeding might outweigh possible risks. The product labels also suggests that large doses of dextroamphetamine could lower milk supply in women who are newly breastfeeding. However, there are no clear reports showing that this happens in patients. Your healthcare providers can talk with you about using dextroamphetamine-amphetamine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man takes dextroamphetamine-amphetamine, could it affect fertility or increase the chance of birth defects?
One study suggested that taking amphetamine medication may lower the amount of sperm made, which would impact a man’s fertility (ability to make healthy sperm). Studies have not been done to see if dextroamphetamine-amphetamine specifically could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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