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Subject:
From:
Jon Ahrendsen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 17 Dec 1998 20:59:22 -0600
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I treat alot of patients (mainly children, some adults for ADD/ADHD)

I agree with the concerns about using Ritalin in the BF mother.
However, I think you need to remember the risk benefit ratio
(and make certain the diagnosis is correct)  If the mother is
just at home now I really doubt that she has a great need to
take medication at the present time.

I use the TOVA test (Test of Variables of Attention) to evaluate the effectiveness of medication
( and to confirm make the diagnosis).  I find that this helps me
dramatically find the correct dose of medication (and sometimes
the correct medication).  I use more Adderall than Ritalin,
sometimes one med. works much better than the other.  I find
that the test allows me to use a lower dose than what is
commonly used.   One of the problems in IMHO is that many
Drs. give too much medication and cause sedation,
that gives the Ed a bad name.

For more information about the TOVA visit

 http://www.tovatest.com/frames/toc.htm

If you contact the company you can find a provider that
uses the TOVA that lives close to you.

It is also worthy of noting that there is one study of ADHD
boys that showed a significant difference in both the incidence
and duration of BF between ADHD boys and control boys.

The study is:
Journal:                American Journal of Clinical Nutrition, 1995; 62:page 761-8
Title:          Essential fatty acid metabolism in boys with ADHD
Authors:        Stevens, Zentall, Deck, etal
Address:        JR Burgess, Dept. of Foods and Nutrition, Purdue University
                Stone Hall, West Lafayette, IN 47907-1264

Summary: 53 Subjects with ADHD had significantly lower concentrations of
key fatty acids in the plasma polar lipids than did the 43 control
subjects.  Although not proven by the limit study as a cause, BF rates
between the two groups were significant.

                Control Group   ADHD Group      P Value
Percent BF      81.4%           45.3%           P< .0003

Duration of
Breastfeeding   6.5 mo.         2.5 mo.         P< .0001

Now my comments again:  Long chain fatty acids are know to be high in
breastmilk and lacking in formula.  These compounds are felt by some to be
responsible for some of the claims of decreased IQ and vision in formula
fed infants.  The skeptic will say, " I gave my kid formula and he is an
honor student so there." The unknown thing is that we don't know how much
smarter that child would be if s/he had been given breastmilk.

As there appears to be a familial tendency of ADHD it would be in the
mother's best interest to BF as long as possible to lessen the
likelihood of ADHD in the child (and a whole host of other problems as well.)

Jon Ahrendsen MD ABFP
Clarion, Iowa

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