We have a mom who is due in June.  She was on Ritalin (Methaphenidate)
S.R. 20 mg. tid prior to the pregnancy, and anticipates needing it again
after delivery. (she doesn't say why).  She is asking about BF on this
drug.  None of the books we have available deals with this drug.  Is it
safe?  Thanks. 2 hospital based IBCLC's
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I don't have any BF patients that take Ritalin but I do treat many children
with Ritalin and a few adults.

20mg of the SR is a HUGE dose for an adult, but the proper dose none the
less in some cases.  I would be concerned at that dose of the drug.  I
would want to talk to her health care provider that prescribes the Ritalin
and see how well she functions without the drug.  (She must have made it
through the pregnancy).  Using the Regular Ritalin which only has a 4 hour
half-life would be better in my opinion.  Buspar is another medication that
can be used for ADD that should have a better safety profile for the
infant.

My opinion is that many times adults with ADD can cope as adults but
depending upon their job demands they may indeed benefit from the
medication.  The mother may cope as well by keeping the money used to by
100 Ritalin tablets a month and use that money to pay for a
housekeeper/mother's helper part time for the first month.

There is also a computer based attention evaluation tool available called
the TOVA.  It is usually used by psychologists to help diagnosis and to
measure the effectiveness of drug treatment.  It is not available in every
city but is searching for in my opinion.

If you have more questions relating to ADD feel free to contact me via
private email.

Jon Ahrendsen MD FAAFP
LLL Medical Associate, Special interest in treating ADD
Clarion, Iowa
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