ADHD & Pregnancy: Managing ADHD

Although some women may be hesitant to continue taking ADHD medication during pregnancy, staying on ADHD meds can be very beneficial. While a few studies have identified a slightly increased risk of cardiac defects, this risk is very small, and other studies haven’t found this association.^[1]

Many studies have shown that ADHD during pregnancy doesn’t cause significant problems for the mother or the offspring.^[2] One study did find that ADHD medication is correlated with slightly higher miscarriage rates, but more research is needed to clarify these results.^[3]

In fact, continuing your medication as prescribed or using a lower dose can lead to improved hyperactivity scores compared to those who discontinued their medication. And signs of depression and mood-related disorders tend to decrease in those who continue their medication.^[4]

Ultimately, it's your choice whether you decide to continue or stop taking medication. It's always best to discuss this with your doctor before coming to a decision. Certain medications might be better for you during pregnancy, and being on meds might also help manage pregnancy symptoms.

Prioritising your health during pregnancy is very important for you and your baby, especially with the potential risk of pregnancy complications, such as preeclampsia, pre-term birth, and low birth weight, associated with having ADHD.

Certain things you should focus on include:

• Sleep: Aim to get at least eight hours of sleep each night throughout your pregnancy. It's also beneficial to take naps during the day, as pregnancy can make you feel more tired. Getting quality sleep supports both your baby's development and can improve ADHD symptoms.

To enhance your sleep, consider reducing screen time before bedtime, avoiding caffeine later in the day, and maintaining good sleep hygiene.

• Exercise: It's recommended to exercise during pregnancy. Choose moderate workouts like walking, swimming, or yoga. These exercises are safe to perform during pregnancy and won't put physical stress on your body.

Staying active can also help manage ADHD symptoms by allowing you to expend excess energy, which can help clear your mind and improve your overall mental and physical health.

• Stress management: Managing stress throughout your pregnancy is crucial, as high levels of stress can worsen anxiety and depression, and may also increase the risk of ADHD in your child. Research has shown that maternal stress is linked to a higher risk of ADHD in children.^[5]

Practicing mindfulness and engaging in meditation can all help you keep stress under control.

Having a good support system around you can make pregnancy less challenging. You should communicate with your partner, family, and friends about how you want to feel supported.

It’s also important to let your doctor or midwife know that you have ADHD so they can support you throughout your pregnancy. They might even refer you to an ADHD specialist or a perinatal psychiatric team for tailored support.

Visiting a specialised perinatal specialist can be beneficial in multiple ways. For example, they can educate you on how to establish routines, practice self-care, prepare for childbirth, and ensure your mental health is well-managed.

It’s common to experience high levels of stress and symptoms of depression during the third trimester,^[6] so it’s important to communicate how you feel early on and to go for regular mental health screenings to ensure everything is okay for you and your baby.

New mothers with ADHD are at a higher risk for postpartum depression and other mood-related disorders.^[7] This increased vulnerability may stem from various factors, such as a decline in oestrogen levels. Regardless of the reasons, it's essential to prioritise self-care during this period.

To prepare for the demands of having a newborn, consider meal-prepping before the baby arrives. Also, set up the nursery and keep the hospital bag packed weeks in advance. Stocking up on snacks can also provide quick energy when needed. Being prepared before the baby arrives can help make the transition smoother.

It's also beneficial to discuss your work situation before going on maternity leave, allowing you to clear your mind of worries. A phased return to work can help you adjust to the new role of motherhood while maintaining a balance between work and life.

Breastfeeding 

Breastfeeding is an important aspect of the postpartum period. Breastfeeding is safe for mothers with ADHD and is often encouraged, as research indicates it can reduce the overall risk of the child developing ADHD. But ADHD can cause some difficulties; for example, fatigue can impact executive functions. It can make it harder to remember breastfeeding times or which side was used last. Keeping a diary can help keep track of your breastfeeding routine.

Have a chat with your mental health specialist to check if it's also safe to breastfeed while taking ADHD medications. In some cases, trace amounts of medication are found in breast milk and some medicines might affect lactation.^[1] This is why it’s best to discuss your options with your doctor, who can provide more tailored information on what to do.