In short: current UK evidence suggests that taking dexamfetamine or lisdexamfetamine (Elvanse) for ADHD during pregnancy is not linked to an increased risk of birth defects. Some studies suggest small increases in other risks, such as low birth weight, so the decision to continue, reduce or stop should be made with your prescriber, balancing these against the risks of untreated ADHD. Don’t stop suddenly without advice. Small amounts pass into breast milk, so breastfeeding needs an individual discussion and monitoring of your baby.

This guide, written by a Ready Health prescribing pharmacist, explains what is known so you can have an informed conversation with your care team.

Planning a pregnancy on ADHD medication

If you are thinking about having a baby, the best time to review your treatment is before you conceive. Things to discuss with your prescriber include:

how much your medicine helps day to day, and what would happen if you stopped it
whether a lower dose, or taking it only on certain days, might be enough
whether a different medicine or non-medicine support might suit you during pregnancy
other medicines or supplements you take that could be reduced or stopped
starting folic acid (usually 400 micrograms a day) before conception

There is no evidence that a father taking dexamfetamine or lisdexamfetamine around the time of conception harms the baby.

I’ve just found out I’m pregnant – what should I do?

Don’t stop suddenly without speaking to your prescriber. Stopping abruptly can cause tiredness, low mood and a return of ADHD symptoms.
Contact your prescriber or GP within a few days to agree a plan. This might mean continuing, lowering the dose or gradually stopping.
Tell your midwife at your booking appointment that you take ADHD medication, so it can be factored into your care.

It’s important to remember that untreated ADHD also carries risks – for example poor sleep, difficulty keeping appointments, accidents, stress, and increased use of alcohol or tobacco. For some people, staying on treatment is the safer option.

What are the risks to my baby?

Lisdexamfetamine is converted into dexamfetamine in the body, so the information below applies to both. Dexamfetamine crosses the placenta.

Birth defects

Studies of prescribed amfetamines for ADHD have not shown an increased risk of birth defects overall, including heart defects. No extra scans are usually needed beyond the routine 20-week anomaly scan.

Miscarriage

There isn’t enough reliable information to say whether prescribed amfetamines affect miscarriage risk. Some older studies involved non-prescribed (illicit) amfetamine use, which is not comparable to treatment at prescribed doses.

Baby’s growth, pre-eclampsia and preterm birth

Stimulants can narrow blood vessels, which may reduce blood flow to the placenta later in pregnancy. Some studies have reported a small increase in low birth weight, preterm birth, pre-eclampsia (high blood pressure in pregnancy) and stillbirth, though not all studies agree and the overall chance of these outcomes remains low. Your maternity team may monitor your blood pressure and your baby’s growth more closely.

Effects on the newborn

If you take dexamfetamine or lisdexamfetamine close to delivery, your baby may show short-lived withdrawal-type symptoms such as jitteriness, irritability, sleep or feeding difficulties, or breathing problems. Let your maternity team know so your baby can be observed after birth.

Longer-term development

Information is limited, but large population studies of children exposed to ADHD medicines in the womb have not shown a clear increase in developmental problems such as autism, ADHD or learning difficulties.

Managing ADHD during pregnancy

Pregnancy changes how your body handles medicines. If symptoms return, ask your prescriber for a review rather than adjusting the dose yourself.
Have your blood pressure checked regularly, and report headaches, swelling or vision changes promptly.
Check any over-the-counter medicine with a pharmacist before taking it.
Use practical supports such as reminders, routines, and help from family, friends or your employer.
Seek help early for nausea and vomiting, low mood or anxiety.

Can I breastfeed while taking dexamfetamine or lisdexamfetamine?

Small amounts of dexamfetamine pass into breast milk. Information is limited, and UK product information advises weighing the benefits of breastfeeding against the benefits of treatment for the mother. Many people do breastfeed while on treatment with appropriate support. If you choose to:

use the lowest dose that controls your symptoms
watch your baby for irritability, poor sleep, poor feeding or slow weight gain, and seek advice if you notice them
get specialist advice first if your baby was born early, has a low birth weight or has other health problems
be aware that stimulants can lower prolactin; tell your midwife or health visitor if your milk supply seems low

Your prescriber can also discuss alternative ADHD medicines that have more breastfeeding data.

When to get urgent help

chest pain, fainting or a racing or irregular heartbeat – call 999
severe headache, vision problems or sudden swelling in pregnancy – contact your maternity unit straight away
feeling unable to cope, or thoughts of harming yourself – contact your GP urgently, call NHS 111 (option 2 for mental health) or 999 in an emergency
your breastfed baby is very sleepy, feeding poorly or not gaining weight – contact your midwife, health visitor or GP

Frequently asked questions

Is Elvanse safe in pregnancy?

No medicine can be called completely safe in pregnancy. Current evidence does not link lisdexamfetamine (Elvanse) to birth defects, but some studies suggest small increases in other risks such as low birth weight. Many people continue treatment after discussing the risks and benefits with their prescriber.

Should I stop ADHD medication when I find out I’m pregnant?

Not without advice. Contact your prescriber within a few days to agree a plan. For some people continuing is the safer choice; for others, reducing or stopping gradually is better.

Does ADHD medication affect fertility?

There’s no evidence that dexamfetamine or lisdexamfetamine reduces fertility in women or men.

Can I breastfeed on Elvanse?

Possibly, with monitoring. Small amounts pass into breast milk, so discuss it with your prescriber, use the lowest effective dose and watch your baby for changes in feeding, sleep or weight.

Key takeaways

Plan ahead with your prescriber if you’re thinking about pregnancy.
Prescribed dexamfetamine and lisdexamfetamine have not been linked to birth defects, but small increases in growth and pregnancy complications have been reported in some studies.
Don’t stop suddenly – agree a plan with your prescriber and tell your midwife.
Breastfeeding may be possible with the lowest effective dose and careful monitoring of your baby.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own prescriber, midwife or pharmacist. Brand names are trademarks of their respective owners.

Need an ADHD medication review? Ready Health’s clinicians can review your ADHD treatment before or during pregnancy. Find out more or book an appointment.

Dexamfetamine and Lisdexamfetamine (Elvanse) in Pregnancy and Breastfeeding: UK Guide