Methylphenidate is one of the most commonly prescribed medicines for ADHD in the UK. But what happens if you’re pregnant, planning a family, or breastfeeding? This fact sheet brings together the latest evidence to help you make informed decisions with your prescriber

Thinking about starting a family while on methylphenidate

If you’re planning a pregnancy, it’s always best to plan in advance and discuss your options with your prescriber. Methylphenidate is not known to affect fertility.

Possible approaches include:

✅ Continuing your current dose of methylphenidate.
✅ Reducing your dose (with medical support).
✅ Switching to another ADHD medicine with a lower risk profile – though methylphenidate is often still the best option in pregnancy.
✅ Stopping unnecessary medicines to reduce risks.

👉 Importantly, if methylphenidate helps you manage ADHD symptoms, staying on treatment may be safer for you and your baby than having untreated ADHD.

I’ve just found out I’m pregnant – should I stop methylphenidate?

Finding out you’re pregnant can be overwhelming. Here are the key points:

There is no urgent need to stop methylphenidate suddenly.
Book an appointment with your prescriber within a few days to make a plan.
Stopping too quickly can bring back ADHD symptoms or cause withdrawal effects such as tiredness, rebound hyperactivity, low mood, or increased appetite.
If you and your prescriber decide to stop, this should be done gradually over weeks.
You may wish to restart after your baby is born if symptoms return.

⚠️ Untreated ADHD in pregnancy may also increase risks of behaviours like smoking, alcohol, or poor self-care – all of which can affect pregnancy outcomes.

Risks of methylphenidate in pregnancy

Early pregnancy (first trimester)

The first three months are when your baby’s organs are developing.
Large studies, including a 2024 review of over 16 million pregnancies, found no clear increase in birth defects with methylphenidate use.
Earlier research hinted at a possible small increase in heart defects, but this has not been confirmed.
There may be a slightly higher risk of miscarriage, but this is also seen in women with untreated ADHD.

Later pregnancy (second and third trimesters)

Body changes in pregnancy can alter how medicines are processed. If you feel methylphenidate isn’t working as well, discuss this with your prescriber.
Some studies suggest babies exposed later in pregnancy may have slightly lower APGAR scores at birth, but most recover quickly with no long-term issues.
Because of this, many prescribers recommend giving birth in hospital where your baby can be monitored.

Methylphenidate and delivery

You will usually be offered a hospital birth, depending on your pregnancy progress.
There is little research on withdrawal symptoms in newborns exposed to methylphenidate, but because it works on the brain, doctors remain cautious.

Methylphenidate and breastfeeding

The good news is that methylphenidate is considered compatible with breastfeeding.

Only tiny amounts pass into breastmilk – often undetectable in babies.
No long-term problems have been reported in infants whose mothers took methylphenidate while breastfeeding.
Some mothers even report increased milk production.
Experts recommend monitoring your baby’s weight, feeding, and irritability.

⚠️ If your baby is premature, unwell, or develops restlessness, excessive sleepiness, or feeding problems, seek advice urgently and pause breastfeeding until reviewed.

Long-term effects on children

Reassuringly, a large study following children exposed in pregnancy for up to 20 years found:

No increased risk of autism, ADHD, epilepsy, seizures, or growth problems.
No evidence of developmental or neurodevelopmental impairments.

How to help yourself stay well during pregnancy

Alongside medication planning, you can lower risks by:

Avoiding unnecessary medicines – always check with your pharmacist first.
Eating a balanced diet rich in fruit and vegetables.
Staying well-hydrated, especially if morning sickness is an issue.
Exercising regularly where safe.
Taking recommended supplements such as folic acid, vitamin D, or iron (check with your prescriber).
Building a support network of friends, family, or professionals who can spot if you’re struggling.
Using non-drug coping techniques for stress and anxiety.

Key takeaways

Don’t stop methylphenidate suddenly if you become pregnant – always consult your prescriber first.
Current research suggests no clear risk of major birth defects, though studies are ongoing.
Breastfeeding is considered safe, with only minimal amounts of methylphenidate passing into milk.
Untreated ADHD can carry risks in pregnancy, so keeping you well is key for both mother and baby.

🔗 Further reading

👉 At Ready Health, we provide ADHD assessments, medication reviews, and ongoing support. If you’re planning a pregnancy or already expecting, our clinicians can help you make safe, informed decisions. Book an ADHD consultation.