These challenges can increase the risk of:
- Preterm birth
- Gestational diabetes
- Preeclampsia
ADHD and women's health
Perinatal risk factors for ADHD
if you have any concerns about the following issues during your pregnancy please speak to your GP or midwife:
- Substance exposure
- Stress
- Poor maternal nutrition
- Environmental toxins
Pregnancy, birth and ADHD symptoms
Individuals with ADHD may face unique challenges during pregnancy:
- Forgetfulness can lead to missed prenatal appointments or inconsistent use of prenatal vitamins.
- Executive dysfunction is when you experience difficulty with the brain’s self-management system. With ADHD this feels like - “I want to start but my brain wont switch on”. Tasks feel big even when they aren’t which may make it harder to follow dietary guidelines, manage medications, or prepare and plan for the birth.
- Emotional dysregulation and increased anxiety can be exacerbated by hormonal changes causing difficulties coping with daily tasks.
ADHD risk of mental health challenges when pregnant and in the first months after birth
ADHD can significantly impact an individual’s mental health during pregnancy, leading to increased risks such as postnatal depression, anxiety, and mood swings. This can affect their ability to cope with the demands of pregnancy and becoming a parent:
- Individuals with ADHD are at a higher risk of experiencing postnatal depression due to the combination of anxiety and depression that often precede pregnancy.
- Untreated ADHD during pregnancy can have long-lasting effects on maternal well-being and child development, including implications for behavioural and cognitive development. If you have concerns please speak to your GP, midwife or ADHD team.
Managing ADHD during pregnancy and in the first two years
Non-pharmacologic strategies
- Cognitive Behavioural Therapy (CBT) for ADHD
- Mindfulness and relaxation techniques
- Routine-building tools: planners, alarms, checklists
- ADHD coaching
- Support groups for neurodivergent parents
- Workplace adjustments to reduce stress.
What may help?
- Put hospital notes and letters in a bright coloured folder to keep all important information together and easy to find
- Inform your midwife of your ADHD and how it affects you so they can discuss any reasonable adjustment that may help within clinic appointments
- Prepare a symptom and medication history before appointments
- Use checklists to track appointments, medications, and questions
- Ask specific questions about ADHD management during pregnancy
- Make notes during appointments or ask for information to be written down
- Take someone with you to appointments who can advocate for you if needed
- Complete a hospital communication passport if you find communicating with others difficult especially when under stress or if you are also autistic. By having this available with your birth plan, the hospital staff can ensure that they consider how they can support you.
Medication for ADHD during pregnancy and breastfeeding
Stopping medication abruptly can negatively affect maternal mental health and parenting ability, so decisions should be made with a healthcare provider.
Pregnancy
There is limited information available about the effects and safety of ADHD medication on the unborn baby during pregnancy and therefore any decisions regarding continuation of ADHD medication need to be considered in relation to risks and benefits. This must be done in conversation with your doctor who may suggest that a referral may be helpful to the specialist ADHD service to explore this further.
For further information about weighing up the risks and benefits of ADHD medication in pregnancy go to: https://www.choiceandmedication.org/leicspart/generate/handyfactsheetperinatalhcadhduk.pdf
Information on medication in pregnancy: https://www.medicinesinpregnancy.org/
Breastfeeding
Once baby is born, you may decide to breastfeed your baby, there are considerations to be made when looking at ADHD medication options with your GP or health professional, such as
- Weighing up risks and benefits of medication
- Explain your ADHD symptoms and how they affect daily functioning
- Share your current medication type, dose, and schedule
- Discuss any previous adjustments or side effects you’ve experienced.
Breastfeeding goals
- Discuss your intention to breastfeed with your GP/midwife/health visiting team and for how long
- Ask professionals about whether medication changes are needed during first few months (when infants are most sensitive), they may not know all the answers but may be able to seek further guidance from the local ADHD specialist services or specialist pharmacists
Medication safety factors
- Ask about Relative Infant Dose (RID) (The amount of medication transferring through into the breastmilk) and whether your medication falls below the 10 per cent safety threshold
- Confirm if your medication is considered compatible with breastfeeding (e.g., methylphenidate is often preferred)
- Discuss differences between immediate-release vs. extended-release formulations and which is safer for breastfeeding
Risk-benefit assessment and monitoring
- Review potential risks to the baby (e.g., irritability, poor weight gain)
- Discuss risks of untreated ADHD for you (mental health, ability to care for baby)
- Ask about monitoring the health and behaviour of your baby/infant (growth, behaviour, sleep). What signs in your baby should prompt you to contact your GP and seek further medical advice
- Arrange a plan to check in with your professionals regularly if needed
Dosage and timing
- Ask if lowering the dose or timing medication after feeds can reduce exposure of the medication through breastmilk
- Confirm if any temporary medication pause is recommended for newborn phase
Alternative options
- Explore behavioural strategies if appropriate
- Ask about complementary approaches (therapy, lifestyle changes)
Additional considerations
- Confirm if any supplements or other medications you take interact with ADHD meds
- Ask about resources or groups for breastfeeding support in your local area or look at the health for under 5s website for more details.