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.

Create predictable routines and schedules

• Use visual schedules for mornings, meals, and bedtime
• Start small – implement one routine at a time (for example, bedtime sequence)
• Use timers, alarms and checklists for tasks, for example, packing bags or preparing snacks
• Schedule outdoor play before quiet activities
• Plan for high-energy moments during the day

Make them feel included

• Involve them in household chores, giving them a brush to help sweep the floor or a cloth to wipe the table helps them to feel included

Watch for triggers

• Keep an eye out for triggers in your preschool aged child, for example hunger, tiredness or overstimulation

Use sensory items and calm areas

• Have sensory items, small snacks or paper and pencils available when out of the home to occupy when they are being asked to wait
• Keep a “calm-down corner” with sensory items like soft toys or weighted blankets

Praise and reward

• Catch good behaviour quickly and praise specifically, positively reinforcing the behaviour you want to encourage (“That is good you are waiting your turn!”)
• Use reward charts for simple goals for example, brushing teeth or sharing toys

Be calm and stay in control

• Give two acceptable options: “Do you want the blue cup or the red cup?” This gives them control without chaos
• Avoid long explanations during a tantrum. Use calm, clear statements for example: “We can play after lunch.”

Look after yourself

• Manage your ADHD first—medication, therapy, or coaching can make parenting easier
• Use pill organisers and reminders for your own treatment plan

Stay calm

• Take a deep breath or step away for a few seconds if safe to do so. Be mindful to communicate this calmly to your child and tell them you will come back after a few minutes
• Remind yourself: “This is about their feelings, not my failure.”

Manage Your ADHD symptoms first

• Medication reminders (pill organisers, alarms)
• Use ADHD coaching or therapy for executive function support
• Break your own tasks into small steps—modelling this helps your child too
• Practice calming strategies together: deep breathing, “calm-down corner,” or mindfulness apps

Validate their feelings

• Use short phrases:
  “I see you’re upset.”
  “It’s okay to feel angry.”
  This helps them feel heard and reduces escalation

Keep language simple

• Avoid long explanations during a tantrum
• Use calm, clear statements:
  “We can play after lunch.”
• “First we are eating lunch then we can go and play.”

Offer choices

• Give two acceptable options:
  “Do you want the blue cup or the red cup?”
  This gives them control without chaos

Use a calm-down space

• Create a cosy corner with soft toys, books, or sensory items
• Teach them it’s a safe place to relax, not a punishment

Distract or redirect

• Offer a different activity or toy
• Sometimes using humour or a silly face can break the tension
• Changing the subject to something the child is interested in may help to reduce stress

Positive reinforcement

• Praise quickly and specifically: “Great job starting your homework without reminders!”
• Use reward charts for consistent behaviours, for example, completing homework or following routines.

Movement and sensory breaks

• Schedule short “brain breaks” every 20–30 minutes during homework
• Include physical activity before quiet tasks (jumping jacks, quick walk)
• Some children benefit from moving around when they are completing homework (walking or standing up to complete work)

Prevent future tantrums

• Stick to routines (visual schedules help)
• If you say you are going to do something, try to make sure this happens and if any changes are made that the child is informed. This provides predictability and promotes feelings of safety and trust
• Watch for triggers for example, hunger, tiredness or overstimulation.  Although they may be able to communicate verbally, children may still miss physical cues and may need someone else to help to regulate their emotions

Predictable routines

• Morning and bedtime charts: Use visuals (pictures or checklists) for steps for example, brushing teeth, packing bags, and bedtime prep
• Homework station: Create a dedicated, clutter-free space with supplies ready
• Timers and alarms: Use countdowns for transitions (for example, “10 minutes left for play.”)

Structured routines reduce stress and help both you and your child stay on track.

Externalise organisation

• Color-coded folders for school subjects
• Use a family calendar (digital or wall-mounted) for homework, activities, and appointments
• Use sticky notes to write reminders and stick them in a visible place such as the front of the refrigerator
• Prepare school bags and clothes the night before to avoid morning chaos

School involvement

• Communicate regularly with teachers and your child’s school or education provider
• If you feel that your child is showing concerning signs and symptoms regarding their attention, focus and/or behaviour, ask about adjustments for example, movement breaks, organisation training, or classroom behaviour management
• If your child has additional needs or concerns have been highlighted by their school, ask about an Individual Education Plan (IEP) or 1 Page Profile.
• If more support is needed at school consider whether an Education Health and Care Needs Assessment could be applied for.

Understand ADHD in teens

• ADHD doesn’t disappear in adolescence; symptoms shift. Hyperactivity may lessen, but impulsivity, emotional intensity, and executive function struggles often increase
• Teens may feel embarrassed or deny their ADHD, impacting their self-esteem. Open, non-judgmental conversations help normalise it

Structure without smothering

• Predictable routines for homework, chores, and bedtime reduce chaos. Use visual schedules and reminders
• Break tasks into smaller steps and reward progress
• Gradually transfer responsibility – start with shared tasks, then let them lead

Collaborate, don’t control

• Teens resist micromanagement. Shift from “command” to problem-solving together
• Discuss curfews, screen time, and responsibilities openly. Explain reasons, then negotiate realistic limits

Emotional regulation

• ADHD teens often have intense emotional reactions. Use calm responses and teach coping skills (deep breathing, short breaks)
• Validate their feelings before addressing behaviour: “I see you’re frustrated. Let’s figure this out together.”

Encourage healthy habits

• Exercise boosts dopamine and focus—sports, walks, or dance breaks really help
• Balanced meals and regular hydration stabilise mood and energy
• Consistent sleep routines are critical for emotional control

Use positive reinforcement

• Pay attention to positive behaviour – praise your teen for spending money the right way, for giving you receipts, for abiding by screen time rules, etc
• Avoid long-term punishments, they breed resentment. Instead, use short, clear logical consequences and immediate rewards

Manage your ADHD first

• Use reminders, planners and coaching for your own executive function
• Be a role model for organisation and emotional regulation – your teen learns from what you do