CBD Oil And Breastfeeding

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Hear about my decision to use CBD while breastfeeding. A pediatrician trained in Western and Ayurvedic medicine along with a celebrity doula advise against use of CBD while breastfeeding. Learn why inside. The main psychoactive component of cannabis, tetrahydrocannabinol (THC), is excreted into breastmilk in small quantities. The duration of detection of THC in milk has ranged from 6 days to greater than 6 weeks in various studies. Concern has been expressed regarding the possible effects of cannabis on neurotransmitters, nervous system development and endocannabinoid-related functions.[1,2] A 1-year study found that daily or near daily use might retard the breastfed infant’s motor development, but not growth or intellectual development.[3] This and another study[4] found that occasional maternal cannabis use during breastfeeding did not have any discernable effects on breastfed infants, but the studies were inadequate to rule out all long-term harm. Although cannabis can affect serum prolactin variably, it appears not to adversely affect the duration of lactation. However, maternal perception that their use of cannabis is harmful to their infants are likely to discontinue breastfeeding earlier than mothers who do not believe it is harmful.[5] Other factors to consider are the possibility of positive urine tests in breastfed infants, which might have legal implications, and the possibility of other harmful contaminants in street drugs.

CBD for Mamas

My experience with Equilibria CBD products. Disclosure: I am an affiliate with Equilibria brand, however all thoughts are my own. Equilibria did not ask me to write this blog post. This is not medical advice.

Everything You Wanted to Know about CBD for Moms!

I’ve gotten so many questions about using CBD, especially about using CBD while breastfeeding. I totally get it! It’s relatively new and there are A TON of products out there, yet there’s not nearly enough research! Today I’m going share a little bit about why I decided to take CBD, and what makes these CBD products special (hint: it has everything to do this incredible company!). Over the last few months, I’ve been sampling products and learning so much about CBD for mamas. I’m really excited to share more and answer some of your most commonly asked questions.

Why I decided to take CBD

My biggest reason for looking into CBD was stress management and headaches. I was getting really bad headaches – so frequently, that they were becoming debilitating. I have never been one to really like prescription medications — I don’t even like to take Advil or Tylenol!

As I started looking for treatments that felt a little bit more natural, I heard about Equilibria’s line of CBD products through a few people I knew and different influencers. I was curious about the products — could they possibly match the hype? When they reached out to me, I was really excited to talk with them and learn more.

As you know, with any partnership or any product I’m trying out, I always ask LOTS of questions. I always make sure that I’m able to try it for a while, long enough to decide if I want to share it. I’ve been using these products for the last few of months and I’m LOVING it. I don’t have headaches anymore, I’m not as stressed out, and I’m not as reactive. It’s been working really well for me, and I’m so happy to be working with this brand.

What are the Benefits of Using CBD?

Proponents of CBD report that the studied benefits are still emerging. Benefits from CBD range from treatment of chronic pain and migraines to anxiety and depression.

Why I chose Equilibria

When I started looking into CBD products, it was really overwhelming! There were so many different options, plus I was looking for some really specific features from the products I tried. Below were a few requirements I had:

I wanted a more natural option. I chose Equilibria is because their products are completely organic and non-GMO. There are no pesticides, herbicides, or heavy metals found in their soils. You can actually go on their website and look up the lab results and learn more about their farm in Colorado!

I wanted to support a woman-focused business. This company is not just an all-women company — the entire focus of their products is women. All of their products are specifically designed for a woman’s body, and all of the changes that women go through.

I wanted a full spectrum products. The products that Equilibrium offers are full spectrum. When you’re looking at the entire market of CBD options, there are three different types of CBD you can choose from: full spectrum, broad spectrum, or CBD isolate. I wanted full spectrum, because I wanted more potent results with a smaller dose.

I wanted (and needed!) help with choosing products. The best thing about this company is that you get access to a Dosage Consultant with every order. You can talk about any specific concerns that you’d like to treat, and they’ll make recommendations based on your personal life — whether you’re looking to reduce inflammation, manage stress, headaches, or anxiety (or all of these things!). But they’re giving you more than product recommendations – they’ll also tell you what time of day to take it, and how often. If you know nothing about CBD, your consultant will walk you through everything you need to know — that accessibility is HUGE for me. I know so many people who are really curious about CBD, but also hesitant, because they just don’t really know where start — this is perfect for you.

Is CBD Right for You? Is CBD healthy for breastfeeding moms?

The FDA currently advises against all CBD and THC products for pregnant and nursing parents. Does CBD get into breast milk? Yes. It’s fat-soluble and will be expelled through your breast milk. However, much of the CBD and breastfeeding controversy lies within the studies done on THC and breast milk, not CBD. The FDA strongly advises against all cannabis products, mostly due to studies regarding THC in pregnancy having negative outcomes. The primary concern with CBD in particular, appears to be the potential for low-quality CBD products to be contaminated with pesticides, bacteria, fungi, and heavy metals. This is why it was a top priority for me to find the cleanest brand possible.

Of course, you should always talk with your doctor before making any major health decisions. CBD is really under researched, especially in pregnant and lactating people. Just like any other medication or supplement, there’s always going to be less research available around pregnancy and lactation, because of ethics with medical testing. We are typically last to be tested for new products.

That being said, everything I’ve learned from my Dosage Consultant has made me feel really comfortable taking it while breastfeeding. Again, you always do what works for you and always talk to your doctor when you’re introducing something new into your routine.

While I do feel that it’s safe for me, it’s also worth considering that there are certain medications that CBD might not react well with it. Always check with your doctor (I did, and mine feels it’s perfectly safe and fine for me!) before starting any new supplement or medication.

A few more resources:

(Note: this is not medical advice, just more information!)

My favorite CBD products

Equilibria’s line is expanding and growing, which is super exciting. While they’re currently US-only, I’ve also been chatting with them about what they might be able to offer international folks. These are my favorite products so far!

Daily Drops (Mint): I was expected CBD products to taste bad, and these don’t taste like that at all! They taste kind of like grassy and minty – it’s nice! I use the little dropper and take these in the morning.

Soft Gels: The soft gels are slow release. These are what you’d take if you’re having trouble sleeping, or want help with stress throughout the day.

Relief Balm: I wanted to get my mother and mother-in-law something beautiful and usable, so I got them both this. It’s a creamy balm used for aches and sore muscles, and it comes in the “relief box.” It would also be a great gift to a new mom or yourself.

Daily Treatment Oil: My mother-in-law and mom have raved about this facial oil. It has a beautiful lemony floral scent, but it’s totally natural, with no added fragrances or chemicals.

Mindful Mineral Soak: This is my new favorite! This would be such a cute gift with a loofah or candle. The mineral soak is like a bath salt and dissolves completely in a warm bath- my favorite form of self care!

NEW Rapid Calming Melts: Peppermint flavored 5mg tablets that dissolve under your tongue and are perfect to take whenever you’re feeling extra stressed and overwhelmed! Discreet and can be taken any time you need fast-acting relief – perfect to stash in your purse when you are on the go. They begin working in as little as 10 minutes and can last up to 6 hours.

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Taking CBD While Breastfeeding Poses Risks—Here’s What You Need to Know

Jill is a Senior Commerce Editor for Byrdie. Her work has appeared in The Los Angeles Times, Refinery 29, NYLON, Milk Media, VICE, Salon, Bustle, Modern Luxury, Autre, and Angeleno.

Dana Myers, LCSW is a licensed clinical social worker and life coach based in Philadelphia. She has a special interest in how race, sex, gender, ethnicity, social status and competencies impact those in marginalized communities and aims to help her clients find purpose and peace in life.

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In This Article

Cannabidiol, or CBD, is everywhere, from topical salves to tinctures. The so-called organic Xanax is being touted by wellness enthusiasts as a panacea to pain, anxiety, depression, and insomnia. Nature’s supposed cure-all might seem like a miracle treatment to sleep-deprived, delirious new mothers, especially those who are breastfeeding and feeling energetically depleted. But despite the widespread availability of CBD, as of 2021, the Food and Drug Administration (FDA) has only approved one CBD drug, leaving many questions around its safety for breastfeeding mothers unanswered. What may seem like natural stress relief to help navigate the many mental and physical challenges of motherhood, especially in trying times, might end up exposing your child to risks that research has yet to uncover.

Nursing offers an unparalleled host of benefits to both mother and child. According to a comprehensive 2013 review, the nutritional, immunological, and anti-inflammatory properties of breastmilk provide health advantages to a nursing baby, including reduced risks of asthma, obesity, type 2 diabetes, ear and respiratory infections, and sudden infant death syndrome (SIDS). Nursing mothers experience a lowered risk of disease, including hypertension, type 2 diabetes, and ovarian and breast cancer, according to a Centers for Disease Control and Prevention (CDC). But that’s not all. Breastfeeding is credited with positive psychosocial outcomes, most noticeably through the bond that develops between mother and child. As such, leading organizations from the American Academy of Pediatrics to the American College of Obstetricians and Gynecologists endorse breastfeeding for at least 12 months of a child’s life. Such consensus around the benefits of breastfeeding have resulted in an uptick in mothers who nurse, with the CDC reporting 58.3% of infants breastfeeding at 6 months in 2017.

Increased duration of breastfeeding does, however, extend the postpartum period, which, as you probably know, may result in fatigue, interrupted sleep, and the emotional pressure that can accompany feeding a little one 24/7. As wonderful as breastfeeding may be, it can also be overwhelming, leaving nursing mothers exhausted and in need of relief; after all, being a source of unconditional comfort is draining. Widely available CBD might seem like a godsend, offering an instant feeling of calm without a hangover or any of the psychoactive effects of marijuana. But here’s the rub: Even though CBD is natural, we don’t yet know how CBD affects a developing baby and child, and what the longterm effects might be to a baby who has been exposed to CBD through breastmilk.

Ahead, our experts help us sift through what we do know about using CBD when breastfeeding, so nursing mothers can make informed choices.

Meet the Expert

  • Natalie Geary, MD, is a pediatric and family doctor based in Miami and New York and the founder and Medical Director of vedaHEALTH and vedaPURE. A Harvard trained physician, Geary integrates Ayurvedic and allopathic medicine in her practice.
  • A celebrity wellness maven and birth doula, Latham Thomas is the founder of Mama Glow, a global maternal health and doula education company, instructing doula-trainees from around the world. Thomas is a graduate of Columbia University and Institute for Integrative Nutrition, and author of two best-selling books, Own Your Glow: A Soulful Guide to Luminous Living and Crowning The Queen Within and Mama Glow: A Hip Guide to Your Fabulous Abundant Pregnancy.

What the Data Says About CBD and Breastfeeding

There is a lack of published research on the safety of using CBD while breastfeeding. Most of the data surrounds maternal use of tetrahydrocannabinol (THC), derived from marijuana. However, CBD and THC are both classified as cannabinoids, which the data suggests enters breastmilk after maternal consumption:

A 2018 study surrounding THC and breastfeeding, published in the Journal of the American Academy of Pediatrics, indicates that THC is measurable in breastmilk for up to six days after maternal marijuana use. Cannabinoids love to adhere to fat, and breastmilk is viscous as it contains long chain polyunsaturated fatty acids.

This means you can’t pump and feel confident the CBD is out of your system, like you might after say, drinking a glass of wine. “CBD takes longer to metabolize and process through the body than alcohol,” says Thomas. “We know that cannabinoids stick to the fatty parts of breast milk and hang out longer.

Geary adds, “Every mother’s metabolism is different; the absorption into the blood stream is different, and the actual dosage of the CBD listed is not considered accurate or reliable.” She also brings up a point about the lack of regulation surrounding CBD products. In March of 2020, the FDA issued a statement promising to advance regulatory practices of CBD, admitting wide gaps in data and a lack of market transparency. The same report notes, “we are also not at a point where we can conclude that unapproved CBD products are safe for use.” Thomas adds that for reliable data, we’ll need to evaluate a couple thousand people over at least 15 years. Current data doesn’t meet either of those criteria.

Topical vs. Ingestible Use of CBD When Breastfeeding

When it comes to topical versus ingestible use of CBD, again, there’s a dearth of data on the longterm effects. However, Thomas says that topical CBD products are a bit safer because CBD isn’t entering your bloodstream in the same way. “Postpartum women might apply a CBD salve to a scar, achy muscles, or to ease sore nipples,” explains Thomas, adding that you should make sure to clean nipples before your baby latches.

Thomas warns to be skeptical of CBD products that are inexpensive. Seek out reputable brands that use conscious farming practices. “None of this stuff is cheap,” she says. “This is an expensive process.”

She says it’s crucial, however, that you bring the product you intend on using to your health care provider and discuss its use before trying it out. She also says it’s important to realize if you choose to use CBD topically when breastfeeding, it’s still considered experimental. “Never feel forced to use something just because you bought it,” she adds.

Risks of Using CBD When Breastfeeding

One reason you might think CBD is safe for nursing mothers is the fact that mother’s milk naturally contains cannabinoids, similar to CBD. These cannabinoids may help stimulate a newborn’s appetite. In fact, they work on the same receptors that are activated when people get the munchies from consuming THC. However, don’t assume a case of “the more the merrier,” says Thomas. Geary, too, warns there’s a big difference between what the body produces naturally and the “artificially imported chemicals” in commercial CBD. She adds, “Women have been breastfeeding forever. Mother’s milk contains no impurities, no chemicals or pesticides, and no chance of an overdose.”

CBD remains out of the purview of the FDA, leaving each company or brand in control of monitoring the product’s safety. “Some companies are able to afford testing and studies,” says Thomas. “Others aren’t.”

Geary adds, “A very real problem is that the products are unregulated and may be contaminated with harmful chemicals—such as pesticides, bacteria, fungus, and heavy metals—which can harm the fetus or baby.”

Geary (who notes that as a pediatrician with a license to provide medical marijuana —CBD and THC products—she’s not an anti-marijuana doctor), says using CBD when breastfeeding just isn’t a safe gamble. “During the time of the developing fetus, through until age three years of life, the infant’s brain reaches 80% of its full adult volume. Any unnecessary exposure, especially in those vulnerable first three years, is worth considering very seriously.”

Final Thoughts

Until we have more evidence, Geary says women who are expecting or breastfeeding should definitely err on the side of caution and avoid cannabis in all forms.

Try to use nursing sessions as a time to pause and reset, letting the oxytocin that’s released during breastfeeding help you enter a state of calm. Play soothing music or a guided meditation, practice deep breathing, and remember that this stage of life is temporary.

See also  Does CBD Oil Expire

Thomas adds that although CBD can seem like a “pathway to self-care,” it’s only one of many wellness tools. She urges women to get to the “root of the stress or anxiety on the road to recovery.” Asking for help is critical. “When we think of stress and how to mitigate it because life is too much, that becomes a pathway for pain and trauma to embed,” she says. But it’s also an opportunity to do the work necessary to heal. “Reaching for a cure-all,” she says, “helps us turn away from a life we’ve created when we need to be so committed to it right now.”

If you or someone you know is struggling with postpartum depression, please see a physician or contact Postpartum Support International, a free helpline.

Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.

Dieterich CM, Felice JP, O’Sullivan E, Rasmussen KM. Breastfeeding and Health Outcomes for the Mother-infant Dyad. Pediatr Clin North Am. 2013;60(1):31-48. doi:10.1016/j.pcl.2012.09.010

Centers for Disease Control and Prevention. Breastfeeding Benefits Both Baby and Mom. Updated July 27, 2021.

Bertrand KA, Hanan NJ, Honerkamp-Smith G, Best BM, Chambers CD. Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk. Pediatrics. 2018;142(3):e20181076. doi:10.1542/peds.2018-1076

Uvnäs Moberg K, Ekström-Bergström A, Buckley S, et al. Maternal Plasma Levels of Oxytocin During Breastfeeding – A Systematic Review. PLoS One. 2020;15(8):e0235806. doi:10.1371/journal.pone.0235806

Bookshelf

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

Drugs and Lactation Database (LactMed) [Internet].

Cannabis

Last Revision: June 20, 2022 .

Estimated reading time: 9 minutes

Drug Levels and Effects

Summary of Use during Lactation

The main psychoactive component of cannabis, tetrahydrocannabinol (THC), is excreted into breastmilk in small quantities. The duration of detection of THC in milk has ranged from 6 days to greater than 6 weeks in various studies. Concern has been expressed regarding the possible effects of cannabis on neurotransmitters, nervous system development and endocannabinoid-related functions.[1,2] A 1-year study found that daily or near daily use might retard the breastfed infant’s motor development, but not growth or intellectual development.[3] This and another study[4] found that occasional maternal cannabis use during breastfeeding did not have any discernable effects on breastfed infants, but the studies were inadequate to rule out all long-term harm. Although cannabis can affect serum prolactin variably, it appears not to adversely affect the duration of lactation. However, maternal perception that their use of cannabis is harmful to their infants are likely to discontinue breastfeeding earlier than mothers who do not believe it is harmful.[5] Other factors to consider are the possibility of positive urine tests in breastfed infants, which might have legal implications, and the possibility of other harmful contaminants in street drugs.

Because of insufficient long-term data on the outcome of infants exposed to cannabis via breastmilk, health professionals’ opinions on the acceptability of breastfeeding by cannabis-using mothers varies. In general, professional guidelines recommend that cannabis use should be avoided by nursing mothers, and nursing mothers should be informed of possible adverse effects on infant development from exposure to cannabis compounds in breastmilk. In addition to possible adverse effects from cannabinoids in breastmilk, paternal cannabis use may also increase the risk of sudden infant death syndrome in breastfed infants. Cannabis should not be smoked by anyone in the vicinity of infants because the infants may be exposed by inhaling the smoke.[6-9]

Drug Levels

The main active psychoactive component of cannabis is delta-9-tetrahydrocannabinol (THC), although it also contains other active compounds. THC is very fat soluble and persistent in the body fat of users and slowly released over days to weeks, depending on the extent of use.

Maternal Levels. Two women who smoked marijuana daily while nursing had their randomly collected milk analyzed. One mother who reported smoking marijuana once daily had a milk tetrahydrocannabinol concentration of 105 mcg/L; other metabolites were absent. The second mother who reported smoking marijuana 7 to 8 times daily had a milk concentration of 340 mcg/L; the metabolite 11-hydroxy-THC was found in a concentration of 4 mcg/L and 9-carboxy-THC was absent. A milk sample that was collected 1 hour after smoking marijuana contained 60.3 mcg/L of THC, 1.1 mcg/L of 11-hydroxy-THC and 1.6 mcg/L of 9-carboxy-THC.[10] One source used data in this case to estimate that the infant receives about 0.8% of the maternal weight-adjusted dosage.[11] However, a poorly characterized assay was used that might not be accurate and the portion of milk (i.e., foremilk versus hindmilk) that was collected by the mothers was not stated. This is important because of the high fat solubility of THC.

A woman who admitted to smoking cannabis (amount not stated) donated milk for analysis at an unknown time after the previous use. THC was present in a concentration of 86 mcg/L and 11-hydroxy-THC was present in a concentration of 5 mcg/L; 11-nor-carboxy-9-tetrahydrocannabinol was not detected.[12]

Eight exclusively nursing women who were 3 to 5 months postpartum and reported previous or current cannabis smoking were studied. After 24 hours of abstinence, each smoked a 100 mg of a standardized cannabis containing 23.18% THC. The product was smoked over 10 to 20 minutes from a glass pipe until it was fully consumed. Milk was pumped before smoking and at 20 minutes, 1, 2 and 4 hours after inhalation. THC and its metabolites, 11-OH-delta-9-tetrahydrocannabinol and 11-nor-9-carboxy-delta-9-tetrahydrocannabinol were measured in the milk samples. Six of the women had baseline THC concentrations of

Fifty women who reported using cannabis in the prior 14 days donated milk samples for analysis of THC and its major metabolites. Four women donated two samples each for a total of 54 samples. THC was detectable in 63% of the samples. The median concentration of THC was 9.47 mcg/L (range 1 to 323 mcg/L). Only 5 samples had measurable concentrations of 11-OH-THC (range 1.3 to 12.8 mcg/L) and 5 samples had measurable concentrations of cannabidiol (range 1.3 to 8.6 mcg/L). Samples collected 140 hours (about 6 days) or longer after reported use contained no detectable (

Twenty women in Oregon who admitted to using a cannabis product while breastfeeding their infants provided milk samples for analysis. The mothers reported using cannabis almost daily. Fifteen women provided milk samples at their infant’s 2-week and 2-month checkup and 5 provided a sample at only one of the visits for a total of 35 milk samples. All but one milk sample contained at least one cannabinoid. None of the mothers reported using a cannabidiol (CBD) product, but 13 had detectable CBD in breastmilk. Median (IQR) concentrations in milk were as follows: THC 27.5 (0.8 to 190.5) mcg/L; 11-OH-THC 1.4 (0.7 to 5.2) mcg/L; THC-COOH 1.9 (0.5-16.6) mcg/L; CBD 1.2 (0.5 to 17) mcg/L. Three patients using edible products had similar cannabinoid levels as those who smoked cannabis. Fourteen mothers reported an increase in use of cannabis between the 2-week and 2-month visit. Median breast milk THC concentrations were 16.7 mcg/L at visit 1 and 54.5 mcg/L at visit 2. The authors estimated that overall the breastfed infants received an average THC dose of 4.12 mcg/kg daily (range 0.52 to 123 mcg/kg daily) in milk.[15]

Seven women who used cannabis during pregnancy more than twice weekly, primarily by smoking, and were documented to be abstinent postpartum donated blood and milk levels 2 to 5 times weekly for 6 to 7 weeks. Maximum milk THC levels ranged from 2.8 to 26.1 mcg/L and the elimination half-life from milk averaged 17 days (range 12.2 to 21 days).[16]

Ninety lactating persons who reported using cannabis within the prior 48 hours donated 104 milk samples to a milk biorepository. THC, 11-hydroxy-THC, 11-COOH-THC, cannabidiol, and cannabinol were measured in the samples. The median concentration of THC was 22.7 mcg/L (range 0.1, 1620.0). The two main metabolites of THC, 11-OH-THC and 11-COOH-THC, were detected in 22 (21.2%) and 84 (80.8%) of samples, respectively. Cannabidiol was measurable in 44 (42.3%) of samples and cannabinol was measurable in 43 (41.3%)of samples. The number of hours since last use, route of use and number of puffs taken were significant predictors of the log of THC concentrations.[17]

Infant Levels. The urine of 2 breastfed infants whose mothers smoked marijuana found none of the 9-carboxy-THC metabolite. One mother reported smoking marijuana once daily and the other reported smoking marijuana 7 to 8 times daily. Analysis of the feces of the latter mother’s infant revealed a higher proportion of metabolites than THC, indicating that THC was probably absorbed from the milk, metabolized by the infant, and excreted in feces.[10]

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Effects in Breastfed Infants

Twenty-seven mothers reported smoking marijuana during breastfeeding. Twelve of them smoked once a month or less, 9 smoked weekly, and 6 smoked daily. Six of their infants were compared at 1 year of age to the infants of mothers who did not smoke marijuana during pregnancy or breastfeeding. No differences were found in growth, or on mental and motor development.[4]

Sixty-eight infants whose mothers reported smoking marijuana during breastfeeding were compared to 68 matched control infants whose mothers did not smoke marijuana. The duration of breastfeeding varied, but the majority of infants were breastfed for 3 months and received less than 16 fluid ounces of formula daily. Motor development of the marijuana-exposed infants was slightly reduced in a dose-dependent (i.e., number of reported joints per week) manner at 1 year of age, especially among those who reported smoking marijuana on more than 15 days/month during the first month of lactation. No effect was found on mental development.[3]

A small, case-control study found that paternal marijuana smoking postpartum increased the risk of sudden infant death syndrome. In this study, too few nursing mothers smoked marijuana to form any conclusion.[18]

A study of women taking buprenorphine for opiate substitution during pregnancy and lactation found that 4 of the women were also using cannabis as evidenced by positive urine screens for THC between 29 and 56 days postpartum. One was also taking unprescribed benzodiazepines. One infant was exclusively breastfed and the other 3 were mostly breastfeeding with partial supplementation. Infants had no apparent drug-related adverse effects and showed satisfactory developmental progress.[19]

Fifty women who reported using cannabis in the prior 14 days donated milk samples for analysis of THC and its major metabolites. THC was detectable in 66% of the samples and below the limit of quantification in 32% of samples. Preliminary evidence found no differences in infant adverse reactions, postnatal growth, or neurodevelopmental outcomes were found between the groups with quantifiable and nonquantifiable THC in breastmilk.[20]

Effects on Lactation and Breastmilk

Acute one-time marijuana smoking suppresses serum concentrations of luteinizing hormone and prolactin in nonpregnant, nonlactating women.[21-23] The effects of long-term use is unclear, with some studies finding no effect on serum prolactin.[24-26] However, hyperprolactinemia has been reported in some chronic cannabis users,[27-29] and galactorrhea and hyperprolactinemia were reported in a woman who smoked marijuana for over 1 year.[29] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Of 258 mothers who reported smoking marijuana during pregnancy, 27 who had smoked marijuana during breastfeeding were followed-up at 1 year. No difference was found in the age of weaning between these mothers and 35 who reported not smoking marijuana during pregnancy or breastfeeding.[4]

The US state of Colorado legalized medical cannabis in 2001 and recreational cannabis in 2012. A cross-sectional survey conducted in Colorado in 2014 and 2015 found that both prenatal and postnatal cannabis use were associated with a shorter duration of breastfeeding. Among women who reported using cannabis during pregnancy, 64% breastfed for 9 or more weeks compared with 78% of women who did not use cannabis during pregnancy. Among women who reported postpartum cannabis use, 58% breastfed for 9 or more weeks compared with 79% of women who did not use cannabis postpartum. Both differences were statistically significant.[30]

A study using a database of 4969 postpartum women found that those who reported using marijuana were more likely to smoke cigarettes, experience postpartum depressive symptoms, and breastfeed for less than 8 weeks.[31] Tobacco smoking is known to decrease the duration of breastfeeding, so the effect of marijuana is not clear. Most of the women who smoked marijuana postpartum also used it during pregnancy.

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