Marijuana and breastfeeding: Is it safe?

This post originally appeared on The Lactation Network

In short, no. Here’s what you need to know.

It’s no secret that many people enjoy cannabis, from the relaxing, pain-relieving, euphoric effects of THC to the purported healing powers of CBD—and there’s no shame in that! But even though recreational cannabis use is now legal in 19 US states, plus Washington, DC and 38 states have legalized medical marijuana, experts agree: Cannabis in all its forms is still not safe for breastfeeding parents and their families. That means CBD and medical marijuana treatments are out, too.

According to the CDC, breastfeeding parents should be advised not to use marijuana or marijuana-derived products of any kind—including those containing CBD—while breastfeeding or pumping.

We consulted with three TLN International Board Certified Lactation Consultants about all things marijuana and breastfeeding, plus baby-safe ways to alleviate pain and anxiety. Here’s what we discovered:

Cannabis does leech into breast milk

Whether smoked, vaped, ingested or passively inhaled, cannabis byproducts wind up in your breast milk. Per Harvard Medical School and the Massachusetts General Hospital, the amount of cannabis in breast milk will vary based on how it was consumed, but both CBD (cannabidiol) and psychoactive THC (the cannabinoid that can get you high) have been detected in the breast milk of marijuana users. In the largest study to date, “the amount of THC detected in pumped breast milk ranged from 0.4%-8.7% of the maternal dose.” 

Related: AAP now recommends breastfeeding beyond age 2 due to benefits for both baby and mother

Not only does cannabis pass from your bloodstream to your breast milk in sizable doses, it can also stay there for a long time. Because cannabis is fat-soluble and most lactating humans contain 25-30% body fat or more, it can take more than six weeks for cannabis to leave your system entirely—especially if you are (or recently were) a frequent cannabis consumer. That means it’s impossible to ‘pump and dump’ cannabis.

“Lactating parents should know that it is possible for their infant to test positive on a drug screening for many days and sometimes weeks after they use cannabis,” said TLN IBCLC Demi Lucas, who also mentioned that cannabis has only become more potent in the past few decades.

The risks for your baby—and for you

THC risks

Due to federal restrictions, medical data on THC and breastfeeding is still fairly limited. However, the FDA reports that “THC may affect a newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences.” Furthermore, we know that weed can seriously impair your caretaking abilities, and that goes for non-lactating partners, as well. According to TLN IBLCLC Chrisie Rosenthal, “cannabis can impair the partner’s ability to care for the child responsibly, shifting all the parenting responsibilities to the breastfeeding parent and increasing that parent’s stress.” That means no edibles, vapes, or tinctures in your home at all—and absolutely no smoke.

Passive smoke risks

You now know that smoking weed while breastfeeding is dangerous, but smoke in a baby’s vicinity can be just as concerning as cannabinoids in breast milk. Secondhand smoke can lead to higher risks of “sedation, sleep apnea, and even Sudden Infant Death Syndrome,” shared Lucas. An infant or lactating person’s exposure to passive smoke can cause “a positive urine test for THC―which means the THC was in their blood.” So not only should you and your partner abstain from smoking weed (or tobacco, for that matter) around your child, your partner should never smoke around you while you’re lactating, either.

CBD risks

Often isolated from other cannabinoids and sold in vitamin aisles, CBD is non-psychoactive… But it’s still not safe for lactating parents to take. While the direct impact of parental CBD consumption on infant health is still unknown, reported CBD risks for adult people include liver toxicity, extreme sleepiness, and negative interactions with other drugs. Per the CDC, CBD supplements are still highly unregulated, so they may also contain “pesticides, heavy metals, bacteria, and fungus” that could be harmful to you and your little one.

Related: I took CBD and it made me a more present, less anxious mom

So what’s the safe alternative?

Many people use cannabis (including CBD supplements) to treat anxiety and depression. So how can you simulate the calming effects of marijuana to alleviate postpartum stress… without actual marijuana? Rosenthal stressed that planning for the newborn period is key. “If possible, line up support in advance,” she said. “That might mean having friends, relatives, or a paid doula come in to provide relief while you take a nap or leave the house for a change of scenery. A therapist can also be an excellent source to help you manage your stress. Support groups (virtual or in-person) can be invaluable, too, in that they provide peer support, and normalize what you’re going through as new parents.” 

Related: Therapy made me a better mom—and wife

You may be able to find medicinal support for what ails you, as well. TLN IBCLC Jennifer Horne said she often refers patients to the LACTmed database, which details lactation-safe therapeutic alternatives to many drugs. Lucas, meanwhile, recommended the Medications & Mother’s Milk App. As always, talk to your physician or IBCLC before taking a new supplement while breastfeeding.

When can you resume cannabis use again?

If you were a regular marijuana user prior to pregnancy, you might just want to feel like yourself again—and that’s nothing to feel guilty about. Still, many new parents are too embarrassed to ask their doctor or IBCLC about cannabis. According to Rosenthal, there’s nothing to fear. Happy to help destigmatize safe cannabis use, Rosenthal said “Thank you for asking about this. As Lactation Consultants, it’s our job to provide you with evidence-based information so you can make the choices that are right for you and your family.” So ask if and when it’s safe to return to cannabis use! Your IBCLC can work out a plan of action with you.

If eliminating cannabis has proven to be a struggle for you, or if you have questions about using CBD or other cannabis-derived products while breastfeeding, talk to your physician or IBCLC. They’re here to help—not to judge—and they can guide you toward safe solutions.

This post originally appeared on The Lactation Network

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