With the marijuana legalization being on the rise in the U.S., there are a lot of controversial topics that need to be discussed. Marijuana use while breastfeeding is one of them. Can a mother continue to use marijuana while breastfeeding an infant? Is it harmful to a child to be exposed to marijuana? What are the real risks (if any) of smoking marijuana while breastfeeding?
Just like with most questions related to the use of marijuana, there is no agreed position among the scientists and pediatricians on whether it is safe to continue using cannabis while breastfeeding. The reason is quite obvious: there is not enough data on the subject.
On the one hand, we have a number of studies showing that cannabis may be harmful to infants. But on the other hand, most of these studies were focused on the effects of THC, the main psychoactive compound in weed, and not on CBD, its non-psychoactive peer.
So, let us take a closer look at each of the aspects of this controversial problem.
So, does marijuana affect breast milk? As you probably know, THC is extremely fat-soluble, and breast milk consists mostly of fat. So, when you consume marijuana, some part of THC stays in your system because it is stored in your fat.
Furthermore, during the lactation period, a woman's body starts to burn fat in order to produce even more milk. As a result, in heavy weed users, the level of THC in breast milk may be up to eight times higher than in blood.
According to a 1982 study, with the breast milk, a baby receives around 0.8 percent of a weight-adjusted maternal dose (WAMD) of THC (the baby will receive 0.8 percent of the dose her mother received, per unit of the body mass). Often, drugs with WAMD of less than 10 percent are considered “safe” for breastfeeding, although there are notable exceptions (especially if the baby is very young, the mother’s dose is very high, or if the drug is very toxic). And a literature review published in 2009 shows that an infant may show positive results if being tested for THC in its urine even 2-3 weeks after being fed by a marijuana-using mother.
According to another study published in 1990, the most dangerous period is the first month of an infant's life. Those infants who have consumed trace amounts of THC with breast milk during the first month after being born showed decreased motor skills in the first year of their lives. However, infants who were exposed to THC at the age of three months or later, showed no decrease in motor or cognitive skills withing the first year of age.
A literature review published in 2012 in Clinical Lactation shows that along with delayed motor development, infants who consumed THC via breast milk reportedly have an increased risk of developing certain health problems, including poor sucking reflex, slow weight gain, and increased risk of tremor.
The most disturbing thing is that we do not know how exactly THC is affecting an infant's brain and its development. So, if you intend to use marijuana during pregnancy of lactation for recreational purposes, you'd better change your mind. Especially if you were considering smoking pot while breastfeeding since an infant can be easily affected by the secondhand cannabis smoke. The National Institutes of Health recommends to minimize an infant's exposure to cannabis smoke and for a mother to reduce marijuana consumption.
But what about the mothers who have switched to using medical cannabis instead of more aggressive and harmful pharmaceutical medications? Can they use marijuana while breastfeeding without harming their kids? The prescribing physician should consider if the benefits of using medical cannabis outweigh potential risks, taking into account the risk-benefit ratio of the available alternative treatments.
In contrast to THC, CBD is widely used for treating children who suffer from severe, treatment-resistant conditions like epilepsy or cancer.
The youngest kid to be treated with medical cannabis was Amylea Nuñez, originally from Albuquerque, New Mexico. She was only two-month-old when she started to receive medical cannabis oil, so she is probably the youngest medical cannabis patient in the world.
One of the latest studies published in the New England Journal of Medicine shows that CBD helps reduce the number of seizures in pediatric patients with the Dravet syndrome, one of the most dangerous treatment-resistant forms of epilepsy.
Does it mean that using medical cannabis and, particularly, CBD, while breastfeeding is safe for infants? There is still not enough data to answer this question. Even though medical cannabis shows positive results in treating and managing various conditions, the long-term effects of this kind of treatment remain unclear.