As an advocate for the responsible usage of cannabis amongst adults, I have been compelled to write about marijuana use and lactation for quite some time. It is glossed over in lactation school but it shouldn't be and we do have answers, and each support group will yield at least one cannabis question so might want to be prepared to answer. Now as capitalism has been married to the budding weed industry, pun intended, dispensaries open as frequently as Starbucks. Using cannabis recreationally and medicinally has become less taboo, at least here in San Diego, so I knew it was finally "acceptable" to have this conversation publicly.
Rhianna is the newest Black celebrity to be pregnant and glowing! What will she and other mamas do when they want to blaze up after having her little one if those baby blues hit too hard?
Many parents have this question and today I'm here to give you some answers!
Don't worry Riri, "if you are reading this, it's not too late", I got you boo...call me if you need a postpartum doula or lactation consultant, I will travel sis!
Is it ok to take a few puffs of a joint if I’m making milk?” Well your answer depends on a few individual things…define what a few puffs is:
What you smoking (strain & THC %)
How you smoking it?
Pipe, vape, blunt, joint?
Does it contain any added substances? other recreational drugs or additives?
Have you used it before?
If so, how well do you respond to it? What are your effects?
What are the benefits to using it?
What are the risks associated with not using it?
What are the risks associated with breastfeeding?
What are the benefits of using it while breastfeeding?
Will someone be home with you?
Do you have milk stored?
Do you plan to combo feed?
Donor milk options? Into informal milk sharing?
Was or is your baby premature? Did they stay in the NICU?
As I've started to get this question at every breastfeeding support group, I’ve compiled this list of things I’ve asked parents when they ask me this question. This is for my own research and data points so I can have anecdotal evidence to provide as I’m asked so frequently and would rather have something to say than nothing. To best support my clients, I like to stay up on current research with regards to lactation. Between professional workshops and such, I find myself obsessively going down internet rabbit holes while doing research on cannabis and human milk consumption, unapologetic Google university alumni and Wikipedia scholar here!
I have seen a significant increase in the numbers of both pregnant and breastfeeding parents who are using marijuana these days, likely increased to manage the surmounting toxic stress of the pandemic and systemic societal issues.
Joel Gator Warsh, M.D. is a board-certified pediatrician at Cedar Sinai Hospital in Beverly Hills, California. He has also seen a rise in marijuana use in his patients. “I do feel that the benefit of breastfeeding outweighs the risks from THC. If one has to decide to breastfeed or not, this study lends additional data that parents should continue to breastfeed as much as possible and interested, even if using THC.”
Talk Nerdy To Me
The Cannabaceae family of plants includes cannabis plants, and from a healthcare perspective, two compounds that are especially important, tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD is not impairing, meaning it does not cause a “high” like THC. Amid all kinds of permissible substances, like sugar, caffeine, and alcohol—often used while breastfeeding—you would think this plant with such amazing health and wellness benefits would be considered just as safe as the above mentioned right?
Unfortunately for my people looking for a concrete yes or no answer, this isn’t sufficient enough to provide a simple black and white answer to parents and it’s beyond frustrating for us in the field of caring. Until it becomes legalized at the federal level, I don’t think we will ever see a concrete yes from government agencies on individual dosage information. So until then, we do what we can to learn more about the consumption of cannabis while chest/breastfeeding.
Figuring out how much is passing into the milk varies considerably from person to person. Both CBD (cannabidoil) and the psychoactive component, THC (delta-9-tetrahydrocannabinol) have been detected in human milk after consumption by the lactating person.
The AAP reports on cannabis and breastfeeding: no effect mentioned; very long half-life for some components. The kinetics of cannabis depends greatly on the method in which it was received such as smoked vs. ingested and usually detectable in bodily fluids for 1 to 30 days after last use and detected in the hair for several months. Yes, THC is passed through human milk. It's stored in the fat of the milk, so it stays in the system and the milk longer than other substances that aren't fat-soluble. One study found that THC remained in milk for up to six days after use. The largest study to date included 8 breastfeeding women and the amount of THC detected in pumped breastmilk ranged from 0.4% - 8.7% of the maternal dose with an estimated mean of 2.5%. Using these data points, the average absolute infant dose was estimated to be 8 micrograms per kilogram per day. Therefore, the concentration of cannabis in the breastmilk are variable and related to the maternal dose and frequency of dosing. The individual advice to this question will depend on you and most importantly, your baby. Age, weight, birth story, NICU stay, prior and current development, any delays? Stay on top of these things if you choose to use cannabis and breastfeed. Marijuana can cause sleepiness in the baby, which can lead to slow weight gain. Hale reports a possibility of decreased milk production. Hence, baby’s struggling to stay on the curve may be affected by heavy users.
Cannabis and it’s byproducts are very fat-soluble or lipophilic and we have a lot of fat in the breast where the milk is made and stored, average percentage of body fat for women is about 25-30% which is a large reservoir for the lipophilic nature of THC to store. For this reason, it’s more likely to see THC and its metabolites in the blood, urine and breast milk of the lactating daily cannabis user. Studies focusing on the detection of THC in milk yields variable results in various studies with duration of detection ranging between 6 days and 6 weeks, which can be very conflicting for parents to hear.
Despite the results, in places where it is legal, lactating parents should be able to use cannabis and receive proper guidance from a professional while doing so without bias or judgment. A growing number of states are legalizing marijuana for medicinal or recreational purposes. Marijuana use is as old as the plant itself so it’s time to have a new perspective on how marijuana affects people in specific ways, the benefits and the risks associated and the discussion should start with: “what is the risk of a substance transferring to breast milk versus the benefits of breastfeeding?”
Let’s start with these basic questions as we would with any substance, does it pass into human milk? If so, at what percentage and what is the half life?
What Parents Need To Know
One way I like to educate parents on their choices on breastfeeding and cannabis is by teaching them about the half-life or the duration of time it takes for the product to leave the system. With marijuana, it’s a much longer half life than say a glass of wine, which would be out of your system/blood in 2-3 hours, whereas with marijuana/cannabis, it’s more like 2-3 days to start leaving the system. Having this knowledge often helps parents to feel empowered to make an informed decision with regards to their choice to use marijuana and breastfeed as safely as possible. The benefits of breastfeeding outweigh the risk of exposure to most therapeutic agents via human milk. Although most drugs and therapeutic agents do not pose a risk to the mother or nursing infant, careful consideration of the individual risk/benefit ratio is necessary for certain agents, particularly those that are concentrated in human milk or result in exposures in the infant that may be clinically significant on the basis of relative infant dose or detectable concentrations.
If parents are able to use cannabis to calm the mind-body connection while restoring a sense of balance on a long intense journey, it could be sanity saving for many. Some people don’t want to use prescription pharmaceuticals to manage their stress, depression and/or anxiety and prefer to use something more natural and holistic—in walks Mary Jane. Keep in mind, a baby in the NICU more than likely meant birth trauma and pardon me but the PTSD that comes with birth trauma, honey it deserves all the weed in the world!
Cannabis helps many parents to relax, navigate their anxiety, and generally help them feel a bit more content if the baby blues try to creep up. Yes, I say parents because it’s a fact that up to 50% of dads/partners experience postpartum depression after a baby is born.
In the end, when considering how little actually passes through to the milk some people believe the benefits far outweigh the risks and in their situation, they might be right. I’m a ‘plants over pills’ person myself, as many of the clients I see are too. A mom who suffered from postpartum mood & anxiety disorders decided to start her own CBD product line after being judged and left without guidance. This business, Atlantis Bloom, is also powered by a mom who wants to help other moms unwind a little or a lot with her discrete and powerful line of homemade and home grown THC gummies, cookies, honey and more!
Studies Provide Insight
To get a better idea of what could actually happen when lactating folks use marijuna, a researcher at UCSD, Dr. Chambers and her colleagues conducted an amazing study by collecting 54 breast milk samples from 50 women who smoked marijuana either daily, weekly, or sporadically. THC was found in 63% of the breast milk samples for up to 6 days after self-reported use. While researchers note that the amount of THC was relatively low and they cannot determine if it’s trace elements are enough to affect a healthy newborn. A small to moderate secretion into breastmilk has been documented, and THC is concentrated in human milk. According to Dr. Thomas Hale, analysis of breastmilk from chronic heavy users indicated an eight-fold concentration in milk compared to mom’s blood plasma, however the dose received by the baby was insufficient to produce significant side effects.
According to a survey conducted on lactation consultants in New England, there is consistency on the messaging. 74 were surveyed and 44% stated they would recommend breastfeeding while using cannabis and 41% reported their recommendation would be influenced by the amount and frequency of cannabis used by the lactating parent. Only 15% stated they would recommend abstaining from cannabis while breastfeeding. Major health and medical organizations like the AAP, FDA, CDC, and ACOG all say lactating people need to be “counseled” on the risks of cannabis but they are not promoting the known benefits which to me presents a transparency issue in which we are not providing people with ALL the information needed to make an informed decision.
Cannabis B(Lactivist) (black lactation activist)
As a lactation consultant and perinatal health professional, my general advice to lactating folks who chose to use cannabis and breastfeed are to use responsibly, protect your supply, feed your baby wisely, focus on optimal nutrition and healthy lifestyle overall, eat enough calories and consume lactogenic foods (i.e. oats, brewer's yeast, fatty fish) in order to avoid pitfalls on your breastfeeding journey, most of all work with a lactation consultant who is cannabis friendly like myself.
Parental “cannacuriosity” during the postpartum period is normal. Postpartum depression treatment usually comes in the form of medication and occasionally a referral to mental health support. However, what happens when a birthing person has a baby and is struggling with PMADs (perinatal mood and anxiety disorders) and their treatment of choice is preferred to be more of a natural and holistic alternative approach to care? They are stigmatized and judged for doing what is best for them when they choose something more holistic such as an herbal remedy like cannabis over big pharma which has far more detrimental effects on society and motherhood, but that’s another story for another day. We know the climate of a home can influence a child's development and many parents report to me they feel better about the role they play in their home's climate with THC in the picture than without.
I’m honestly tired of hearing the B.S. excuse “we just don’t know enough about…” well then let’s look at what we do know!
Parental Cannabis Consumption Isn't All Recreational
Many parents are being more vocal about their use of cannabis through social media and blogs. Parents are using cannabis to treat everything from preconception wellness and fertility to postpartum depression/anxiety and birth trauma PTSD. I’ve even heard some folks in the birthing community talking about THC tampons for fibroids and crippling endometriosis or other reproductive pain. Some even use medically prescribed cannabis for children with rare serious seizure disorders. This could be a huge win for the mental health and stress that NICU postpartum parents often experience. “Postpartum” means the time after childbirth and Postpartum depression is a serious mental illness that can be mild to severe and affects behavior and feelings. It is very common, 1 in 9 new mothers has postpartum depression. Perinatal depression is a mood disorder that can affect women during pregnancy and after childbirth. The word “perinatal” refers to the time before and after the birth of a child. Perinatal depression includes prenatal/pregnancy depression. Cannabis consumption can help those struggling to eat enough calories to maintain a healthy milk supply. Particular marijuana can also improve your appetite, which helps promote breast milk production through sustained caloric intake. One intriguing new study done recently by the American Academy of Pediatrics shows how breast milk containing THC may have no dangers to preterm babies.
The current cannabis climate industry has outpaced regulations, the DEA and FDA are being irresponsible by leaving consumers and healthcare providers confused by having to base on morals rather than science. This is why people are reluctant to speak out on their cannabis usage to their health care team. Since nearly half of U.S. states have legalized marijuana, and as the cannabis business continues to rapidly grow, we will begin to have more parents asking if it’s safe to use while nursing. Some folks view cannabis as a healthier alternative to alcohol as a part of adult recreation. So, as we watch the promotion and rise of breastfeeding and cannabis use individually, we must continue to do the research that allows parents to consume cannabis through informed decision making.
Subscribe and follow my blog and Instagram or Tik Tok @melaninmilksd for more content on this topic series coming soon including: How To Be a Health Conscious Smoker and the lactating & Cannabis consumption flow chart for parents.
Citations & References:
www.mothertobaby.org
www.acog.com
www.aap.com
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