As of April 2024, recreational marijuana is legal in 24 states, or nearly half the country, according to the Pew Research Center and medical marijuana is legal in 13 states. This can indicate that many mothers may be questioning the safety of using medical or recreational cannabis while breastfeeding. The official guideline is that breastfeeding women are advised against using cannabis, due to insufficient research to determine “safe amounts” of cannabis use during breastfeeding. The emphasis is on caution due to the unknowns surrounding the transfer and effects of THC through breast milk. This article aims to dissect the most recent research on THC transfer to breast milk. 

The Biology of Breastfeeding

Breastfeeding is a complex biological process that provides essential nutrients and antibodies to infants. According to the American Academy of Pediatrics (AAP), breastfeeding is recommended exclusively for the first six months of life, followed by continued breastfeeding along with appropriate complementary foods for up to one year or longer, as mutually desired by mother and infant. The AAP emphasizes that breastfeeding offers numerous health benefits for both the mother and the baby, including reduced risks of infections, chronic conditions, and certain types of cancers.

Breast milk composition is influenced by the mother’s diet and health, making it crucial to understand how substances like cannabis can affect breast milk and, subsequently, the infant. A recent study indicates that only minimal amounts of THC, the psychoactive component in cannabis, transfer into breast milk. Research from Colorado involving eight breastfeeding mothers shows that, on average, just 2.5% of the THC consumed by the mother reaches the baby.

Key Findings:

1. Low THC Concentration: Only 2.5% of the mother’s THC dose is passed through breast milk, with an even lower bioavailability rate in the baby’s system.
2. Rapid Decline Post Consumption: Peak THC concentration in breast milk occurs one hour after consumption, dropping significantly after four hours.

Practical Recommendations for Breastfeeding Mothers:

1. Timing of Consumption: Consuming cannabis immediately after breastfeeding can minimize the baby’s exposure to peak THC levels.
2. Use of Pumped Milk: Utilizing previously pumped breast milk or formula for the first feeding after cannabis consumption can further reduce exposure.
3. Strain Selection: Choosing cannabis strains with higher CBD and lower THC content can reduce overall THC exposure.
4. Consider Edibles: Edibles may produce a longer-lasting but lower-intensity THC exposure compared to inhaling.

Considerations for Mother’s Using Cannabis

The discussion around cannabis use while breastfeeding should focus on compassion and understanding. Raising children is demanding, and many mothers might seek relief through cannabis, which can calm anxiety and reduce stress.

Key Points:

• Risk and Benefit Analysis: Rather than simply advising against cannabis use, it’s essential to help mothers weigh the risks and benefits, based on their unique situation.
• Stress and Cortisol: Maternal mental health significantly impacts the well-being and development of the infant. Elevated stress levels can harm both mother and baby, as cortisol is transferred through breast milk.
• Breastfeeding Benefits: Extended breastfeeding has significant health benefits that may outweigh the minimal transfer of THC when usage is carefully timed and managed.
• Informed Decisions: Providing mothers with accurate data and risk mitigation strategies supports them in making responsible choices.

Understanding that many mothers already use cannabis, offering guidance on minimizing risks is a more practical approach than outright prohibition. This empowers mothers to make informed decisions that best suit their individual situations.

Pharmaceuticals and Breastfeeding

It is essential to note that many pharmaceuticals also pass through breast milk and can have side effects on infants. Common medications prescribed for postpartum depression, anxiety, and other health issues are known to be present in breast milk to varying degrees. Healthcare providers often weigh the benefits of these medications for the mother’s health against potential risks for the infant. This same consideration should be applied to cannabis, particularly when it is used for therapeutic purposes.

Conclusion

Cannabis use during breastfeeding should be approached with caution. Informed choices, careful timing, and consulting with healthcare providers can help mitigate potential risks. Mothers must weigh the benefits and risks, with more support and compassion needed to help them make the best decisions for their unique situations.