So What's The Deal With Pot And Breastfeeding?

First and foremost, I need to tell you that I am not a doctor, not at all. I do have a background in lactation, having worked with mothers as a board certified lactation consultant (IBCLC) for many years. But even in that official role— although I could point mothers toward good medical information — I could never give medical advice. Again, only doctors can do that.

Cool, now that we got that out of the way (whew!), let’s talk about a subject tons of breastfeeding moms want some answers to: Can I smoke weed while nursing my little one?

Some people might scoff at the idea of this question even being asked at all. But breastfeeding moms can drink in moderation, and a cup or two of coffee is totally fine. Asking about pot smoking is a totally legit question.

And the fact is, marijuana is becoming more and more of a mainstream drug. It’s legal for medical purposes in more half of American states, and legal for all uses in nine states — and counting. Moreover, it turns out cannabis has all kinds of uses besides getting people stoned and giving them the munchies. Many people use pot responsibly and under doctor supervision to help with medical issues, and even as a form of mental health therapy and maintenance.

It’s estimated that as many as 34–60% of pot smokers continue to toke up during pregnancy, and one can assume they are likely to continue while nursing. So, what are the dangers (if any) of smoking weed while nursing your child?

Unfortunately, the quick answer to that is that medical experts really don’t know enough at this point.

Because it was illegal for so long, moms who smoke weed while nursing did not always feel comfortable having the effects of their usage studied by medical experts. So there just isn’t a lot of data on it, and the data that is available tends to be somewhat outdated. For this reason, major medical organizations like The American College of Gynecologists and Obstetricians (ACOG) do not recommend its use, either in pregnancy or during lactation.

(As a quick sidenote: I’m not going to go into cannabis use during pregnancy, because that’s another topic in and of itself. Plus, the way that substances are processed and absorbed by fetuses are entirely different than how they are excreted into breastmilk).

But the recommendation from ACOG only goes so far, and we know that tons of moms still end up smoking weed while breastfeeding, sometimes even under the instruction of their doctors.

So let’s talk about what we do know about pot use during lactation. If you look up “cannabis” on the Lactmed database (Lactmed is a trusted government-funded site that keeps tracks of everything breastfeeding and medicine related — it’s awesome), you’ll find that THC, the active component in pot, is found in the breastmilk of moms who smoke pot.

“Although published data are limited, it appears that active components of marijuana such as tetrahydrocannabinol (THC) are excreted into breastmilk in small quantities,” explains Lactmed.

In terms of side effects for babies, Lactmed explains that studies have found that daily (or near daily) use of pot might have a negative impact on a babies’ motor development, but not on growth or intellectual development. One long-term study found that daily use might delay the breastfed infant’s motor development, but not growth or intellectual development. And yet another study found that pot use by moms while breastfeeding didn’t have any effects on babies at all, though long-term use was not studied here. (Again, you can go to the Lactmed database online and read the full entry, with links to each of these studies.)

Lactmed cautions mothers from smoking up in the vicinity of their kids, and that others in the home should abstain from this practice too (remember that second-hand pot smoke is a different thing than pot that ends up in breastmilk). It’s also important to note that moms should be aware that being stoned can impair their ability to parent responsibly at times.

Lactmed’s main takeaway?

“Because breastfeeding can mitigate some of the effects of smoking and little evidence of serious infant harm has been seen, it appears preferable to encourage mothers who use marijuana to continue breastfeeding and reducing or abstaining from marijuana use while minimizing infant exposure to marijuana smoke.”

Hmmm … sounds a little, ummmm, inexact and confusing, right? What’s a pot smoking breastfeeding mama to do?

Well, all of this is why Dr. Thomas Hale, PhD. — who’s basically the guru of medications and how they affect breastfeeding babies — has been working diligently on a brand new study he hopes will shed some real light on pot use while breastfeeding. Dr. Hale, the author of Medications and Mothers’ Milk, now in its 17^th edition, as well as the director of the Infant Risk Center, explains why he’s involved in this current research, and the importance of it.

“The need in this field is just enormous,” Dr. Hale said in a 2017 interview with Westword, “Right now, the current estimates are that somewhere between 10 to 15 percent of mothers use marijuana while they’re pregnant, so we know they’re probably going to use it while they’re breastfeeding…. We just need to know with some good hard data if there are risks to the baby.”

Hell yes. We sure do.

In an even more recent interview with Kellymom.com, Dr. Hale explains what his research team has found thus far — and the results sound promising, at least in terms of giving pot-smoking breastfeeding moms a little more clarity about the whole thing.

“The samples are slowly coming in and we are able to measure small levels of THC in milk,” Dr. Hale explains. “It’s too soon to know, but I’m thinking the relative infant dose is going to be small and the oral absorption poor.”

Hmmmm … so what should you do until a more conclusive study comes out? Your best bet is to read the studies yourself, talk to your health professionals about them, and make an informed decision. This is especially true for mothers who use pot for medical or mental health issues – you need to carefully weight the pros and cons here. And a little common sense can go a long way here (i.e., everything in moderation, if you know what I mean).

Oh, and go and beg the lovely Dr. Hale to release those new study results ASAFP.