Mothers are scrutinized from the moment they share the news of their pregnancy and for the rest of their lives. The way they eat, the environments they place themselves in, the way they interact with their children, the way they feed their children, the way they look… These are all placed under microscope and judged relentlessly from all sides.
For mothers who use cannabis, this pressure is immense, and the consequences can range from being ostracized to having their children taken from them. While the topic of cannabis use during pregnancy is already polarizing, breastfeeding with cannabis in her system is an issue that mothers are extremely interested in but afraid to speak about publically.
Why Are Breastfeeding Mothers Using Cannabis in the First Place?
It can be easy to assume that a nursing mother who chooses to consume cannabis is selfish and irresponsible, especially if what you know about cannabis is that it is illegal. I mean, if you choose to become a mother, you should be prepared to give up partying and getting stoned, right?
Well, the situation is more complicated than that. Yes, the THC in cannabis gives users the sensation of being high, and there are many people who use cannabis for that recreational purpose alone. However, cannabis is so much more than a recreational drug. Study after study reveals that cannabis has incredible therapeutic benefits because of the way that it engages with our endocannabinoid systems. To put it simply, cannabis is good for you—for many people, cannabis is literally a life-saver. And mothers who choose to use it during pregnancy and beyond use it for that reason.
The Benefits of Breastfeeding
There isn’t a lot of evidence about the potential harms or benefits of cannabis use while breastfeeding, but one of the reasons women are so torn about this issue is that there is a plethora of research enumerating the benefits of breastfeeding.
According to the World Health Organization, breastfeeding saves infant lives. Breastfeeding significantly reduces the risk of SIDS (Sudden Infant Death Syndrome), a terrifying occurrence in which a baby suddenly dies without explanation. Breastmilk contains all the nutrients a developing infant needs and antibodies that protect babies from illnesses responsible for most infant mortality. Additionally, adults and adolescents who were breastfed as babies show elevated performance levels in intelligence tests and a reduced likelihood of becoming overweight, obese, or developing type II diabetes. Breastfeeding is also beneficial for mothers, providing them with a natural form of birth control and reducing their risks of ovarian and breast cancer, postpartum depression, and type II diabetes. Finally, breastmilk is free, and this is especially important for economically disadvantaged women.
The alternative to breastmilk, formula, will enable babies to thrive, but it falls quite short of mother’s milk. Formula does not contain the antibodies that liquid gold continuously provides, but it does contain refined sugar. It can be contaminated with unclean water. It is expensive, and sometimes desperate mothers will dilute formula to stretch out their supply, putting their babies at risk of malnutrition.
So you see, the recommendation to stop breastfeeding and opt for formula if a woman desires to continue her use of cannabis is not a simple choice at all and is arguably more detrimental to the child than the cannabis could ever be. The research on the long-term impact of cannabis use while breastfeeding on children is frustratingly limited, but here are the most popular arguments against and for it.
It interferes with maternal judgment.
Mothers who smoke or ingest cannabis may not be fit to properly take care of the baby. The thought is that if she is high, her judgment may be impaired. Newborns are totally dependent on their caregivers, so a mother should be completely sober when taking care of her child.
THC passes to the child through breastmilk.
A 1982 study discovered that an average of 0.8% of a mother’s dose per her weight of THC passes through breastmilk to the baby. Additionally, research indicates that babies actually metabolize this THC since they will test positive for the cannabinoid via urine tests for up to three weeks.
THC may adversely affect an infant’s brain development.
This is one of the most controversial arguments since the evidence is inconclusive. A 1990 study found that infants who had consumed small amounts of THC during their first month of life demonstrated poorer motor skills within their first year. However, infants who consumed trace amounts of THC after three months of age did not show poorer cognitive or motor skills in their first year. It is important to note that the researchers themselves stated that these findings do not “necessarily mean that the relationship [between cannabis and breastfeeding] is one of cause and effect.”
THC may inhibit an infant’s ability to thrive.
A literature review on lactation and cannabis published in Clinical Lactation stated that nursing babies exposed to THC were at increased risk of developing tremors and a poor sucking reflex. They were also more likely to feed for smaller amounts of time, gain weight at a slower rate, and experience delays in motor development. However, the review also stated that these findings were inconclusive because of the difficulty of studying cannabis use in nursing mothers.
The benefits of breastfeeding outweigh the potential risks of cannabis exposure via breastmilk.
The most commonly cited research indicating that cannabis may be harmful to infants has been deemed inconclusive by the researchers themselves, so it isn’t at all clear that cannabis actually is harmful. Moreover, studies exist demonstrating no harm. A 1982 study followed 756 women, 34% of whom were cannabis users, and found that there were no developmental differences between children exposed to THC via breastmilk and those who were not at one year. However, the study indicated that more long-term research was needed to conclude that cannabis doesn’t affect verbal learning and other more complex cognitive developments. What is certain are the benefits of breastfeeding. For this reason, the National Institutes of Health has stated:
“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 while minimizing infant exposure to marijuana smoke and reducing marijuana use.”
Cannabinoids are naturally present in breastmilk.
All mammals have endocannabinoid systems, including humans. We produce endocannabinoids, chemical compounds very similar to THC, and research suggests that these endocannabinoids are responsible for stimulating suckling in newborns and in fetal brain development. This means that cannabinoids present in cannabis may have a far more complicated—and potentially beneficial—relationship with babies than we realize.
The expert on drug safety while nursing doesn’t have the evidence to back up his conclusions about cannabis.
Thomas W. Hale is the guy medical professionals reference when telling their patients what drugs are safe during pregnancy and breastfeeding. Hale has determined that cannabis is contraindicated because
“studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience, or it is a medication that has a high risk of causing significant damage to an infant. The risk of using the drug in breastfeeding women clearly outweighs any possible benefit from breastfeeding. The drug is contraindicated in women who are breastfeeding and pregnant.”
The problem with this is that his statement isn’t based on any solid evidence. There are no studies conclusively indicating the high risks he mentions, and he makes some claims without citations at all.
Doctors are okay with breastfeeding mothers (and people generally) ingesting far more dangerous substances.
You cannot overdose from cannabis, and it cannot kill you. The worst side-effects you may experience are paranoia, dry mouth, and an increased appetite. Most of the synthetic drugs prescribed by doctors can kill you or result in very damaging side effects. The difference between cannabis and synthetic drugs? Cannabis is federally illegal. The label of illegality is what scares doctors away, but if the medical community took a closer look at the quality of the drugs, it is clear that cannabis is not nearly as dangerous as the Feds have made it out to be.
The Bottom Line
The decision to continue using cannabis while breastfeeding is a deeply personal one, and quite frankly, there isn’t enough evidence to conclusively deem it a harmful decision as well. Given that and as an act of compassion, it is better to assume that a mother who uses cannabis does have her child’s best interests at heart.