No easy answers about cannabis use and breastfeeding


Cannabis is exploding all over the world with a here-to-stay attitude, so you’d better get used to it. I don’t see the reversal of legalization happening anytime soon, and the money keeps rolling in. I believe the applicable phraseology is “cha-ching.”

What I’m hearing from the more conservative public about the spread of legal weed are concerns about how it will affect the children in our communities. That also happens to be what many parents who consume marijuana have on the forefront of their minds too — including new mothers with legitimate concerns about the potential effects of their marijuana use, should they choose to breastfeed their babies.

And boy, is that a touchy subject.

Most official medical channels side with the conservative public.

“Kaiser Permanente agrees with the American Academy of Pediatrics that pregnant women or nursing moms should not use marijuana,” Amy Whited, manager of public relations and digital media for managed care giant Kaiser Permanente Colorado, told The Cannabist in a recent statement. “Marijuana use in pregnancy has been linked with decreased birth weight, leukemia and neuro-behavioral changes in newborns and adolescents.”

On the flip side, the people I have encountered that have used cannabis and breastfed their child (not simultaneously, come on) are quick to defend their choices. The people who are against such practice assert that it has negative effects on a fully grown human, so of course it harms a baby. And there are those who say they just don’t know what kind of effect it has on a child or an adult and we need more research, don’t we?

So what does one tell those moms who ask the question, either in preparation for their new babe’s arrival or in reflection of their past choices, “Is breastfeeding while cannabis is in my system safe for my child?”

I’ve found there are a number of websites that will tell you marijuana will hurt a breastfeeding baby.  Not a surprise, right? There are a comparable number of websites that state the exact opposite. That’s to be expected, as the country is split with 58 percent in favor of marijuana legalization, according to a recent Gallup poll.

A clear distinction between two sides comes with those numbers – but which one is right?

And why are the camps so split? It’s not as though anyone disputes the harm tobacco causes the human body – by law, manufacturers put a warning on their product packaging. There are years upon years of research logged about its adverse health effects. The words “cancer” and “cigarette” have become tied up with each other forever.

However, because of marijuana’s Schedule I status in the United States, research has been, at best, limited. The federal government says there is no current accepted medical value in Schedule I substances, and they have a high potential for abuse. Right or wrong, that’s the state of things.

An element that makes maternal cannabis research more difficult in particular is the inability to pinpoint cannabis, above all other factors, as the reason for any particular issue or abnormality with the baby — physically or mentally. Overconsumption of caffeine can cause problems with a breastfeeding mom and infant, as can too much sugar or stress; then there are the issues of education and socio-economic status — need I go on?

Additionally, getting large groups of pregnant women to feel safe enough to admit they use weed while breastfeeding is a hurdle that has yet to be cleared in any consistent way. By now most of us know that just because cannabis has been legalized for medical use in 23 states and for recreational purposes in two states doesn’t mean it’s politically correct for a parent to use it — and most especially if that parent is a breastfeeding mommy.

With that said, there are a few studies out there and evidence from both camps that provide some valuable food for thought.

A University of Colorado Health Sciences Center study led by researcher Katherine Tennes in the 1980s examined, in small part, women who had consumed cannabis while they were pregnant and also during their time breastfeeding. Near the end of their report, Tennes and her team reveal their findings that postnatal marijuana exposure had “no apparent effects” on infant growth, mental or motor development. In their discussion of the report they assert that more research needs to be done to understand the tipping point of non-harmful marijuana use and harmful marijuana use. Agreed.

Conversely, of the three midwives I polled, just one said smoking while breastfeeding was OK. One midwife said that no kind of smoking was OK while breastfeeding because it affects the mother’s milk supply.

In 1989, a study on maternal marijuana use by Dr. Susan J. Astley of the University of Washington and Dr. Ruth E. Little of the University of Michigan showed that pot use in the first month of lactation led to infants with a lower average Psychomotor Development Index score. Basically, that means the babies’ motor development, and some psychological or conceptual functioning was shown to be lower than those with mothers who didn’t consume marijuana and breastfeed. But when discussing their conclusions, the researchers caution against using the study’s findings as a hard and fast rule, stating: “One cannot infer from the results presented here that marijuana exposure during lactation impairs infant motor development.” It goes on, “Marijuana exposure during lactation appeared to be a better predictor of infant motor development, but it does not necessarily mean that the relationship is one of cause and effect.”

Kaiser Permanente has an online flyer that lists the dangers of using cannabis after pregnancy. The flyer states using marijuana “causes the drug to be in the mother’s breastmilk which can hurt the baby’s brain development.”

Kaiser’s Whited elaborated: “THC and its metabolites are absorbed into breast milk and are passed on to the infant during breastfeeding. In addition, due to varying concentrations of THC in products people use, it can be unclear exactly how much THC is being absorbed. There is also a concern that THC use can worsen the effects of alcohol exposure in pregnancy.”

I reached out to breastfeeding advocacy group La Leche League of Colorado and Wyoming. Sara Dale-Bley, area professional liasion at La Leche League, responded warmly with, “La Leche League is a mother-to-mother, lay support organization and we do not provide families with specific guidance on any drug, or medication, of any kind, and encourage all families to discuss those issues with their healthcare providers.” Dale-Bley continued, “However, we do often refer mothers to drug information provided by the National Institutes of Health LactMed database and Dr. Tom Hale’s Infant Risk Center. Both of the resources provide specific drug information that parents can discuss with their healthcare providers.”

When I researched what the National Institutes of Health had to say, I discovered they are surprisingly loose on the subject.  At one point they cite an article from the Obstetrical and Gynecological Survey stating, “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.”

Expecting to find a wealth of information to discount cannabis use by breastfeeding moms, I went to the official state website for Colorado and found this newsletter from the fall of 2010. Instead of a treasure trove of only negative data I found a list, “What We Don’t Know” about maternal marijuana use. The very thing we don’t know that is listed: “The long-term effects of maternal marijuana use on a breastfeeding infant/child.”

How on earth can I presume to give an answer I feel good about when no one seems to know what the right answer is? And how can anyone state they know the answer when there just hasn’t been enough research done within the marijuana-using community to validate how pot affects breastfeeding babies? While appealing to the emotions of the public is an effective way to win a battle, presenting unaffected and genuine data will always win the war. Until that time, in my experience, you can talk people’s ears off about right and wrong and half of them are going to do what they feel right about — what their intuition tells them is the correct path.

 

This article is republished with permission from the author.