What's the Deal With Cannabis and Breastfeeding?

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All through history, cannabis has served as a medicinal aid for women, healing everything from menstrual pain to headaches. In Ancient Egypt, women would reportedly use cannabis suppositories to ease vaginal pain whereas later, in the 11th century, European women applied a mixture of cannabis and lamb’s fat to swollen, painful breasts. And even Queen Victoria was allegedly prescribed cannabis for her cramps. In modern times, women are turning to cannabis to help with pain, migraines, and more.

Some of those women are mothers, including new moms who breastfeed.

A 2017 study published in the Journal of the American Medical Association revealed more women turning to cannabis to alleviate symptoms such as morning sickness and anxiety while pregnant, and cannabis is the most commonly used recreational drug among breastfeeding women in the United States. However, in 2018, the American Academy of Pediatrics (AAP) released an official report recommending that pediatricians advise women against using cannabis during pregnancy or while nursing, due to potential health risks.

According to the Center for Disease Control and Prevention (CDC), a mother can pass chemicals from cannabis to her infant through breast milk, which may possibly affect neurodevelopment.

2.5 percent of the THC—the main psychoactive compound found in cannabis—a mother ingests can end up in breast milk, and the length of time it remains in the milk varies, depending on whether it’s smoked or ingested. However, the CDC does point out that current data is insufficient to affirm whether or not it’s safe for a mother to use cannabis while breastfeeding. Naturally, physicians feel that it’s better to err on the side of caution for the sake of the infant.

So why are more nursing women turning to cannabis despite warnings? Well suffice to say, becoming a new mom is no walk in the park. These days, more women are becoming vocal about their struggles after childbirth, whether it’s postpartum depression, anxiety, or pain, and the fact that they’re choosing to see cannabis as an option.

“Up to 85 percent of women experience some type of mood disturbance during the postpartum period, or suffer from lack of sleep, pain, hormone imbalances, and other physical changes like anxiety and stress because they suddenly have this intense responsibility of a new life. All these changes can damage a woman's mental health and physical health,” says Dr. Genester Wilson-King, MD, FACOG, a board-certified obstetrician and gynecologist and Medical Director at Victory Rejuvenation Center.

“If you're not getting enough sleep on a chronic and prolonged basis, there’s a potential domino effect leading to a person with more serious problems such as deep depression, anxiety, significant moodiness, weight problems, and the complications associated with that,” she says. “All of that combined can make a new mom feel helpless and detached especially if she doesn't have much in the way of support."

Jessilyn Dolan, registered nurse, herbalist, doula, and founder of Vermont Cannabis Nurses Association, says women could also be using cannabis due to preference for a more natural remedy. “They gravitate more towards an herb, which they feel is more natural and safe rather than a pharmaceutical. I feel people are using it in pregnancy and breastfeeding more—so therapeutically and medicinally—rather than just as recreation,” she says.

Since CBD has become the wellness trend du jour due to it having various benefits without the psychoactive properties, it’s not too farfetched to assume nursing women are turning to it as well. Dolan says she has seen an increase in families who are turning to CBD to help with stress, pain, and sleep issues. “With more medical support and movement with medical marijuana programs, people are making the choice to use CBD and cannabis in general with legalization. Again, people are resonating more towards something they feel is natural, like a plant, rather than a pharmaceutical,” Dolan says.

“People are asking questions, learning about it, being more open and willing to say they are using it if they're pregnant or breastfeeding.” Unfortunately when it comes to CBD, the most popular non-intoxicating compound found in the cannabis plant, the research is even more scarce because most of the studies done in this area only focus on THC.

As cannabis becomes increasingly legal, the stigma surrounding it is undoubtedly lessening, but not necessarily within the medical community. Hence, more research is needed to determine whether there are legitimate risks connected to breastfeeding while using cannabis while breastfeeding. When it comes to the studies we have to rely on currently, there is insufficient data on both sides, as well as dependency on self-reporting or other factors, such as whether or not the mother used different substances alongside cannabis, like tobacco or alcohol. However, there is one interesting study that focuses on pure cannabis usage during pregnancy.

The study, conducted by Dr. Melanie Dreher and published in 1994, was done in a rural Jamaica, on a sample of women that frequently uses cannabis and no other substances (nicotine, alcohol, other illicit drugs or pharmaceuticals). Dreher and her team observed 24 expecting mothers who used cannabis teas and tinctures. They said the cannabis helped with depression and stress, as well as nausea and served to increase appetite in the early stages of pregnancy.

Dreher also evaluated 20 mothers in the population who did not use cannabis. “Dreher found no significant differences between the exposed and non-exposed infants. In fact, at one month, the exposed newborns showed better physiological ability,” Dr. Wilson-King says, adding that Dreher did a five-year follow up testing the children and there were no significant differences in developmental testing outcomes.

“The study is really small and old, but the main strength of the study is that cannabis is legally and socially acceptable in this community. All of the self-reporting was more reliable,” Dr. Wilson-King points out. She says this is important because similar studies are conducted in the United States or Canada, where, until recently, cannabis had been held in a negative and highly racialized light.

“When you're doing studies in other countries where there's such a negative connotation, when you rely on the mom's self-report, you're relying on the fact that people are going to be honest. I don't know if I would be honest if somebody asked me if I used cannabis during my pregnancy, and I knew that I could end up losing my children and being criminalized because I admitted using to cannabis. That makes the study unreliable or not as reliable as it could be.”

Indeed, the cannabis-related injustices against people of color, let alone mothers of color, have been happening for decades, prior to legalization. But legalization had made no difference so far, when it comes to protecting mothers. Dr. Wilson-King cites the case of Shakira Kennedy, a 27-year-old black woman who was pregnant with twins and suffered from hyperemesis gravidarum, or severe nausea that persists throughout the pregnancy and, in many cases, compromises both the mother’s health and the baby’s health. It was so severe she repeatedly ended up in the emergency room. As a last resort, she turned to cannabis to help her with her symptoms.

Kennedy admitted this during a doctor’s visit, and when she returned to have her babies, she was ordered to attend rehab and undergo drug screenings and home inspections by the New York Administration for Children’s Services (ACS), even though the newborns tested negative for cannabinoids.

“You see on Facebook, white, middle-class mothers in these groups crowing about the benefits of cannabis and how it helps them be more patient with their kids and things like that. They never seem to be investigated by ACS,” Dr. Wilson-King says. “Ms. Kennedy suffered from hyperemesis gravidarum and a few puffs of cannabis allowed her to eat and avoid hospitalization. Why should she be criminalized or threatened with the loss of her children? … We need to stop criminalizing women for cannabis use, and instead counsel them with the facts as we know them now, suggest alternatives, and work with them.”

This story should not be interpreted to be in any way supportive of cannabis as an alternative to professional medical advice, which should be sought before making any changes to your health and wellness regimen.

Marie Lodi is an LA-based writer and editor covering beauty, fashion, cannabis, and pop culture. She runs a food blog about period cravings called The Bloodfeast and co-hosts the costume design podcast Fishnet Flix.