Is It Okay To Smoke Weed While Breastfeeding?

With the legalization of marijuana slowly spreading across the country, there's no denying the stigma surrounding the drug is slowly dissipating. As such, more and more questions are arising as to the appropriate time and place to bust out a joint. And those looming questions apply to everyone, including moms and moms-to-be. After all, if some experts now say it's acceptable to have the occasional glass of wine while pregnant and breastfeeding, does the same go for marijuana?

Picture: Broadly

In short: no. While there isn’t much data to show how many nursing moms are also smoking weed, there is research to show that pregnant women are smoking weed in growing numbers. In a self-reported research letter newly published in JAMA, the rate of pot-smoking pregnant moms increased from 2.4 to 3.9 percent between 2002 to 2014. (It’s important to note that the data relied on women reporting their own use—so in reality, the numbers may be even higher.) The study notes that this can be problematic as prenatal marijuana may impair fetal growth and neurodevelopment. Plus, these women are likely continuing their habit post-pregnancy, says Lauren Jansson, M.D., associate professor of pediatrics at the Johns Hopkins University School of medicine who specializes in drug abuse research.

Another factor: It’s less likely that women are simply picking up a recreational weed habit postpartum, or getting high on a one-off basis with their baby by their side. Rather, there may be a dependency issue at play. “One in five women using marijuana during pregnancy are likely to have cannabis-use disorder,” she adds, which is clinically defined as a problematic pattern of cannabis use leading to clinically significant impairment or distress. That may be associated with higher instances of psychiatric issues, too, which can further compromise a mom’s ability to care for baby. 

From Joint to Breastmilk

First a little primer: The chemical tetrahydrocannabinol (THC) is the ingredient in cannabis that activates cannabinoid receptors in your brain to produce mind-altering side effects (ranging from euphoria to panic).

Smoke weed as a breastfeeding mama, and the THC goes into your bloodstream, which then concentrates in breastmilk (THC loves fat, something breastmilk has a lot of). Just like THC affects your brain, says Jansson, it also triggers the cannabinoid receptors in a fetus' or infant’s brain, too, setting off many potential effects on their development.

There are some limited studies that looked at fetuses exposed to marijuana in utero (like this one published in Future Neurol), which found that it led to negative effects on infant behavior. Other research found that issues with things like executive functioning (the part that controls planning and organization) only first begin to surface during adolescence. 

 

Jansson says that when looking at marijuana in breastmilk, earlier research has linked smoking marijuana while breastfeeding with delayed motor development at 1 year of age, while other research shows no effects.

One thing to keep in mind: Many of these studies were done in the 1980s, and today levels of THC are much higher in cannabis, points out a 2015 research review in the American Journal of Obstetrics & Gynecology. That means that potential problems could be a lot worse if you breastfeed and use weed today.

Not only should you worry about THC in your breastmilk, but it also stays on your breath after a single marijuana cigarette, which you can then breathe on your baby, says Jansson. “Animal studies show that this second-hand exposure has a big effect on an animal’s development,” she adds. What’s more, you can’t “pump and dump” after smoking up—marijuana can stay in your system for days, weeks, or up to two months (if you’re a chronic user).

What Does It All Mean?

So where do you go with conflicting research? “We don’t have evidence that good things happen, but there is evidence that bad things happen. Anecdotally, I see pretty significant effects on early infant development because of a mom’s chronic marijuana use,” says Jansson.

Because of the limited data, the American College of Obstetricians and Gynecologists discourages pregnant or breastfeeding women from using pot, they write in a 2017 statement. The committee also says that ob-gyns should not prescribe medical marijuana to these women.

Do You Need Help?

Because of the medical benefits of certain strains of marijuana, as well as legalization in many states, pot has gotten a rap as a safe drug that helps you mellow out. That ignores the seriousness of chronic pot use, says Jansson. “People don’t realize it’s a substance use disorder. There’s treatment for it. If you’re having a difficult time quitting while pregnant or breastfeeding, you should seek help,” she says.

“There are moms who are going on record in the press saying that marijuana makes them a better mother. No one’s a better mother for chronic use,” says Jansson. “You’re using it in the face of significant consequences.”

By Jessica Migala