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Pot-Smoking Mom Fights to Breastfeed. What Are the Risks?

Beth Greenfield

A new mom in Portland, Ore., said she was barred from breastfeeding her premature newborn because she is a regular user of medical marijuana. “They’re refusing to allow me to breastfeed,” Crystal Cain told local news station KATU, referring to officials at Oregon Health Science University. The hospital quickly compromised, though, allowing Cain to sign a waiver acknowledging the potential risks of smoking pot and nursing, with its chief medical officer noting “we can’t stop her from using it.”

Cain, who has now begun breastfeeding 8-week-premature Karrisma, noted in the interview, “There are several studies that indicate that it can’t transfer through your milk ducts. Your body automatically kind of filters it.” She said she smoked prescribed marijuana throughout her pregnancy on the advice of her midwife, to combat anxiety and nausea, and believed that there haven’t been enough studies regarding the effect of cannabis on breast milk. “It’s such a touchy subject,” she said, “that nobody wants to mess with it.”

Whether Cain is ultimately right or wrong about her pot smoking and its effect on her breastmilk, she’s right about the lack of information. “One of the problems is there has not been a lot of studies on this,” University of Rochester Medical Center breastfeeding expert Ruth Lawrence told Yahoo Health. More of the focus, according to Lawrence, has been on the effects of secondhand marijuana smoke, on both children and fetuses, and, she noted, those findings “suggest there would be a problem with breastfeeding.”

Cannabis appears on LactMed, the U.S. National Library of Medicine’s database of drugs and possible side effects on nursing infants, with less-than-definite warnings. “Although published data are limited, it appears that active components of marijuana are excreted into breastmilk in small quantities,” the entry notes. “Data are from random breastmilk screening rather than controlled studies because of ethical considerations in administering marijuana to nursing mothers.” Some studies have raised concerns regarding pot’s effects on brain and nervous-system development of the breastfeeding baby, it states, and that “the studies were inadequate to rule out all long-term harm.”

The American Academy of Pediatrics (AAP) advises against it. As does medical marijuana expert Michael Backes, who writes in his forthcoming “Cannabis Pharmacy” book, “The use of cannabis during pregnancy and breastfeeding cannot be recommended,” as cannabinoids (compounds that activate certain receptors in our bodies) get passed along in breast milk, though there is not a lot known about the effects.

Because of the lack of studies, and lack of regulation of marijuana as a medical drug, there is often more concern over its effects on infants than over that of some pharmaceuticals. In 2013, in fact, in its first statement on the issue in a dozen years, the AAP noted that nursing mothers can take most prescription drugs without risking their babies’ health — but that they should still avoid certain painkillers, psychiatric drugs, and herbal treatments. The report stated that many women are ill-advised to either stop breastfeeding or give up medicines.

But marijuana is different, noted Lawrence, who is a professor of pediatrics and obstetrics as well as the director of the Breastfeeding and Human Lactation Study Center in Rochester, N.Y. “When we talk about medications, there is a known dose, a known time for taking it, and knowledge about aspects such as solubility, so we can estimate the risk,” she told Yahoo Health. “The trouble with marijuana is that it sort of hangs around [in the body]. It’s not like taking an aspirin.”

While acknowledging that cannabis might indeed be the best option for treating anxiety in a mom like Cain, Lawrence advises mothers in general to look at various options, so that a solution that’s best for both mom and baby can be found. “What we try to do for a mother,” she said, “is choose [a medication] with the least probability of getting into the milk.”