Lit Tits - A Blog Series on Cannabis & Lactation
Updated: Mar 22
As an advocate for the responsible usage of cannabis amongst adults, I have been compelled to write about marijuana use and lactation for quite some time. It is glossed over in lactation school but it shouldn't be and we do have answers, and each support group will yield at least one cannabis question so might want to be prepared to answer. Now as capitalism has been married to the budding weed industry, pun intended, dispensaries open as frequently as Starbucks. Using cannabis recreationally and medicinally has become less taboo, at least here in San Diego, so I knew it was finally "acceptable" to have this conversation publicly.
Rhianna is the newest Black celebrity to be pregnant and glowing! What will she and other mamas do when they want to blaze up after having her little one if those baby blues hit too hard?
Many parents have this question and today I'm here to give you some answers!
Don't worry Riri, "if you are reading this, it's not too late", I got you boo...call me if you need a postpartum doula or lactation consultant, I will travel sis!
Is it ok to take a few puffs of a joint if I’m making milk?” Well your answer depends on a few individual things…define what a few puffs is:
What you smoking (strain & THC %)
How you smoking it?
Pipe, vape, blunt, joint?
Does it contain any added substances? other recreational drugs or additives?
Have you used it before?
If so, how well do you respond to it? What are your effects?
What are the benefits to using it?
What are the risks associated with not using it?
What are the risks associated with breastfeeding?
What are the benefits of using it while breastfeeding?
Will someone be home with you?
Do you have milk stored?
Do you plan to combo feed?
Donor milk options? Into informal milk sharing?
Was or is your baby premature? Did they stay in the NICU?
As I've started to get this question at every breastfeeding support group, I’ve compiled this list of things I’ve asked parents when they ask me this question. This is for my own research and data points so I can have anecdotal evidence to provide as I’m asked so frequently and would rather have something to say than nothing. To best support my clients, I like to stay up on current research with regards to lactation. Between professional workshops and such, I find myself obsessively going down internet rabbit holes while doing research on cannabis and human milk consumption, unapologetic Google university alumni and Wikipedia scholar here!
I have seen a significant increase in the numbers of both pregnant and breastfeeding parents who are using marijuana these days, likely increased to manage the surmounting toxic stress of the pandemic and systemic societal issues.
Joel Gator Warsh, M.D. is a board-certified pediatrician at Cedar Sinai Hospital in Beverly Hills, California. He has also seen a rise in marijuana use in his patients. “I do feel that the benefit of breastfeeding outweighs the risks from THC. If one has to decide to breastfeed or not, this study lends additional data that parents should continue to breastfeed as much as possible and interested, even if using THC.”
Talk Nerdy To Me
The Cannabaceae family of plants includes cannabis plants, and from a healthcare perspective, two compounds that are especially important, tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD is not impairing, meaning it does not cause a “high” like THC. Amid all kinds of permissible substances, like sugar, caffeine, and alcohol—often used while breastfeeding—you would think this plant with such amazing health and wellness benefits would be considered just as safe as the above mentioned right?
Unfortunately for my people looking for a concrete yes or no answer, this isn’t sufficient enough to provide a simple black and white answer to parents and it’s beyond frustrating for us in the field of caring. Until it becomes legalized at the federal level, I don’t think we will ever see a concrete yes from government agencies on individual dosage information. So until then, we do what we can to learn more about the consumption of cannabis while chest/breastfeeding.
Figuring out how much is passing into the milk varies considerably from person to person. Both CBD (cannabidoil) and the psychoactive component, THC (delta-9-tetrahydrocannabinol) have been detected in human milk after consumption by the lactating person.
The AAP reports on cannabis and breastfeeding: no effect mentioned; very long half-life for some components. The kinetics of cannabis depends greatly on the method in which it was received such as smoked vs. ingested and usually detectable in bodily fluids for 1 to 30 days after last use and detected in the hair for several months. Yes, THC is passed through human milk. It's stored in the fat of the milk, so it stays in the system and the milk longer than other substances that aren't fat-soluble. One study found that THC remained in milk for up to six days after use. The largest study to date included 8 breastfeeding women and the amount of THC detected in pumped breastmilk ranged from 0.4% - 8.7% of the maternal dose with an estimated mean of 2.5%. Using these data points, the average absolute infant dose was estimated to be 8 micrograms per kilogram per day. Therefore, the concentration of cannabis in the breastmilk are variable and related to the maternal dose and frequency of dosing. The individual advice to this question will depend on you and most importantly, your baby. Age, weight, birth story, NICU stay, prior and current development, any delays? Stay on top of these things if you choose to use cannabis and breastfeed. Marijuana can cause sleepiness in the baby, which can lead to slow weight gain. Hale reports a possibility of decreased milk production. Hence, baby’s struggling to stay on the curve may be affected by heavy users.
Cannabis and it’s byproducts are very fat-soluble or lipophilic and we have a lot of fat in the breast where the milk is made and stored, average percentage of body fat for women is about 25-30% which is a large reservoir for the lipophilic nature of THC to store. For this reason, it’s more likely to see THC and its metabolites in the blood, urine and breast milk of the lactating daily cannabis user. Studies focusing on the detection of THC in milk yields variable results in various studies with duration of detection ranging between 6 days and 6 weeks, which can be very conflicting for parents to hear.
Despite the results, in places where it is legal, lactating parents should be able to use cannabis and receive proper guidance from a professional while doing so without bias or judgment. A growing number of states are legalizing marijuana for medicinal or recreational purposes. Marijuana use is as old as the plant itself so it’s time to have a new perspective on how marijuana affects people in specific ways, the benefits and the risks associated and the discussion should start with: “what is the risk of a substance transferring to breast milk versus the benefits of breastfeeding?”