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  • Writer's pictureChardá Bell, IBCLC, CBE, CD

Lit Tits - A Cannabis Blog Series: High Hopes, Vol.5

Updated: 3 days ago


In volume 5 of our series, let’s talk about high hopes for cannabis rescheduling and its impact on lactation research.


Feel free to jump ahead:


Cannabis, also adoringly referred to as marijuana, Mary Jane, kush, sticky icky, bud, ganja, weed, pot, and many other clever monikers, is consumed by more than 200 million adults (18+) globally. Thats a lot of folks!


In numerous parts of the United States and other countries, cannabis has recently been legalized for both medical and recreational use. In 2023, about 20% of Americans reportedly use cannabis, a substantial rise from the 2021 estimate of 6%. 


It's definitely a fast growing industry, with dispensaries popping up like Starbucks and CBD products available in your local Target. The global cannabis market size was valued at 57 billion USD in 2023 and expected to grow to 444 billion USD by 2030. No wonder the government is suddenly showing an interest in rescheduling...$$$


So what’s the buzz around cannabis rescheduling? 


The DEA recently confirmed news that it was proposing cannabis move from Schedule I to III, aligning with the U.S. Department of Health and Human Services recommendation and report that was submitted to the DEA in August of 2023. 


A Schedule I drug means it's considered to have a high potential for abuse and has no accepted medical use, at least according to federal law. However, there's been a growing push for change, because as we cannabis advocates know, anything can be addictive, but cannabis isn’t the highest on that list, there are far worse things. I’m looking at you highly addictive legal cancer causing killer cigarettes. According to the CDC, Cigarette smoking causes about one of every five deaths in the United States each year. Cigarette smoking is estimated to cause more than 480,000 deaths annually (including deaths from secondhand smoke). Unlike federally legal tobacco, there are also plenty of studies proving the medical benefits of the federally illegal canna plant. While there are marijuana use disorders, most medical experts agree that it's highly unlikely that any amount or duration of use of cannabis alone to cause death.


Advocates have argued for years that cannabis should be reevaluated and potentially moved to a different schedule that reflects its medical potential and relatively low risk compared to other substances, Schedule III. 


Now, there have been promising developments on this front. The tide seems to be turning, slowly but surely. The hope for me and many? To open up more avenues for research, regulation, reform, and access.


Cannabis and Lactation: Why this big news matters


Lactation research around the impact of cannabis use on lactating parents and their babies has been largely underexplored due to federal restrictions. 


With cannabis potentially on the path to rescheduling, hopefully researchers, like the ones at UCSD Human Milk Institute, are eyeing this area with fresh curiosity. 


There's a growing need to understand how cannabis compounds, particularly CBD and THC, interact with human milk and affect infant development. I'm particularly interested in learning more about any potential long term effects. Future studies are needed to standardize milk production measurements, breast adiposity and tissue characteristics and changes, medication usage, time of day when milk collection is performed, and time since the last breastfeeding session and ensure accurate analysis.


Here’s the scientific facts we DO know from limited research on cannabinoids in human milk:


The effects of maternal cannabis use on lactation and the infant remain largely unknown. Cannabinoids appear in blood most rapidly after THC inhalation, rather than ingestion, at two to 10 minutes as compared to one hour, respectively.


OK, time to use my clinical voice with all that anatomy, physiology and biology that I took while studying to become a board certified lactation consultant, we're about to get real scientific.

*cue Ms. Frizzle Ph.D. and her magic school bus*


The concentration of cannabinoids within milk varies with the time postpartum. During early lactation, drugs and proteins move easily from the blood into the milk through gaps between loosely packed epithelial cells. These gaps eventually narrow and utilize facilitated or passive diffusion to transfer molecules. THC cannot return from milk into the maternal blood, which leads to a higher concentration in milk as compared to blood. Cannabis metabolites are stored within fat tissue and are slowly released during lactation into the milk.


Advocating for Parents' Use of Cannabis: 


I’m excited for our future as the conversation around cannabis has evolved significantly, especially concerning its use among parents. While it was once taboo, advocating for responsible cannabis use by parents is gaining traction as more people recognize its benefits and navigate considerations.


Historically, there has been stigma associated with parents using cannabis, largely due to its classification as an illegal drug. However, with the legalization of cannabis for medicinal and recreational purposes, attitudes are shifting and perspectives are changing and I believe both choices should be supported. Many parents are exploring cannabis as a potential option for managing stress, anxiety, chronic pain, and other health conditions.


For parents facing the everyday challenges of balancing work, family, and personal well-being, cannabis can offer relief. Some parents find that cannabis helps them relax and unwind after a long day, promoting better sleep and overall stress reduction. Others use it to manage symptoms of conditions like arthritis or migraines, allowing them to be more present and engaged with their families.


Photo Credit: ADWEEK


In one study of cannabis using parents, five participants (25%) reported having a physician's recommendation to use cannabis for medical purposes. Eleven participants (55%) reported that they used cannabis to treat or manage medical or health conditions, but only two of these reported having a physician’s recommendation to do so. I'd like to meet these two amazing and supportive physicians!


Ten out of the eleven (91%) participants reported using cannabis to treat or manage mental health conditions such as anxiety and depression, while five (45%) reported chronic pain conditions such as arthritis and back pain. Three participants (27%) reported using cannabis to treat sleep problems, and one reported using cannabis to treat psychogenic nonepileptic seizures. Sleep issues, PMADs (perinatal anxiety and mood disorders) and post birth pain are very common among parents.


Thirteen participants reported never receiving advice or guidance from a healthcare provider about cannabis use while breastfeeding. Five participants reported they had received advice but did not find it helpful, and one reported receiving advice that they found helpful.


Clinician counseling regarding substance use while breastfeeding is an important avenue for patient education, yet participants in the study reported receiving either. For medical providers to advise on best practices, they must be aware and open to understanding the reasons people choose to use cannabis while breastfeeding. 


To date, few studies have explicitly explored the reasons why breastfeeding people use cannabis, and it may be these reasons, including health management, that influence the continuation, reduction, or cessation of cannabis use during breastfeeding. 


Public health messaging on cannabis use during lactation is variable, leading to confusion for breastfeeding individuals. For instance, in a content analysis of Twitter messages, found that "78% of posts about pre- and postnatal cannabis use and associated health outcomes were neutral in tone, suggesting uncertainty about the risk of cannabis use during the pre- and postnatal periods." Themes from the participants in the study had responses that indicate awareness of insufficient research which lead folks to seek out their own information. 


For me, it's about acknowledging a parent’s right to explore alternative wellness options while promoting safety, responsibility, and informed decision-making. As laws and use of cannabis continue to evolve, it's essential to support parents in navigating this landscape with confidence and awareness.


Advocacy for parents using cannabis involves fostering open dialogue and promoting education. By encouraging informed discussions and providing resources, we can empower parents to make responsible decisions regarding their health and well-being.


High Hopes:


As federal policies evolve and cannabis research gains momentum, we can expect more nuanced studies on lactation and cannabis use! This doesn't mean we are suggesting folks to use indiscriminately. Caution is still of the utmost importance until we have a clearer picture of the risks vs. benefits.


I’m thankful for the evidence based information that is out there, such as Bonnie Goldsmith MD of Canna-Centers as well as Dr. Kathleen Kendall-Tackett’s webinars around cannabis use during pregnancy and breastfeeding. We need more clinical professionals like this doing the research, providing the results and supporting families to make informed choices. 


Ultimately, the intersection of cannabis rescheduling and lactation research highlights the broader shifts happening in drug policy and healthcare. It's a reminder that science and societal attitudes are ever-evolving. 


By advocating for responsible cannabis use among parents, we can contribute to a more tailored and understanding approach to cannabis consumption, emphasizing personal choice, education, and well-being. 


Keep your eyes peeled for more updates on this intriguing journey by subscribing to my Lit Tits blog series and following me on social media @melaninmilksd on all platforms. Until then, stay curious and stay informed!



Update: The saga continues! On May 16, 2024, A few days after I published this blog, news broke that president Biden announced a formal shift to reschedule marijuana. Depending upon who the next president is, and who the attorney general is, will determine if we have a plot twist of the rescheduling attempting to make its way backward. Only time and our country’s voice when it comes to election season, will tell.


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