Hear about my decision to use CBD while breastfeeding. Curiosity around the therapeutic uses for CBD has reached a fever pitch, but is it safe when you're nursing? Here's what experts say. The main psychoactive component of cannabis, tetrahydrocannabinol (THC), is excreted into breastmilk in small quantities. The duration of detection of THC in milk has ranged from 6 days to greater than 6 weeks in various studies. Concern has been expressed regarding the possible effects of cannabis on neurotransmitters, nervous system development and endocannabinoid-related functions.[1,2] A 1-year study found that daily or near daily use might retard the breastfed infant’s motor development, but not growth or intellectual development. This and another study found that occasional maternal cannabis use during breastfeeding did not have any discernable effects on breastfed infants, but the studies were inadequate to rule out all long-term harm. Although cannabis can affect serum prolactin variably, it appears not to adversely affect the duration of lactation. However, maternal perception that their use of cannabis is harmful to their infants are likely to discontinue breastfeeding earlier than mothers who do not believe it is harmful. Other factors to consider are the possibility of positive urine tests in breastfed infants, which might have legal implications, and the possibility of other harmful contaminants in street drugs.
CBD for Mamas
My experience with Equilibria CBD products. Disclosure: I am an affiliate with Equilibria brand, however all thoughts are my own. Equilibria did not ask me to write this blog post. This is not medical advice.
Everything You Wanted to Know about CBD for Moms!
I’ve gotten so many questions about using CBD, especially about using CBD while breastfeeding. I totally get it! It’s relatively new and there are A TON of products out there, yet there’s not nearly enough research! Today I’m going share a little bit about why I decided to take CBD, and what makes these CBD products special (hint: it has everything to do this incredible company!). Over the last few months, I’ve been sampling products and learning so much about CBD for mamas. I’m really excited to share more and answer some of your most commonly asked questions.
Why I decided to take CBD
My biggest reason for looking into CBD was stress management and headaches. I was getting really bad headaches – so frequently, that they were becoming debilitating. I have never been one to really like prescription medications — I don’t even like to take Advil or Tylenol!
As I started looking for treatments that felt a little bit more natural, I heard about Equilibria’s line of CBD products through a few people I knew and different influencers. I was curious about the products — could they possibly match the hype? When they reached out to me, I was really excited to talk with them and learn more.
As you know, with any partnership or any product I’m trying out, I always ask LOTS of questions. I always make sure that I’m able to try it for a while, long enough to decide if I want to share it. I’ve been using these products for the last few of months and I’m LOVING it. I don’t have headaches anymore, I’m not as stressed out, and I’m not as reactive. It’s been working really well for me, and I’m so happy to be working with this brand.
What are the Benefits of Using CBD?
Proponents of CBD report that the studied benefits are still emerging. Benefits from CBD range from treatment of chronic pain and migraines to anxiety and depression.
Why I chose Equilibria
When I started looking into CBD products, it was really overwhelming! There were so many different options, plus I was looking for some really specific features from the products I tried. Below were a few requirements I had:
I wanted a more natural option. I chose Equilibria is because their products are completely organic and non-GMO. There are no pesticides, herbicides, or heavy metals found in their soils. You can actually go on their website and look up the lab results and learn more about their farm in Colorado!
I wanted to support a woman-focused business. This company is not just an all-women company — the entire focus of their products is women. All of their products are specifically designed for a woman’s body, and all of the changes that women go through.
I wanted a full spectrum products. The products that Equilibrium offers are full spectrum. When you’re looking at the entire market of CBD options, there are three different types of CBD you can choose from: full spectrum, broad spectrum, or CBD isolate. I wanted full spectrum, because I wanted more potent results with a smaller dose.
I wanted (and needed!) help with choosing products. The best thing about this company is that you get access to a Dosage Consultant with every order. You can talk about any specific concerns that you’d like to treat, and they’ll make recommendations based on your personal life — whether you’re looking to reduce inflammation, manage stress, headaches, or anxiety (or all of these things!). But they’re giving you more than product recommendations – they’ll also tell you what time of day to take it, and how often. If you know nothing about CBD, your consultant will walk you through everything you need to know — that accessibility is HUGE for me. I know so many people who are really curious about CBD, but also hesitant, because they just don’t really know where start — this is perfect for you.
Is CBD Right for You? Is CBD healthy for breastfeeding moms?
The FDA currently advises against all CBD and THC products for pregnant and nursing parents. Does CBD get into breast milk? Yes. It’s fat-soluble and will be expelled through your breast milk. However, much of the CBD and breastfeeding controversy lies within the studies done on THC and breast milk, not CBD. The FDA strongly advises against all cannabis products, mostly due to studies regarding THC in pregnancy having negative outcomes. The primary concern with CBD in particular, appears to be the potential for low-quality CBD products to be contaminated with pesticides, bacteria, fungi, and heavy metals. This is why it was a top priority for me to find the cleanest brand possible.
Of course, you should always talk with your doctor before making any major health decisions. CBD is really under researched, especially in pregnant and lactating people. Just like any other medication or supplement, there’s always going to be less research available around pregnancy and lactation, because of ethics with medical testing. We are typically last to be tested for new products.
That being said, everything I’ve learned from my Dosage Consultant has made me feel really comfortable taking it while breastfeeding. Again, you always do what works for you and always talk to your doctor when you’re introducing something new into your routine.
While I do feel that it’s safe for me, it’s also worth considering that there are certain medications that CBD might not react well with it. Always check with your doctor (I did, and mine feels it’s perfectly safe and fine for me!) before starting any new supplement or medication.
A few more resources:
(Note: this is not medical advice, just more information!)
My favorite CBD products
Equilibria’s line is expanding and growing, which is super exciting. While they’re currently US-only, I’ve also been chatting with them about what they might be able to offer international folks. These are my favorite products so far!
Daily Drops (Mint): I was expected CBD products to taste bad, and these don’t taste like that at all! They taste kind of like grassy and minty – it’s nice! I use the little dropper and take these in the morning.
Soft Gels: The soft gels are slow release. These are what you’d take if you’re having trouble sleeping, or want help with stress throughout the day.
Relief Balm: I wanted to get my mother and mother-in-law something beautiful and usable, so I got them both this. It’s a creamy balm used for aches and sore muscles, and it comes in the “relief box.” It would also be a great gift to a new mom or yourself.
Daily Treatment Oil: My mother-in-law and mom have raved about this facial oil. It has a beautiful lemony floral scent, but it’s totally natural, with no added fragrances or chemicals.
Mindful Mineral Soak: This is my new favorite! This would be such a cute gift with a loofah or candle. The mineral soak is like a bath salt and dissolves completely in a warm bath- my favorite form of self care!
NEW Rapid Calming Melts: Peppermint flavored 5mg tablets that dissolve under your tongue and are perfect to take whenever you’re feeling extra stressed and overwhelmed! Discreet and can be taken any time you need fast-acting relief – perfect to stash in your purse when you are on the go. They begin working in as little as 10 minutes and can last up to 6 hours.
CBD and Breastfeeding: Is It Safe?
Curiosity around the therapeutic uses for CBD has reached a fever pitch, but is it safe when you’re nursing? Here’s what experts say.
Maressa Brown is a seasoned lifestyle journalist, writer, and astrologer. In addition to being a regular contributor to Parents.com, her bylines appear on InStyle, Shape, What to Expect, Cosmopolitan, et al. She is the author of a forthcoming parenting title to be published by Artisan Books in early 2023. A graduate of Emerson College, she’s based in Los Angeles.
Pregnancy is one thing, but postpartum life often comes with a variety of mental and physical challenges. As many as one in five women suffer from postpartum depression, according to the Centers for Disease Control and Prevention (CDC). Other concerns include anxiety, chronic pain, and insomnia, all compounded by the lack of sleep and hormonal shifts that naturally occur after giving birth. It’s no wonder more new parents are gravitating to CBD, or cannabidiol, a component of either a marijuana or hemp plant that is non-psychoactive (unlike THC, or tetrahydrocannabinol, which only comes from marijuana).
CBD has been touted as the active ingredient in a variety of therapeutic products that boast anti-inflammatory, antioxidant, anti-psychotic, anti-convulsant, and antidepressant properties. But is it safe to use CBD while breastfeeding? Here’s what nursing parents need to know about CBD.
- RELATED: Which Medications Are Safe While Breastfeeding?
What the Science Says About Using CBD While Breastfeeding
Research has focused primarily on THC, as opposed to CBD, in breast milk, and the conclusion is that it is possible to pass low levels of the psychoactive ingredient to your baby while nursing. A study published in the journal Obstetrics and Gynecology looked at samples of breast milk from eight anonymous test subjects who regularly use cannabis and found that babies who were three to five months old and who were breastfed exclusively ingested an estimated 2.5 percent of the maternal dose of THC. (Researchers didn’t, however, take blood samples from the infants to see if they had measurable levels of THC in their bodies.)
And trying to “pump and dump” doesn’t work for cannabis products, as chemicals from cannabis that entered the body days or weeks prior to breastfeeding can make their way into breast milk, according to Medical News Today. In fact, other research published in the journal Pediatrics found that low levels of THC may be found in breast milk for up to six days after smoking cannabis or eating an edible.
Granted, this research was done on marijuana and THC, not hemp and CBD. But experts are concerned about the effect of any cannabinoid on an infant’s brain development.
“We truly do not know what short- or long-term impact on the baby it may have,” says Felice Gersh, M.D., a board-certified obstetrician and gynecologist and author of PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones, and Happiness.
Is CBD Safe While Breastfeeding?
“Having a new baby is stressful, and some may wish to turn to cannabis products,” Dr. Gersh notes. But the limited data on its safety—and the fact that it will pass into breast milk—makes it difficult for many experts to advise its use for nursing parents. “Unfortunately, there is no safety data to allow a doctor to recommend the use of cannabis or CBD,” says Dr. Gersh.
Mary Clifton, M.D., an internal medicine doctor in New York City agrees, stating, “If a new parent is breastfeeding, it’s probably not wise to use CBD. The medical community doesn’t support the use of CBD in these settings, because proper studies can’t be completed on the effect on the baby or infant.”
Despite the lack of published research, new parents have used cannabinoids for thousands of years, notes Robert Flannery, Ph.D, owner of Dr. Robb Farms. “Yes, THC and CBD are expressed in small quantities in breast milk,” Dr. Flannery says. And while he doesn’t feel comfortable suggesting CBD for a new parent who is breastfeeding, he acknowledges the use of cannabis in the past.
“We do not have enough research to make claims one way or another on how that breast milk would affect the milk-fed babies,” says Dr. Flannery. “Cannabis is a medicine that has been used specifically for pregnant and breastfeeding parents for millennia. I will never make a claim without the science to back it up, but we should understand that anecdotal evidence can be used to formulate testable hypotheses to validate the use of cannabis at this time in a one’s life.”
Risks Vs. Benefits of CBD While Breastfeeding
Ultimately, because CBD “has been shown to be little risk to both adults and children” and therefore, “may not pose a problem,” it is important to weigh the risk versus benefits for the breastfeeding parent and the infant, says Hilary Peckham, the co-founder of Etain Health, the only all-women, family owned medical marijuana dispensary company in New York.
For instance, many new parents suffer from postpartum depression, anxiety, fatigue, mood swings and detachment from the infant. “Many sufferers start a treatment of antidepressants which may not be appropriate for breastfeeding and may need to be discontinued,” Peckham says. “Starting CBD may still allow the parent to breastfeed and prolong the bonding time with the infant. That said, you should speak to your doctor before starting CBD, especially if you are breastfeeding.”
The Bottom Line
The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) recommend physicians counsel parents to abstain from all cannabis products—including CBD—if they wish to breastfeed. However, given the minimal amount of the substance that make its way into breast milk, and the fact that research has yet to confirm the exact effects on an infant, anyone interested in trying CBD while nursing would do well to speak to their doctor.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.
Drugs and Lactation Database (LactMed) [Internet].
Last Revision: June 20, 2022 .
Estimated reading time: 9 minutes
Drug Levels and Effects
Summary of Use during Lactation
The main psychoactive component of cannabis, tetrahydrocannabinol (THC), is excreted into breastmilk in small quantities. The duration of detection of THC in milk has ranged from 6 days to greater than 6 weeks in various studies. Concern has been expressed regarding the possible effects of cannabis on neurotransmitters, nervous system development and endocannabinoid-related functions.[1,2] A 1-year study found that daily or near daily use might retard the breastfed infant’s motor development, but not growth or intellectual development. This and another study found that occasional maternal cannabis use during breastfeeding did not have any discernable effects on breastfed infants, but the studies were inadequate to rule out all long-term harm. Although cannabis can affect serum prolactin variably, it appears not to adversely affect the duration of lactation. However, maternal perception that their use of cannabis is harmful to their infants are likely to discontinue breastfeeding earlier than mothers who do not believe it is harmful. Other factors to consider are the possibility of positive urine tests in breastfed infants, which might have legal implications, and the possibility of other harmful contaminants in street drugs.
Because of insufficient long-term data on the outcome of infants exposed to cannabis via breastmilk, health professionals’ opinions on the acceptability of breastfeeding by cannabis-using mothers varies. In general, professional guidelines recommend that cannabis use should be avoided by nursing mothers, and nursing mothers should be informed of possible adverse effects on infant development from exposure to cannabis compounds in breastmilk. In addition to possible adverse effects from cannabinoids in breastmilk, paternal cannabis use may also increase the risk of sudden infant death syndrome in breastfed infants. Cannabis should not be smoked by anyone in the vicinity of infants because the infants may be exposed by inhaling the smoke.[6-9]
The main active psychoactive component of cannabis is delta-9-tetrahydrocannabinol (THC), although it also contains other active compounds. THC is very fat soluble and persistent in the body fat of users and slowly released over days to weeks, depending on the extent of use.
Maternal Levels. Two women who smoked marijuana daily while nursing had their randomly collected milk analyzed. One mother who reported smoking marijuana once daily had a milk tetrahydrocannabinol concentration of 105 mcg/L; other metabolites were absent. The second mother who reported smoking marijuana 7 to 8 times daily had a milk concentration of 340 mcg/L; the metabolite 11-hydroxy-THC was found in a concentration of 4 mcg/L and 9-carboxy-THC was absent. A milk sample that was collected 1 hour after smoking marijuana contained 60.3 mcg/L of THC, 1.1 mcg/L of 11-hydroxy-THC and 1.6 mcg/L of 9-carboxy-THC. One source used data in this case to estimate that the infant receives about 0.8% of the maternal weight-adjusted dosage. However, a poorly characterized assay was used that might not be accurate and the portion of milk (i.e., foremilk versus hindmilk) that was collected by the mothers was not stated. This is important because of the high fat solubility of THC.
A woman who admitted to smoking cannabis (amount not stated) donated milk for analysis at an unknown time after the previous use. THC was present in a concentration of 86 mcg/L and 11-hydroxy-THC was present in a concentration of 5 mcg/L; 11-nor-carboxy-9-tetrahydrocannabinol was not detected.
Eight exclusively nursing women who were 3 to 5 months postpartum and reported previous or current cannabis smoking were studied. After 24 hours of abstinence, each smoked a 100 mg of a standardized cannabis containing 23.18% THC. The product was smoked over 10 to 20 minutes from a glass pipe until it was fully consumed. Milk was pumped before smoking and at 20 minutes, 1, 2 and 4 hours after inhalation. THC and its metabolites, 11-OH-delta-9-tetrahydrocannabinol and 11-nor-9-carboxy-delta-9-tetrahydrocannabinol were measured in the milk samples. Six of the women had baseline THC concentrations of
Fifty women who reported using cannabis in the prior 14 days donated milk samples for analysis of THC and its major metabolites. Four women donated two samples each for a total of 54 samples. THC was detectable in 63% of the samples. The median concentration of THC was 9.47 mcg/L (range 1 to 323 mcg/L). Only 5 samples had measurable concentrations of 11-OH-THC (range 1.3 to 12.8 mcg/L) and 5 samples had measurable concentrations of cannabidiol (range 1.3 to 8.6 mcg/L). Samples collected 140 hours (about 6 days) or longer after reported use contained no detectable (
Twenty women in Oregon who admitted to using a cannabis product while breastfeeding their infants provided milk samples for analysis. The mothers reported using cannabis almost daily. Fifteen women provided milk samples at their infant’s 2-week and 2-month checkup and 5 provided a sample at only one of the visits for a total of 35 milk samples. All but one milk sample contained at least one cannabinoid. None of the mothers reported using a cannabidiol (CBD) product, but 13 had detectable CBD in breastmilk. Median (IQR) concentrations in milk were as follows: THC 27.5 (0.8 to 190.5) mcg/L; 11-OH-THC 1.4 (0.7 to 5.2) mcg/L; THC-COOH 1.9 (0.5-16.6) mcg/L; CBD 1.2 (0.5 to 17) mcg/L. Three patients using edible products had similar cannabinoid levels as those who smoked cannabis. Fourteen mothers reported an increase in use of cannabis between the 2-week and 2-month visit. Median breast milk THC concentrations were 16.7 mcg/L at visit 1 and 54.5 mcg/L at visit 2. The authors estimated that overall the breastfed infants received an average THC dose of 4.12 mcg/kg daily (range 0.52 to 123 mcg/kg daily) in milk.
Seven women who used cannabis during pregnancy more than twice weekly, primarily by smoking, and were documented to be abstinent postpartum donated blood and milk levels 2 to 5 times weekly for 6 to 7 weeks. Maximum milk THC levels ranged from 2.8 to 26.1 mcg/L and the elimination half-life from milk averaged 17 days (range 12.2 to 21 days).
Ninety lactating persons who reported using cannabis within the prior 48 hours donated 104 milk samples to a milk biorepository. THC, 11-hydroxy-THC, 11-COOH-THC, cannabidiol, and cannabinol were measured in the samples. The median concentration of THC was 22.7 mcg/L (range 0.1, 1620.0). The two main metabolites of THC, 11-OH-THC and 11-COOH-THC, were detected in 22 (21.2%) and 84 (80.8%) of samples, respectively. Cannabidiol was measurable in 44 (42.3%) of samples and cannabinol was measurable in 43 (41.3%)of samples. The number of hours since last use, route of use and number of puffs taken were significant predictors of the log of THC concentrations.
Infant Levels. The urine of 2 breastfed infants whose mothers smoked marijuana found none of the 9-carboxy-THC metabolite. One mother reported smoking marijuana once daily and the other reported smoking marijuana 7 to 8 times daily. Analysis of the feces of the latter mother’s infant revealed a higher proportion of metabolites than THC, indicating that THC was probably absorbed from the milk, metabolized by the infant, and excreted in feces.
Effects in Breastfed Infants
Twenty-seven mothers reported smoking marijuana during breastfeeding. Twelve of them smoked once a month or less, 9 smoked weekly, and 6 smoked daily. Six of their infants were compared at 1 year of age to the infants of mothers who did not smoke marijuana during pregnancy or breastfeeding. No differences were found in growth, or on mental and motor development.
Sixty-eight infants whose mothers reported smoking marijuana during breastfeeding were compared to 68 matched control infants whose mothers did not smoke marijuana. The duration of breastfeeding varied, but the majority of infants were breastfed for 3 months and received less than 16 fluid ounces of formula daily. Motor development of the marijuana-exposed infants was slightly reduced in a dose-dependent (i.e., number of reported joints per week) manner at 1 year of age, especially among those who reported smoking marijuana on more than 15 days/month during the first month of lactation. No effect was found on mental development.
A small, case-control study found that paternal marijuana smoking postpartum increased the risk of sudden infant death syndrome. In this study, too few nursing mothers smoked marijuana to form any conclusion.
A study of women taking buprenorphine for opiate substitution during pregnancy and lactation found that 4 of the women were also using cannabis as evidenced by positive urine screens for THC between 29 and 56 days postpartum. One was also taking unprescribed benzodiazepines. One infant was exclusively breastfed and the other 3 were mostly breastfeeding with partial supplementation. Infants had no apparent drug-related adverse effects and showed satisfactory developmental progress.
Fifty women who reported using cannabis in the prior 14 days donated milk samples for analysis of THC and its major metabolites. THC was detectable in 66% of the samples and below the limit of quantification in 32% of samples. Preliminary evidence found no differences in infant adverse reactions, postnatal growth, or neurodevelopmental outcomes were found between the groups with quantifiable and nonquantifiable THC in breastmilk.
Effects on Lactation and Breastmilk
Acute one-time marijuana smoking suppresses serum concentrations of luteinizing hormone and prolactin in nonpregnant, nonlactating women.[21-23] The effects of long-term use is unclear, with some studies finding no effect on serum prolactin.[24-26] However, hyperprolactinemia has been reported in some chronic cannabis users,[27-29] and galactorrhea and hyperprolactinemia were reported in a woman who smoked marijuana for over 1 year. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Of 258 mothers who reported smoking marijuana during pregnancy, 27 who had smoked marijuana during breastfeeding were followed-up at 1 year. No difference was found in the age of weaning between these mothers and 35 who reported not smoking marijuana during pregnancy or breastfeeding.
The US state of Colorado legalized medical cannabis in 2001 and recreational cannabis in 2012. A cross-sectional survey conducted in Colorado in 2014 and 2015 found that both prenatal and postnatal cannabis use were associated with a shorter duration of breastfeeding. Among women who reported using cannabis during pregnancy, 64% breastfed for 9 or more weeks compared with 78% of women who did not use cannabis during pregnancy. Among women who reported postpartum cannabis use, 58% breastfed for 9 or more weeks compared with 79% of women who did not use cannabis postpartum. Both differences were statistically significant.
A study using a database of 4969 postpartum women found that those who reported using marijuana were more likely to smoke cigarettes, experience postpartum depressive symptoms, and breastfeed for less than 8 weeks. Tobacco smoking is known to decrease the duration of breastfeeding, so the effect of marijuana is not clear. Most of the women who smoked marijuana postpartum also used it during pregnancy.
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