Management of Cannabis Use in Breastfeeding Women: The Untapped Potential of International Board Certified Lactation Consultants

Abstract

Recent increases in maternal cannabis use, in combination with rapidly changing cannabis policies in the United States, pose a unique threat to maternal and child health. To date, 33 states and the District of Columbia (D.C.) have legalized medicinal cannabis, and 11 states and D.C. have legalized recreational cannabis. Many other states have decriminalized cannabis and are considering legalization. Recent data suggest that maternal cannabis use is increasing. Maternal cannabis use in the postpartum period, including breastfeeding women, may contribute to negative health outcomes in young children. Perinatal health professionals should work collaboratively to safeguard maternal and child health outcomes from potential adverse health effects of cannabis use. To that end, we highlight the critical role International Board Certified Lactation Consultants Ò (IBCLCs Ò) could play in postpartum management of cannabis use. IBCLCs have direct access to a large number of women shortly after delivery and throughout the postpartum period. They are an extremely well-positioned, but arguably underutilized, and are potential partners for postpartum management of cannabis use. Given the rapport IBCLCs frequently develop with their patients, these mothers may be especially willing to disclose cannabis use and be receptive to education and advice to quit cannabis use while breastfeeding. As such, we propose that the role of IBCLCs be promoted to support families with nonpunitive education about the potential risks, advice to not use cannabis while breastfeeding, and timely referral for treatment, when needed. This approach holds promise for improving the health and quality of life for breastfeeding women and their infants.

The ethics and management of cannabis use in pregnancy following decriminalisation and licensing for medical use: narrative review

“… 107 For example, pharmacists and lactation consultants are in unique positions and may be able to identify those who are using cannabis, offer advice on abstinence, support with education on the known risks and benefits of cannabis use during breastfeeding and provide referrals for treatment, if required. 108 , 109 …”

Effects of maternal toxic substance consumption during breastfeeding on lactic acid bacteria abundance and nutritional content

“…This compound can be transferred in small amounts to breast milk, changing its organoleptic characteristics such as taste and smell. Metabolically, newborns are incapable of oxidising alcohol, having negative effects on their behavior, sleep patterns, psychomotor development, and in the worst-case scenario, future kidney problems 16 , 17 .…”

“…Its consumption can change organoleptic properties, causing breast refusal 9 . The complications that arise include the inhibition of prolactin release, low milk production, and interference with ejection of breast milk 16 . Nicotine, which is the main component of tobacco, can be present in breast milk as cotinine and cause adverse effects such as inadequate weight gains and more frequent colic in the infant 18 .…”