Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk

Abstract

∆9-THC was measurable in a majority of breast milk samples up to ∼6 days after maternal marijuana use.

Perinatal THC Exposure via Lactation Induces Lasting Alterations to Social Behavior and Prefrontal Cortex Function in Rats at Adulthood

“…During the early postnatal period, breastfeeding by cannabis-using mothers actively transfers the principle psychoactive component of cannabis, ∆9-tetrahydrocannabinol (THC) and other cannabinoids to the developing infant, as the lipophilic nature of these cannabinoids results in concentrations in breast milk which are equal to or exceeding that found in the plasma of the user 7,8 . Importantly, this transfer may persist well beyond the intoxication period of the user due to the long half-life of THC in breast milk 9 , thus occluding the possibility of simply breastfeeding outside of the acute cannabis consumption period as is often done with alcohol consumption 10 . Therefore, understanding and disseminating data regarding the consequences of THC consumption during the breastfeeding period is paramount to public health in the evolving age of cannabis use.…”

A Modern Conundrum for the Pediatrician: The Safety of Breast Milk and the Cannabis-Using Mother

“…Both the American Academy of Pediatrics and American College of Obstetricians and Gynecologists currently recommend counseling the mother to abstain from all cannabis products if desiring to breastfeed. 7,8 With their study, Bertrand et al 3 have provided additional and valuable support for those current recommendations. But the picture is incomplete without our understanding of what is happening at the level of those infants exposed to cannabinoid-containing breast milk.…”

“…Until now, the scientific evidence that would be used to help a provider make an informed decision has been essentially nonexistent. Thus, the study reported by Bertrand et al 3 in this current edition of Pediatrics, entitled "Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk, " is timely and important, because it provides, for the first time, data from a large sample of human milk donors (N = 50) who were currently breastfeeding and using cannabis products, both smoked and edible.…”

“…Before Bertrand et al's 3 report, the only data available on the levels of cannabinoids in breast milk were 2 case reports of individual lactating women (N = 3). The authors of these reports found that Δ-9-tetrahydrocannabinol (THC), cannabidiol, and THC metabolite 11-hydroxy-Δ-9-tetrahydrocannabinol were present in the breast milk of cannabis-using women, the level of THC in breast milk was 8 times higher than the mother's plasma level, and a fecal sample from 1 of these breastfed infants contained higher concentrations of THC metabolites than the mother's breast milk.…”

“…Authors of these previous reports suggested that the cannabinoids can transfer into breast milk and that the infant can absorb and possibly metabolize the THC. 4,5 Using sophisticated mass spectroscopy techniques, Bertrand et al 3 identified and quantified the concentration of several cannabinoids found in the milk samples. They found measurable levels of THC in 63%, 11-hydroxy-Δ-9-tetrahydrocannabinol in 9%, and cannabidiol in 9% of their samples of breast milk collected between 2014 and 2017.…”