Persistence of Δ-9-Tetrahydrocannabinol in Human Breast Milk

Wymore, Erica; Palmer, Claire; Wang, George S.; Metz, Torri D.; Bourne, David W. A.; Sempio, Cristina; Bunik, Maya

doi:10.1001/jamapediatrics.2020.6098

Cited by 33 publications

(26 citation statements)

References 6 publications

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“…As found in human studies, CBD, THC, and THC metabolites are present in breast milk after maternal consumption [5][6][7][8]. Here, we add to this knowledge by showing that CBD metabolites are present in the milk as well.…”

Section: Maternally Administered Cannabinoids Are Differentially Present In Breast Milksupporting

confidence: 77%

“…Our labs recently showed that perinatal cannabinoid exposure leads to longterm behavioral changes on repetitive tasks and alters the effect of fluoxetine on immobility time during a forced swim task [4]. Because of the effects of early-life CB exposure and the detection of THC, THC metabolites, and CBD in human breast milk [5][6][7][8], it is important to evaluate how CBs given to lactating females transfer into milk and how these levels affect the lipid composition of milk, including endogenous cannabinoids (eCBs) and related signaling lipids.…”

Section: Introductionmentioning

confidence: 99%

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Cannabinoids accumulate in mouse breast milk and differentially regulate lipid composition and lipid signaling molecules involved in infant development

Johnson

Abreu

et al. 2021

Preprint

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Maternal cannabis use during lactation may expose developing infants to cannabinoids (CBs) such as tetrahydrocannabinol (THC) and cannabidiol (CBD). CBs modulate lipid signaling molecules in the central nervous system in age- and cell-dependent ways, but their influence on the lipid composition of breastmilk has yet to be established. This study investigates the effects of THC, CBD, or their combination on milk lipids by analyzing the stomach contents of CD1 mouse pups that have been nursed by dams injected with CBs on postnatal days (PND) 1-10 collected 2 hours after the last injection on PND10. HPLC/MS/MS was used to identify and quantify over 80 endogenous lipid species and cannabinoids in pup stomach contents. We show that CBs differentially accumulate in milk, lead to widespread decreases in free fatty acids, decreases in N-acyl methionine species, increases N-linoleoyl species, as well as modulate levels of endogenous CBs (eCBs) AEA, 2-AG, and their structural congeners. Our data indicate the passage of CBs to pups through breast milk and that maternal CB exposure alters breast milk lipid compositions.

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Section: Maternally Administered Cannabinoids Are Differentially Present In Breast Milksupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Cannabinoids accumulate in mouse breast milk and differentially regulate lipid composition and lipid signaling molecules involved in infant development

Johnson

Abreu

et al. 2021

Preprint

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show abstract

“…Research on how marijuana use by breastfeeding mothers affects infants is more limited, but emerging findings have stimulated concerns that it induces health harms. Its potential to affect infant physiological function is underscored by findings that tetrahydrocannabinol (THC), the main psychoactive component, can be detected in breastmilk 6 days to six weeks after use (Baker et al, 2018;Bertrand et al, 2018;Wymore et al, 2021). A systematic review evaluating the safety of marijuana use while breastfeeding found that human and animal studies providing evidence supporting concerns about risks outnumber those finding no concerning evidence (Mourh & Rowe, 2017).…”

Section: Infant Health Harms Of Marijuana Use While Pregnant and Brea...mentioning

confidence: 99%

Beliefs about marijuana use during pregnancy and breastfeeding held by residents of a Latino-majority, rural region of California

et al. 2022

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Marijuana use among pregnant and breastfeeding women is on the rise and carries risks for infant health and well-being. Decisions to use marijuana while pregnant and breastfeeding are motivated by beliefs that use poses minimal risk to infants and offers benefits to maternal users. Misperceptions and usage trend higher among disadvantaged populations. This study surveyed 401 community residents on beliefs about risks and benefits of marijuana use by pregnant and breastfeeding women. The study utilized techniques to enhance recruitment of Latino and disadvantaged residents of rural communities in California, a state where recreational marijuana use is legal. Analyses revealed substantial endorsement of beliefs about benefits and low risks of marijuana use while pregnant and breastfeeding, many of which run counter to current evidence. Misperceptions were particularly prevalent for cannabis users and male respondents. Trends in valid beliefs, while modest, were higher for Latinos and parents.

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“…From the studies published on LactMed regarding the transfer of cannabinoids in breast milk, we can conclude that THC, 11-OH-THC, THC-COOH, CBD and CBG are present in breast milk for at least 40 h ( Baker et al, 2018 ; Bertrand et al, 2018 ; Moss et al, 2021 ; Wymore et al, 2021 ). THC could be detectable in breast milk for up to 6 days with higher concentrations than in plasma.…”

Section: Discussionmentioning

confidence: 99%

“…It has the advantage of assessing both the exposure of the mother and the breastfed child to cannabis. Unfortunately, only a few studies have measured cannabinoids in breast milk and assessed their pharmacokinetics in this matrix ( Presence of Δ9, 1982 ; Marchei et al, 2011 ; Baker et al, 2018 ; Bertrand et al, 2018 ; Moss et al, 2021 ; Wymore et al, 2021 ; Sempio et al, 2020 ) . Indeed, such studies are difficult to conduct because many mothers refuse to enroll by fear of being judged or underreport their cannabis consumption making it difficult to correlate measured concentrations and the dose taken or simply stop their consumption during the study.…”

Section: Methodsmentioning

confidence: 99%

Pharmacokinetics of Cannabis and Its Derivatives in Animals and Humans During Pregnancy and Breastfeeding

et al. 2022

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Cannabis is one of the most widely used illicit drugs during pregnancy and lactation. With the recent legalization of cannabis in many countries, health professionals are increasingly exposed to pregnant and breastfeeding women who are consuming cannabis on a regular basis as a solution for depression, anxiety, nausea, and pain. Cannabis consumption during pregnancy can induce negative birth outcomes such as reduced birth weight and increased risk of prematurity and admission to the neonatal intensive care unit. Yet, limited information is available regarding the pharmacokinetics of cannabis in the fetus and newborn exposed during pregnancy and lactation. Indeed, the official recommendations regarding the use of cannabis during these two critical development periods lack robust pharmacokinetics data and make it difficult for health professionals to guide their patients. Many clinical studies are currently evaluating the effects of cannabis on the brain development and base their groups mostly on questionnaires. These studies should be associated with pharmacokinetics studies to assess correlations between the infant brain development and the exposure to cannabis during pregnancy and breastfeeding. Our project aims to review the available data on the pharmacokinetics of cannabinoids in adults, neonates, and animals. If the available literature is abundant in adult humans and animals, there is still a lack of published data on the exposure of pregnant and lactating women and neonates. However, some of the published information causes concerns on the exposure and the potential effects of cannabis on fetuses and neonates. The safety of cannabis use for non-medical purpose during pregnancy and breastfeeding needs to be further characterized with proper pharmacokinetic studies in humans feasible in regions where cannabis has been legalized. Given the available data, significant transfer occurs to the fetus and the breastfed newborn with a theoretical risk of accumulation of products known to be biologically active.

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Persistence of Δ-9-Tetrahydrocannabinol in Human Breast Milk

Abstract: Author Contributions: Drs Ghiggeri and Ravani had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Ravani, Ghiggeri.

Cited by 33 publications

References 6 publications

Cannabinoids accumulate in mouse breast milk and differentially regulate lipid composition and lipid signaling molecules involved in infant development

Cannabinoids accumulate in mouse breast milk and differentially regulate lipid composition and lipid signaling molecules involved in infant development

Beliefs about marijuana use during pregnancy and breastfeeding held by residents of a Latino-majority, rural region of California

Pharmacokinetics of Cannabis and Its Derivatives in Animals and Humans During Pregnancy and Breastfeeding

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