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How should you counsel pregnant, breastfeeding women on marijuana use? :

July 9, 2019

Editor's note:The 2019 AAP National Conference & Exhibition will take place from Oct. 25-29 in New Orleans.

A mom brings her 2-year-old in for a well-child visit. She tells you she is pregnant and is experiencing horrible morning sickness. She’s read on the internet that marijuana can help and asks your opinion.

Another mother confides in you that she is using marijuana to relieve the stress of having a newborn. She asks if it’s OK to breastfeed her baby.

Pediatricians may start getting more questions like these as an increasing number of states legalize marijuana.

“This is a very tricky topic,” acknowledges Mary O’Connor, M.D., M.P.H., FAAP, co-author of the 2018 AAP clinical report Marijuana Use During Pregnancy and Breastfeeding: Implications for Neonatal and Childhood Outcomes.

Dr. O’Connor will review the report’s recommendations and new information that has come out since it was released during a session titled “Marijuana Use During Pregnancy and Breastfeeding: Good, Bad, Unknown,” from 9:30-10:15 a.m. Sunday, Oct. 27 (F3105) in rooms 356-357 of the convention center and again from 7:30-8:15 a.m. Monday, Oct. 28 (F4008) in rooms 217-219.

She will begin the session by discussing information pediatricians might not be aware of about marijuana and the marijuana industry.

“… State legislatures see this as a moneymaker for their state, and that may not be the best reason to legalize adult use,” said Dr. O’Connor, clinical professor of pediatrics, Geisel School of Medicine at Dartmouth, and professor emerita of pediatrics, University of Colorado School of Medicine.

Next, she will review the evidence — and lack thereof — on the effects of marijuana use during pregnancy, lactation and by secondhand smoke exposure on short-term outcomes on the fetus and newborn and long-term developmental outcomes as children grow.

She also will touch on whether pediatricians are mandated to report mothers who are using marijuana while pregnant or breastfeeding to child protective services.

Finally, she aims to clarify the clinical report’s recommendation regarding use of marijuana while breastfeeding, which some people have interpreted as breastfeeding is contraindicated for mothers who use marijuana.

“What we’re saying is that we’re concerned about marijuana exposure during pregnancy and breastfeeding because there may be some adverse neurologic outcomes,” said Dr. O’Connor, a member of the AAP Section on Breastfeeding. “But at this point, we’re not saying, ‘no you can’t breastfeed’ because there are so many positive effects of breastfeeding on both the mother and baby.”

For more coverage of the 2019 AAP National Conference & Exhibition, visit http://bit.ly/AAPNationalConference19.

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