With more states legalizing recreational marijuana and even more states legalizing it for medical usage, it should come as no surprise that marijuana is one of the most commonly used recreational drugs in women who breastfeed. Given the developmental concerns raised by exposure to cannabinoid derivatives in adolescence as the brain continues its growth and development, one can only wonder what the effect of cannabinoid derivatives would be if they cross over in breastmilk to infants whose brains are also undergoing enormous growth and development in that first year of life. So, does marijuana pass through the placenta? Bertrand et al. (10.1542/peds.2018-1076) in a study being early released this week studied 50 women who breastfeed and reported using marijuana (smoked or edibles) while lactating. The authors looked at 54 samples of breastmilk from these mothers and found that evidence of marijuana use was still able to be found in those milk samples 6 days after last reported use of the drug. What does this mean?
We asked adolescent specialist Dr. Sheryl Ryan, an expert on the risks associated with marijuana use in teens to weigh in with an accompanying commentary (10.1542/peds.2018-1921). Dr. Ryan points out that without information on cannabinoid levels from mothers and infants and what these levels might mean and information on how an infant metabolizes these cannabinoids compared with adults, it is difficult to predict how serious a problem it is. Since marijuana accumulates as a lipophilic substance in organs rich in fats such as the brain, Dr. Ryan highlights the fact that these metabolites might be deposited in growing brain tissue raising concerns in regard to whether or not a mother should continue breastfeeding her baby. The AAP recommends that we advise mothers not to use marijuana if planning to breastfeed but is less clear about whether or not a mother should stop if she is using marijuana while also breastfeeding. Given the findings in this study, what do you think? We welcome your comments either directly to this blog, or to the article on our website via its “Comments” section, or via our Twitter and Facebook pages.
