Dear Nurse Susan,

I’m a mom to my 5-year-old son and 3-month-old daughter. I’ve suffered from anxiety and depression for a majority of my adult life and have found that cannbis helps me feel grounded, present, and allows me to be my true self to my children, my partner, and myself. Since getting pregnant with my daughter nearly a year ago, I used cannbis to help with nausea during the first trimester (it literally was the only thing that actually helped), but cut back on my usage thereafter for fear of the “unknown.” Now, as a nursing mother, I’m really looking to learn more about cannbis and breastfeeding and if I’m doing harm to my baby girl by using in moderation. It’s hard to think that cannbis would be causing her harm when it is so helpful to me, but I really just don’t know and haven’t found any helpful literature. Can you help?

California CannaMom

Dear CannaMom,

This is an important question, and to cut to the chase, there really is no clear cut answer. As of now, this controversial topic continues to be an “unknown”. I have included numerous resources here so any moms with this question can weigh the evidence for themselves. Please check out as many as you like to make your decision. We’ll start with the clinical evidence I’ve found.

There have been a few research studies on the effects of cannabis use during pregnancy and the neonatal outcomes of cannabis exposure. The results have been inconclusive. One study,  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163087/ concluded that prenatal cannabis exposure was associated with fetal growth reduction and decreased head circumference. Some investigators have reported deficits in birth weight, length and gestational age, whereas other investigators observed no adverse effects: https://www.ncbi.nlm.nih.gov/pubmed/1957518.  Long-term consequences of prenatal cannabis exposure have been reported, including poorer performance on intelligence tests, increased depressive symptoms and increased likelihood of cannabis use during adolescence, but results of other studies have demonstrated no differences between prenatally exposed and nonexposed children and adolescents.

The American College of Obstetricians and Gynecologists (ACOG, 2015) recommends screening and education regarding potential adverse effects of marijuana use in pregnancy. Women contemplating pregnancy or currently pregnant are encouraged to discontinue medicinal or recreational marijuana use and also discourages marijuana use during breastfeeding and lactation due to insufficient evidence regarding safety: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Marijuana-Use-During-Pregnancy-and-Lactation.

So, to paraphrase, we just don’t know. Another consideration is the possibility of intervention by the Department of Child Protective Services. Unfortunately, depending on the attitudes in your community, it is not uncommon for children to be removed from the home where cannabis is present when certain authorities are informed. Know what happens with your medical test results and your community politics to avoid this awful possibility!

In all medically related questions you need to weigh the risks and benefits of any intervention, including medicinal cannabis. For example, a child with intractable epilepsy, and having 300+ grand mal seizures per week, is at very low risk from using cannabis to control seizures, compared to the risk of continual brain damage from the seizures and pharmaceutical anti-convulsant medications. Conversely, in a healthy baby/child/adolescent, with a developing brain and nervous system, cannabis exposure may pose a higher risk than non-exposure.

A different option, with similar inconclusive evidence is using only CBD to relieve your symptoms. CBD has no psychoactive component and is an effective anti-inflammatory and neuroprotectant for healthy adults. We all know the incredible value that CBD plays in relieving autism and epilepsy in children. As well, both patient’s experience and the research shows that CBD effectively stops inflammation in the way of soothing the nerves and pain receptors as well as creating a way in which the body is able to relax. The following article does a good job of outlining how CBD use can be helpful in pregnancy and suggests that it is safe.  http://www.womendailymagazine.com/cbd-hemp-oil-safe-use-pregnant/  While it certainly seems there would be no ill effects, I have not found any conclusive research regarding CBD use during pregnancy being “safe”.

As all women know, everyone has their opinions of what is good and bad, helpful and not helpful during and post pregnancy. My experience with frequent cannabis users is they have made a lifestyle choice and presume “it’s all good” regarding cannabis. As a nurse, I do my best to stick with the facts and research. In my opinion, when it comes to babies and kids, it’s usually best to err on the side of caution. If you’re having insufferable symptoms I’d start with CBD only (oil, vaping, topicals, etc.) and see if that helps. After looking at the information I’ve provided here, if you want to use THC to help you out let your doctor and partner know of your choice so you’re going forward with as much awareness, openness and support as possible.

Pregnancy and babies are a beautiful time in your life…do what you think is best to insure the best outcome for you and the baby.

To you and your baby’s excellent health!

Nurse Susan

p.s. Here are some additional resources to check out on the topic.

https://www.projectcbd.org/about/clinical-research/cannabis-use-during-pregnancy-safety

https://www.whattoexpect.com/news/pregnancy/why-are-more-pregnant-women-smoking-pot/

https://www.whattoexpect.com/pregnancy/pregnancy-health/things-to-know-about-marijuana-use-during-pregnancy/

https://www.hellomd.com/answers/57f5d66c0a6dfc000b6f0cee/is-it-safe-to-use-cbd-products-during-pregnancy

Hayes JS, Lampart R, Dreher MC, Morgan L. Five-year follow-up of rural Jamaican children whose mothers used marijuana during pregnancy. West Indian Med J 1991;40:120 –3