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Breast feeding and maternal use of marijuana

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Regarding Marijuana. The American Academy of Pediatrics states that the use in breast milk from a mother using marijuana is contraindicated. The LacMed state that it is not contraindicated. The American College of OBGyN recommends that mothers stop using marijuana but does not mention stopping mothers from providing breast milk. There is a conflict between the benefits of breast milk in premies and the potential harm. What are your recommendations?

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I found this on drugs.com: https://www.drugs.com/breastfeeding/cannabis.html

Seems like there is not so much data. Although gut feelings should not gear our minds too much, I personally would not actively promote breast feeding in such a case.

OT and needless to say, IMHO marijuana and parenthood would be a combination that no infant should need to be exposed to. In our little pond here in Sweden, we are obliged to inform parental abuse to the Social Services (according to our laws on child protection and the child's own interest)

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I think that feeding breast milk from a mother using marijuana is too harm, so does the mother,s nervous sysstem is quite and stable after uzimanje marijuana? i think No, this affects on the baby and as we know all what themother takes, this will be transferred to the baby

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Hale lists it as an L4 (Limited Data-Possibly Hazardous). The population I counsel are breastfeeding mothers of high-risk NICU infants. Along with the potential harmful effects of cannabis, I discuss how being in an altered state (with any drug) can potentially effect their parenting skills. It's tricky because many mothers respond, "But, it's legal" (here in California). In this area (San Joaquin Valley) there's a perception of legality=safety.

Michelle Harris, BSN, PHN, RNC-NIC

Developmental Nurse, NICU

Certified Lactation Counselor

Kaweah Delta Medical Center

400 W. Mineral King Ave.

Visalia, CA. 93291

559 624 2476

miharris@kdhcd.org

Drug Details for:
CANNABIS
Trade Names:
Drug Type:Sedative, hallucinogen, antiemetic
Usual Dose:
Lactation Risk Category: L4 - Limited Data-Possibly Hazardous
Relative Infant Dose:
Side Effects:Sedation, fatigue, hallucinations, increased sensory perception, poor memory, seizures, tachycardia, dry mouth, constipation, changes in menstrual cycle, inhibition of platelet aggregation, weakness, changes in motor coordination.[1] Possible decreased milk production.
Alternative Meds:
T1/2:25-57 hours
Oral Bioavailability:4-12%
MW:314



 

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There is a lot of debate when it comes to marijuana and breastfeeding. Although, it has been reported that  breastfeeding from mothers who smoke marijuana during lactation showed a delay in motor development at 1 year of age, It can be hard to draw any conclusions because mothers who smoke marijuana during lactation are much likely to have smoked during pregnancy, as well.  This means we can’t always determine whether exposure in utero through smoking marijuana during pregnancy, or from exposure through breastfeeding causes changes in the baby’s development.

One must weigh the pros and cons, On one hand, there are many benefits to breastfeeding babies, that is well established. On the other hand, the risks of using marijuana while breastfeeding are under debate.

I would recommend, sharing the decision with the mom, explain to her the benefits of breastfeeding vs. formula and the debate on the risks of using marijuana while breastfeeding. Advocate for her baby by encouraging mom to wean-off the marijuana she is taking by 5 ~10 % during pregnancy and every 2 to 3 weeks after and to get professional help for her weaning-off.

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Once the the extremely premature infant is admitted to the NICU, it may be too late to  ask the mother to abstain from using marijuana. THC can stay in her system and excreted in breast milk for weeks.

We know that using mothers breast milk decreases the incidence and severity of NEC. Mother’s breast milk is not just for nutrition. It decreases the occurance of both NEC and surgical NEC. The later has significant increase in mortality and long term neurologic morbidity. From what I have read, donor milk does not have nearly the same protective effect. 

Treating or not treating the premie with mother’s breast milk. Until we have more data, what do we do? Are we causing more harm withholding mother’s breast milk for a 26 week premie? 

Statement from LactMed

Because breastfeeding can mitigate some of the effects of smoking and little evidence of serious infant harm has been seen, it appears preferable to encourage mothers who use marijuana to continue breastfeeding and reducing or abstaining from marijuana use while minimizing infant exposure to marijuana smoke.”

 

 

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