Can CBD help with breastfeeding, and is it safe to use for nursing mothers and their babies?
- Cannabinoids naturally exist in breast milk, as a 2016 research published by the National Institutes of Health indicates(1). However, CBD is entirely fat-soluble, making it nearly impossible to accurately measure the CBD component in breast milk, which is also full of fats.
- According to the U. S. Food and Drug Administration (FDA), based on what the experts already know about CBD, some amount of CBD may be transferred to babies through breast milk.
- While there is no evidence that explicitly confirms the presence of CBD or THC in human breast milk, the data remain inconclusive about the potential interactions between CBD and nursing mothers and their babies.
- There have been no studies on the effects of CBD alone on pregnancy and breastfeeding. However, there have been studies done on subjects with prolonged exposure to marijuana. Thus, doctors are cautious about recommending the non-psychoactive CBD because of its close association with marijuana, and because of the lack of research around CBD alone.
- Meanwhile, the FDA continues to investigate reports of CBD products containing contaminants, such as pesticides, heavy metals, bacteria, and fungus, that may pose a risk to the fetus or breastfed baby.
Why Some Women May Be Thinking of Taking CBD During Breastfeeding
The many changes that happen to a woman’s body after giving birth may bring about several pains, mental health issues, postpartum anxiety, stress, and nausea-related problems. Postpartum nausea warrants a prompt medical evaluation of the thyroid, gallbladder, or liver.
Unfortunately, the verified safe options available are limited, as many prescription medications can bring about adverse side effects that may harm both the nursing mother and her new baby.
Having heard that CBD has many potential benefits, some mothers may be looking to it for alleviating some of these issues, including postpartum depression (PPD), which affects 15% of all mothers.
But as new moms look to CBD as a natural alternative to pharmaceuticals, they must also know whether or not CBD is safe for them and their babies.
CBD and Breastmilk: What Research Says
The critical issue surrounding CBD oil and breastfeeding is the necessity for more deductive and conclusive research on nursing mothers and their infants.
Considering the dearth of evidence on the effects of CBD oil and breastfeeding, complete abstinence is the safest course of action.
The limited clinical studies that exist on only CBD were either done in vitro or on non-human subjects.
The Risks of Using CBD While Breastfeeding
A 2011 study led by Chia-Shan Wu, Ph.D. of The Cain Foundation Laboratories, suggested that prenatally cannabis-exposed children display neurological and behavioral problems(2).
Another study from 2016, published by the National Institutes of Health, had shown that prenatal exposure to cannabis might increase adverse outcomes for women and their babies, such as low birth weight, placement in the neonatal intensive care unit, and preterm birth(3).
Studies that show the impact of cannabis on pregnancy are limited. However, there have been studies done on subjects with prolonged exposure to marijuana.
A 2013 study, “Cannabidiol changes P-gp and BCRP expression in trophoblast cell lines”, conducted by the Department of Clinical Biochemistry and Pharmacology at Ben-Gurion University of the Negev, Israel, concluded that CBD use during pregnancy might change the physiological characteristics of the placenta.
However, it must be noted that the aforementioned study was not based on the exclusive use of CBD which traditionally contains low to zero levels of THC, but rather on marijuana, which contains high levels of THC.
CBD and marijuana are not the same thing. Thus, it is difficult to draw any conclusions from this study.
Studies like this make doctors cautious about recommending the non-psychoactive CBD because of its close association to marijuana and because of the lack of research around CBD alone.
Also, CBD has to be measurable to determine how much CBD ends up in breast milk. However, CBD is a highly lipophilic molecule, which means it is entirely fat-soluble. Thus, it is nearly impossible to accurately measure the CBD component in breast milk, which is full of fats.
In 2006, some CBD products were tested by the U. S. Food and Drug Administration (FDA), and they were found to contain trace amounts of other cannabinoids, like THC (tetrahydrocannabinol).
THC is the main psychoactive component of marijuana. While there are methods used to detect concentrations of THC in breast milk, nothing is conclusive as of yet for CBD.
Researchers at the Centers for Disease Control and Prevention developed a novel technique that begins with saponification to separate cannabinoids from fat in milk.
Saponification, a process often used in soap-making, is a chemical reaction that occurs when fatty acids come into contact with lye. With this novel approach involving saponification, the team can detect trace levels of active marijuana compounds, including cannabinol (CBN) and cannabidiol (CBD).
Researchers are hopeful that, in the future, saponification could help in detecting and measuring the exact amount of CBD in breast milk. When and if this takes effect, any doubts about CBD oil and breastfeeding can be cleared.
However, given the current lack of regulations on CBD products available in the market, there is a wide range of disparities in potency, quality, and general effectiveness.
Regardless of what the labels say, consumers, especially new mothers and breastfeeding women, should be wary of the brand of CBD that they consume.
In 2018, a group of researchers from the University of California San Diego conducted a study on marijuana use by breastfeeding mothers and cannabinoid concentrations in breast milk(4).
However, as CBD was not the focus of the study, the research is still limited in scope. Thus, the results of the study are still inconclusive with regards to the safety of CBD oil when used during breastfeeding.
The test also recognized psycho-motor deficits in more than half of the 12-month old infant participants involved in the study. However, the results of CBD on these breastfed children are not yet available.
Meanwhile, studies on THC and its effects on infants has been alarming. A 2017 research, “Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research”, published by the National Academy of Sciences, demonstrated that exposure to cannabis use in utero has an adverse influence on birth weight and increases the risk of an infant baby going into intensive care.
While the results are defeating to most people, it is essential to note that in the Pharmacology and Therapeutics Journal published in 2018, researchers of the study on “Cannabis Use during Pregnancy: Pharmacokinetics and Effects on Child Development” emphasized the fact that women should not smoke marijuana while pregnant. However, the study does not mention anything about CBD use during pregnancy.
Since CBD and marijuana are not the same thing, it is difficult to draw any conclusions from this study.
Still, studies like this make doctors cautious about recommending the non-psychoactive CBD because of its close association to marijuana and because of the lack of research around CBD alone.
There are potential dangers of THC in breast milk, according to the aforementioned 2018 study.
- THC can remain in breast milk for up to 6 days, according to the study.
- THC can affect the baby. The same study found that infants exposed to THC in breastmilk had a lower motor function by the time they were one year old.
- THC poses an enormous risk. Breastfed babies of mothers who smoked heavy amounts of marijuana would test positive for THC for up to three weeks.
Breast Milk and the Endocannabinoid System
It is only recently that scientists discovered the full potential of these cannabinoid receptors that exist within the endocannabinoid system (ECS). The primary function of the ECS is the regulation and homeostasis (balance) within the body.
- A developing fetus has a growing endocannabinoid system, which is the system that CBD benefits.
- Endocannabinoids in breast milk are crucial for a newborn baby’s development. They stimulate hunger and teach the infant how to suckle.
- Breast milk contains endocannabinoids that are very similar in structure to CBD.
- The lack of these endocannabinoids may result in a disorder called ‘non-organic ability to thrive’ wherein the infant has no desire to feed.
Endocannabinoids help teach a newborn baby how to feed by stimulating the process of suckling. In the absence of these endocannabinoids, babies would be unaware of how to feed, nor would they have the appetite to eat. The result could be fatal, as it could lead to malnourishment or death.
Cannabinoids naturally exist in breast milk, as the 2016 research published by the National Academies Press indicates(5).
There are dozens of cannabinoids, but there is no evidence that explicitly confirms the presence of CBD or THC in human breast milk.
Given that it is nearly impossible to find an accurate estimate of the amount of CBD that breast milk contains, it is potentially unsafe for babies to consume CBD.
CBD Oil and the Endocannabinoid System
CBD oil works by binding to cannabinoid receptors in the body. Through this method, CBD can influence the modulation of activities in the ESC.
The ESC impacts several bodily functions, such as mood and anxiety. Hence, ESC is involved in particular disorders as well, such as movement disorders such as Parkinson’s disease, mood and anxiety disorders, neuropathic pain, multiple sclerosis, and spinal cord injury, obesity, metabolic syndrome, and osteoporosis.
What Women Should Know
Women who are contemplating to take CBD while pregnant or nursing should consider the following imperatives:
- Consult with a medical professional about the risks and benefits of CBD, as well as interactions that CBD may have with any prescription medications that are being taken in conjunction with CBD.
- Ensure that the CBD product that would be purchased contains no THC. Read product labels and only purchase from reliable manufacturers.
- Select products that contain pure CBD, no heavy metals, solvents, or harmful pathogens. Third-party lab tests are essential under any circumstances, but for a breastfeeding mother, the availability of those tests should be non-negotiable.
- Monitor any changes in the baby’s behavior and feeding schedule. Any changes must be reported to the baby’s doctor.
Before considering CBD, it is important to remember that there is still a lack of enough evidence at this stage. Studies have also shown that the use of cannabis while pregnant or breastfeeding can lead to an increased risk of low birth weight, preterm labor, and neurological, and behavioral problems.
Other Benefits of CBD
Nursing mothers may be tempted to turn to CBD because it can provide a number of general benefits that is safe to those who are not pregnant or breastfeeding:
- A 2009 study, “The endocannabinoid system and the treatment of mood and anxiety disorders”, conducted by the Laboratory of Neuroendocrinology of Rockefeller University in New York, showed how CBD might impact mood by regulating the body’s response to stress. An improved stress response promotes a positive mood and increases energy levels.
- “The Profile of Immune Modulation by Cannabidiol (CBD) Involves Deregulation of Nuclear Factor of Activated T Cells (NFAT)”, a research conducted in 2018 by the Center for Integrative Toxicology and Department of Pharmacology and Toxicology in Michigan State University, demonstrated CBD as a potent immune suppressor, making it potentially beneficial for use in autoimmune disorders where the immune system is overactive. Since the immune system is linked to the endocannabinoid system (ECS), CBD also promotes a stable immune system.
- New moms typically suffer from a lack of sleep. On The Permanente Journal published online in 2019, results of the study on “Cannabidiol in Anxiety and Sleep: A Large Case Series” showed that CBD might help reduce anxiety levels, which can potentially result in improved sleep.
- CBD has been shown to be able to restore a sense of calm. According to a 2019 report on “Cannabinoid Regulation of Fear and Anxiety: an Update” by the School of Biosciences at the University of Nottingham, CBD may help balance the neurotransmitter anandamide, which can help alleviate feelings of unease.
- CBD allegedly stimulates the brain and improves cognitive performance. It is believed to respond to numerous receptors throughout the brain and the central nervous system. In a 2015 report presented by Nora D. Volkow, Director, National Institute on Drug Abuse, to the Senate Caucus on International Narcotics Control, cannabidiol was shown to possess therapeutic effects, indicating that it may also provide neuroprotective and anti-inflammatory benefits(6). Volkow says there is also growing evidence that CBD acts on other brain signaling systems, and that these actions may be important contributors to its therapeutic effects.
While the results of the aforementioned studies may seem beneficial for those who are not nursing a baby, at this stage, several studies have shown that the use of cannabis while pregnant or breastfeeding can lead to increased risk of low birth weight, preterm labor, and neurological and behavioral problems.
There has been limited research and not enough information on cannabis, breastfeeding mothers, and their infants. These studies primarily focus on the effects of THC on breast milk and children. However, THC and CBD are two vastly different cannabinoids.
To date, there have not been any conclusive studies about the safety of CBD oil use during breastfeeding, so it is not recommended until further studies are completed.
Wei B, McGuffey JE, Blount BC, Wang L. Sensitive Quantification of Cannabinoids in Milk by Alkaline Saponification-Solid Phase Extraction Combined with Isotope Dilution UPLC-MS/MS. ACS Omega. 2016;1(6):1307-1313. Doi: 10.1021/acsomega.6b00253. Epub 2016 Dec 20. PubMed PMID: 28956022; PubMed Central PMCID: PMC5611668.
Chia-Shan Wu, Christopher P Jew, and Hui-Chen Lu. “Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain.” Future Neurol. 2011 Jul 1; 6(4): 459–480.
Gunn JK, Rosales CB, Center KE, Nuñez A, Gibson SJ, Christ C, Ehiri JE.”Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis.” 2016 Apr 5;6(4):e009986. doi: 10.1136/bmjopen-2015-009986.
“Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk.” Kerri A. Bertrand, MPH, Nathan J. Hanan, PharmD, Gordon Honerkamp-Smith, MS, Brookie M. Best, PharmD, MAS, and Christina D. Chambers, PhD, MPH. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California. 2018 Aug 31. doi: 10.1542/peds.2018-1076.
Wei, 2016, op. Cit.
Nora D. Volkow.”The Biology and Potential Therapeutic Effects of Cannabidiol.”
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