After a mother in Oregon posted a photo of herself smoking marijuana while breastfeeding, the internet went into its own feeding frenzy.
Many people posted comments condemning her behavior.
Although they don’t advocate shaming mothers, most experts do advise against pairing breastfeeding with smoking marijuana.
But they’re hard-pressed to cite actual research, since there isn’t much of it.
The few studies that do exist on the topic date back to the 1980s and 1990s, Dr. Lisa Stellwagen, a professor of pediatrics at the University of California, San Diego, told Healthline.
“The literature is so poor” she said. “Each study was increasingly flawed. It’s a huge problem.”
Even so, Stellwagen and others suggested avoiding marijuana while breastfeeding for a variety of safety reasons.
One important reason she said, is that THC, one of the active compounds in marijuana, could stimulate the baby’s brain during a time of rapid brain growth.
“It works via receptors in the brain that are important for brain development,” she explained. “So we recommend not using marijuana during pregnancy or while breastfeeding.”
Small amounts in breast milk
The dearth of scientific research on women breastfeeding while smoking marijuana comes during changing times.
Recreational marijuana is now legal in seven states, including Oregon and the District of Columbia. Another 19 states have legalized marijuana for medicinal purposes.
But today’s marijuana is different than it was in decades past.
It’s at least three times more powerful than the varieties being grown in 1995. There also are more than 60 extra compounds in marijuana besides THC, said Stellwagen.
With that in mind, in February the American Academy of Pediatrics (AAP) warned parents that marijuana may be harmful to children, despite its therapeutic uses.
Breastfeeding while smoking marijuana will produce small amounts of the drug in breast milk, said Dr. Sheryl Ryan, who chairs the AAP’s Committee on Substance and Prevention.
“But there will be THC in it,” she told Healthline.
The problem is worse during pregnancy, she added.
“There’s emerging data on the effects of prenatal exposure on long-term development,” Ryan said. “The highest exposure is during pregnancy.”
Keep breastfeeding … without drugs
The answer, though, isn’t to stop breastfeeding, experts said.
“We always encourage women to breastfeed. It’s one of the best things you can do to give a child a healthy start,” said Ryan. “But we also encourage mothers to stop using substances.”
There are many reasons to be cautious, she added. There are also many other substances in marijuana smoke, such as pesticides or arsenic.
“Babies are ingesting those,” she said.
Doctors are limited in what can be said about the dangers of smoking marijuana, Ryan noted, since research is scant.
“However, it took us a while to understand the effects of tobacco or alcohol on kids,” she said. “We’re starting to learn the effect that these substances have at the basic brain level.”
There are more recent studies on pregnant mothers who use marijuana, but they mainly involve animals.
Researchers used mice, for example, to show that marijuana appears to effect the retinas of newborn mice when they’re exposed to marijuana.
“But we must be careful not to extrapolate the effect of mice exposed to marijuana on their babies to humans,” she said.
Helpful sites to consult
A lack of research on women who use marijuana while breastfeeding puts both mothers and healthcare providers in a tricky position, said Sarah Heil, an associate professor of psychology at the Vermont Center on Behavior and Health at the University of Vermont.
“Lots of other drugs haven’t been tested during pregnancy either,” she told Healthline.
She advised weighing the pros and cons of breastfeeding while smoking marijuana.
“There’s so much variability in terms of potency or how much marijuana you’re using,” she said.
Stellwagen recommended consulting the National Institutes of Health’s new site, LactMed, which is a database for women who may be breastfeeding that provides information on drugs and other chemicals.
“It’s the gold standard,” she said.
Another useful site is MotherToBaby.org.
“There will be more research in the years ahead,” Stellwagen said.
“There’s a window of time to optimize a baby’s health and well-being,” said Ryan. “Why wouldn’t you want to do anything possible?”