Cannabis use during breastfeeding raises questions about its presence in breast milk and transfer to infants. Understanding how cannabis compounds move from a mother’s system into her milk and how long they remain in a baby’s body is important for informed decision-making. This article explores the physiological processes of cannabis transfer and its potential implications for infants.
How Cannabis Enters Breast Milk
Cannabis contains delta-9-tetrahydrocannabinol (THC), its primary psychoactive component. THC is highly fat-soluble (lipophilic), allowing it to readily transfer from the mother’s bloodstream into breast milk. Breast milk’s relatively high fat content (3% to 5%) further facilitates THC accumulation.
The concentration of THC in breast milk varies based on the mother’s dosage, frequency of use, and individual metabolism. THC is stored in the body’s fat tissues and slowly released over days to weeks. Studies show THC concentrations in breast milk can be significantly higher than in maternal blood, with one report indicating an eight-fold increase in milk compared to plasma in chronic users. The estimated half-life of THC in breast milk averages around 27 hours, though this can range from 12 to 39 hours.
How Long THC Stays in a Baby’s System
Infants metabolize THC differently than adults due to their developing liver function. This slower process means THC and its metabolites can remain in a baby’s system for an extended period after breast milk exposure. THC metabolites have been detected in infant feces, indicating absorption.
THC can be detected in an infant’s urine for approximately two to three weeks following exposure. While meconium testing identifies prenatal drug exposure, it primarily reflects exposure before birth, not solely through breast milk. The duration of detection in infants varies considerably depending on the mother’s cannabis consumption pattern (occasional or heavy use), the infant’s age, and individual metabolic rates.
Effects of Cannabis Exposure on Infants
Research on cannabis exposure through breast milk is complex due to challenges in conducting definitive studies. It is difficult to isolate direct effects from other factors like prenatal exposure, other substance use, or environmental influences. The increased potency of cannabis also makes older research less applicable.
Adverse effects have been identified, including concerns for infant neurodevelopment, such as potential associations with hyperactivity and poor cognitive function. Some studies suggest a decrease in motor development at one year, particularly if exposure occurred during the first month of life. Infants exposed to cannabis through breast milk have shown signs of sedation, lethargy, less frequent feeding, shorter feeding times, poor sucking ability, reduced muscular tone, and growth delay.
Recommendations for Breastfeeding Parents
Major health organizations advise against cannabis use during breastfeeding due to potential infant risks. The American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention (CDC), and American College of Obstetricians and Gynecologists (ACOG) all recommend breastfeeding parents avoid cannabis and cannabis-containing products.
The “pump and dump” practice is not effective for eliminating THC from breast milk. Because THC is stored in body fat and slowly released, discarding milk after use does not ensure subsequent milk is free of the compound.
Parents who use cannabis while breastfeeding should discuss their use with a healthcare provider to explore alternative strategies for managing stress, pain, or sleep issues. Awareness of local laws and potential child welfare implications is also important, as cannabis can impair a caregiver’s judgment and ability to provide safe care.