A pediatrician trained in Western and Ayurvedic medicine along with a celebrity doula advise against use of CBD while breastfeeding. Learn why inside. FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.
Taking CBD While Breastfeeding Poses Risks—Here’s What You Need to Know
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In This Article
Cannabidiol, or CBD, is everywhere, from topical salves to tinctures. The so-called organic Xanax is being touted by wellness enthusiasts as a panacea to pain, anxiety, depression, and insomnia. Nature’s supposed cure-all might seem like a miracle treatment to sleep-deprived, delirious new mothers, especially those who are breastfeeding and feeling energetically depleted. But despite the widespread availability of CBD, as of 2021, the Food and Drug Administration (FDA) has only approved one CBD drug, leaving many questions around its safety for breastfeeding mothers unanswered. What may seem like natural stress relief to help navigate the many mental and physical challenges of motherhood, especially in trying times, might end up exposing your child to risks that research has yet to uncover.
Nursing offers an unparalleled host of benefits to both mother and child. According to a comprehensive 2013 review, the nutritional, immunological, and anti-inflammatory properties of breastmilk provide health advantages to a nursing baby, including reduced risks of asthma, obesity, type 2 diabetes, ear and respiratory infections, and sudden infant death syndrome (SIDS). Nursing mothers experience a lowered risk of disease, including hypertension, type 2 diabetes, and ovarian and breast cancer, according to a Centers for Disease Control and Prevention (CDC). But that’s not all. Breastfeeding is credited with positive psychosocial outcomes, most noticeably through the bond that develops between mother and child. As such, leading organizations from the American Academy of Pediatrics to the American College of Obstetricians and Gynecologists endorse breastfeeding for at least 12 months of a child’s life. Such consensus around the benefits of breastfeeding have resulted in an uptick in mothers who nurse, with the CDC reporting 58.3% of infants breastfeeding at 6 months in 2017.
Increased duration of breastfeeding does, however, extend the postpartum period, which, as you probably know, may result in fatigue, interrupted sleep, and the emotional pressure that can accompany feeding a little one 24/7. As wonderful as breastfeeding may be, it can also be overwhelming, leaving nursing mothers exhausted and in need of relief; after all, being a source of unconditional comfort is draining. Widely available CBD might seem like a godsend, offering an instant feeling of calm without a hangover or any of the psychoactive effects of marijuana. But here’s the rub: Even though CBD is natural, we don’t yet know how CBD affects a developing baby and child, and what the longterm effects might be to a baby who has been exposed to CBD through breastmilk.
Ahead, our experts help us sift through what we do know about using CBD when breastfeeding, so nursing mothers can make informed choices.
Meet the Expert
- Natalie Geary, MD, is a pediatric and family doctor based in Miami and New York and the founder and Medical Director of vedaHEALTH and vedaPURE. A Harvard trained physician, Geary integrates Ayurvedic and allopathic medicine in her practice.
- A celebrity wellness maven and birth doula, Latham Thomas is the founder of Mama Glow, a global maternal health and doula education company, instructing doula-trainees from around the world. Thomas is a graduate of Columbia University and Institute for Integrative Nutrition, and author of two best-selling books, Own Your Glow: A Soulful Guide to Luminous Living and Crowning The Queen Within and Mama Glow: A Hip Guide to Your Fabulous Abundant Pregnancy.
What the Data Says About CBD and Breastfeeding
There is a lack of published research on the safety of using CBD while breastfeeding. Most of the data surrounds maternal use of tetrahydrocannabinol (THC), derived from marijuana. However, CBD and THC are both classified as cannabinoids, which the data suggests enters breastmilk after maternal consumption:
A 2018 study surrounding THC and breastfeeding, published in the Journal of the American Academy of Pediatrics, indicates that THC is measurable in breastmilk for up to six days after maternal marijuana use. Cannabinoids love to adhere to fat, and breastmilk is viscous as it contains long chain polyunsaturated fatty acids.
This means you can’t pump and feel confident the CBD is out of your system, like you might after say, drinking a glass of wine. “CBD takes longer to metabolize and process through the body than alcohol,” says Thomas. “We know that cannabinoids stick to the fatty parts of breast milk and hang out longer.“
Geary adds, “Every mother’s metabolism is different; the absorption into the blood stream is different, and the actual dosage of the CBD listed is not considered accurate or reliable.” She also brings up a point about the lack of regulation surrounding CBD products. In March of 2020, the FDA issued a statement promising to advance regulatory practices of CBD, admitting wide gaps in data and a lack of market transparency. The same report notes, “we are also not at a point where we can conclude that unapproved CBD products are safe for use.” Thomas adds that for reliable data, we’ll need to evaluate a couple thousand people over at least 15 years. Current data doesn’t meet either of those criteria.
Topical vs. Ingestible Use of CBD When Breastfeeding
When it comes to topical versus ingestible use of CBD, again, there’s a dearth of data on the longterm effects. However, Thomas says that topical CBD products are a bit safer because CBD isn’t entering your bloodstream in the same way. “Postpartum women might apply a CBD salve to a scar, achy muscles, or to ease sore nipples,” explains Thomas, adding that you should make sure to clean nipples before your baby latches.
Thomas warns to be skeptical of CBD products that are inexpensive. Seek out reputable brands that use conscious farming practices. “None of this stuff is cheap,” she says. “This is an expensive process.”
She says it’s crucial, however, that you bring the product you intend on using to your health care provider and discuss its use before trying it out. She also says it’s important to realize if you choose to use CBD topically when breastfeeding, it’s still considered experimental. “Never feel forced to use something just because you bought it,” she adds.
Risks of Using CBD When Breastfeeding
One reason you might think CBD is safe for nursing mothers is the fact that mother’s milk naturally contains cannabinoids, similar to CBD. These cannabinoids may help stimulate a newborn’s appetite. In fact, they work on the same receptors that are activated when people get the munchies from consuming THC. However, don’t assume a case of “the more the merrier,” says Thomas. Geary, too, warns there’s a big difference between what the body produces naturally and the “artificially imported chemicals” in commercial CBD. She adds, “Women have been breastfeeding forever. Mother’s milk contains no impurities, no chemicals or pesticides, and no chance of an overdose.”
CBD remains out of the purview of the FDA, leaving each company or brand in control of monitoring the product’s safety. “Some companies are able to afford testing and studies,” says Thomas. “Others aren’t.”
Geary adds, “A very real problem is that the products are unregulated and may be contaminated with harmful chemicals—such as pesticides, bacteria, fungus, and heavy metals—which can harm the fetus or baby.”
Geary (who notes that as a pediatrician with a license to provide medical marijuana —CBD and THC products—she’s not an anti-marijuana doctor), says using CBD when breastfeeding just isn’t a safe gamble. “During the time of the developing fetus, through until age three years of life, the infant’s brain reaches 80% of its full adult volume. Any unnecessary exposure, especially in those vulnerable first three years, is worth considering very seriously.”
Until we have more evidence, Geary says women who are expecting or breastfeeding should definitely err on the side of caution and avoid cannabis in all forms.
Try to use nursing sessions as a time to pause and reset, letting the oxytocin that’s released during breastfeeding help you enter a state of calm. Play soothing music or a guided meditation, practice deep breathing, and remember that this stage of life is temporary.
Thomas adds that although CBD can seem like a “pathway to self-care,” it’s only one of many wellness tools. She urges women to get to the “root of the stress or anxiety on the road to recovery.” Asking for help is critical. “When we think of stress and how to mitigate it because life is too much, that becomes a pathway for pain and trauma to embed,” she says. But it’s also an opportunity to do the work necessary to heal. “Reaching for a cure-all,” she says, “helps us turn away from a life we’ve created when we need to be so committed to it right now.”
If you or someone you know is struggling with postpartum depression, please see a physician or contact Postpartum Support International, a free helpline.
Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.
Dieterich CM, Felice JP, O’Sullivan E, Rasmussen KM. Breastfeeding and Health Outcomes for the Mother-infant Dyad. Pediatr Clin North Am. 2013;60(1):31-48. doi:10.1016/j.pcl.2012.09.010
Centers for Disease Control and Prevention. Breastfeeding Benefits Both Baby and Mom. Updated July 27, 2021.
Bertrand KA, Hanan NJ, Honerkamp-Smith G, Best BM, Chambers CD. Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk. Pediatrics. 2018;142(3):e20181076. doi:10.1542/peds.2018-1076
Uvnäs Moberg K, Ekström-Bergström A, Buckley S, et al. Maternal Plasma Levels of Oxytocin During Breastfeeding – A Systematic Review. PLoS One. 2020;15(8):e0235806. doi:10.1371/journal.pone.0235806
What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding
FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.
Cannabis and Cannabis-derived products have become increasingly available in recent years, with new and different types of products appearing all the time. These products raise questions and concerns for many consumers. And if you are pregnant or breastfeeding, you might have even more questions about whether these products are safe for you.
FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.
What are cannabis, marijuana, hemp, THC and CBD?
Cannabis is a plant of the Cannabaceae family and contains more than eighty biologically active chemical compounds. The most commonly known compounds are THC and CBD. One type of cannabis plant is marijuana, which contains varying levels of THC, the compound that produces the “high” that is often associated with marijuana. Another type of cannabis plant is hemp. Hemp plants contain extremely low amounts of THC. CBD, which does not produce a “high,” can be derived from either marijuana or hemp.
We are now seeing CBD-containing products everywhere. CBD can be found in many different products, like drugs, foods, products marketed as dietary supplements, and cosmetics. These products often make questionable health promises about CBD.
FDA wants you to know there may be serious risks to using cannabis products, including those containing CBD, if you are pregnant or breastfeeding.
What do we know about the effects of marijuana use during pregnancy and while breastfeeding?
There are many potential negative health effects from using marijuana and other products containing THC during pregnancy and while breastfeeding. In fact, the U.S. Surgeon General recently advised consumers that marijuana use during pregnancy may affect fetal brain development, because THC can enter the fetal brain from the mother’s bloodstream. The Surgeon General also advised that marijuana may increase the risk of a newborn with low birth weight. Research also suggests increased risk for premature birth and potentially stillbirth 1 .
While breastfeeding, it is important to know that breastmilk can contain THC for up to six days after use. This THC may affect a newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences.
Additionally, marijuana smoke contains many of the same harmful components as tobacco smoke. Neither marijuana nor tobacco products should be smoked around a baby or children.
What do we know about the effects of CBD use during pregnancy and while breastfeeding?
There is no comprehensive research studying the effects of CBD on the developing fetus, pregnant mother, or breastfed baby. FDA is continuing to collect and study the data on the possible harmful effects of CBD during pregnancy and while breastfeeding. However, based on what we do know, there is significant cause for concern.
High doses of CBD in pregnant test animals have caused problems with the reproductive system of developing male fetuses 2 . In addition, based on what we already know about CBD, we expect that some amount of CBD will be transferred to babies through breast milk.
We also know that there is a potential for CBD products to be contaminated with substances that may pose a risk to the fetus or breastfed baby, including THC. We have also heard reports of CBD potentially containing other contaminants (e.g., pesticides, heavy metals, bacteria, and fungus); we are investigating this.
Moreover, CBD has known risks for people in general. Based on clinical studies in humans, risks can include the following:
- liver toxicity (damage)
- extreme sleepiness
- harmful interactions with other drugs
FDA is studying the effects of CBD use from different angles, such as: (1) the use of CBD-containing products, like food, cosmetics, or supplements, over a person’s entire life; and (2) the effects of using these various products in combination. There are many unanswered questions about the science, safety, and quality of products containing CBD.
We especially want to learn more about the effects of CBD during pregnancy and while breastfeeding, including, for example, whether and to what extent the presence of CBD in human milk harms the breastfed baby or the mother’s milk production.
Has FDA approved any CBD products and are there any benefits?
FDA has not approved any CBD products except for one prescription drug to treat rare, severe forms of seizure disorders in children. It is still unclear whether CBD has any other benefits.
Other than the one approved prescription drug, CBD products have not been evaluated or approved by FDA for use as drug products. This means that we do not know:
- if they are safe and effective to treat a particular disease
- what, if any, dosage may be considered safe
- how they could interact with other drugs or foods
- whether they have dangerous side effects or other safety concerns
The clinical studies that supported the approval of the one available CBD drug product identified risks related to the use of CBD, including liver toxicity (damage), extreme sleepiness, and harmful interactions with other drugs.
What about hemp seeds?
FDA recently completed an evaluation of some hemp seed-derived food ingredients and had no objections to the use of these ingredients in foods. THC and CBD are found mainly in hemp flowers, leaves, and stems, not in hemp seeds. Hemp seeds can pick up miniscule amounts of THC and CBD from contact with other plant parts, but these amounts are low enough to not raise concerns for any group, including pregnant or breastfeeding mothers.
What should you remember about using cannabis or cannabis-derived products?
If you are considering using cannabis, or any products containing THC or CBD, you should be aware of the following:
- FDA strongly advises that during pregnancy and while breastfeeding, you avoid using CBD, THC, or marijuana in any form.
- Although many of these products are being sold, FDA has not approved these products, other than one prescription CBD drug product and two prescription drug products containing dronabinol, a synthetic version of THC (which are approved to treat certain side effects of HIV-AIDS or chemotherapy). All three of these prescription products have associated risks and side effects.
- Always talk with your doctor, nurse, or pharmacist before taking any medicines, vitamins, or herbs while pregnant or breastfeeding.
Do not put yourself or your baby at risk by using cannabis products while pregnant or breastfeeding. Check out these links to learn more about cannabis, marijuana, CBD, and THC, and about taking medicines while you are pregnant.