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can cbd help with morning sickness

Since we really don’t know enough about CBD’s effects on pregnancy and a developing fetus, we have to rely on what we know about THC, since they are both cannabis components. Animal studies show a connection between THC and early miscarriage, but Dr. Mouanness points out that if you get a positive pregnancy test, you haven’t miscarried. As long as you stop using CBD right away, the earlier CBD use won’t cause miscarriage.

The Federal Drug Administration (FDA) says it "strongly advises against" taking CBD while pregnant or breastfeeding. You should avoid CBD during pregnancy, largely because its effects on a developing fetus are simply unknown. We do know that THC can enter a developing baby's brain, so there is reason to believe CBD may be able to as well.

Potential Reproductive Harm

Once you have fully weaned your baby from the breast, it is safe to start using CBD again. At this point, there is no longer any risk to your child. There are pros and cons to taking CBD, but those are up to you to discuss with a doctor once you're no longer sustaining your child with your body.

Every pregnancy is different. Be sure to consult with a healthcare provider about your circumstances if you have any questions about taking CBD while pregnant.

Safety Precautions

There is some evidence that CBD in breastmilk may negatively affect infant motor development. And since it stays in your milk for a while, this isn't something you can "pump and dump." "Some studies have shown that CBD oil derivatives can be found in breastmilk for up to six days after use," Dr. Mouanness points out.

In these 4 severe cases of HG, cannabis preparations containing 20%THC and traces of CBD appeared to have a dramatic effect on the course and severity of the condition. We included all 4 cases collected by us, hence there was no bias in applying statistical analysis, and despite the small numbers, the differences following cannabis were highly significant. The concentrations of the cannabis compounds were measured as part of the quality assurance programs of the official suppliers to the Ministry of Health. The mean PUQE score improved from 14.5 which is in the upper range of severity, to 7.5, corresponding to the middle range of moderate cases. To put these changes into perspective, this is a very large effect size of 7 using Cohen’ d. In studies on NVP, the typical effect of anti emetics such as diclectine has been of medium effect size. Although the cannabis was produced in several different laboratories, the ranges of concentrations of active THC and CBD were similar. Small doses of 2–3 puffs appeared to deliver optimal relief. In British Columbia, of 79 pregnant respondents, 51 (65%) reported using cannabis during their pregnancies. While 59 (77%) of the respondents who had been pregnant had experienced nausea and/or vomiting of pregnancy, 40 (68%) had used cannabis to treat the condition, and of these respondents, 37 (over 92%) rated cannabis as ‘extremely effective’ or ‘effective’ (Westfal et al., 2006). A major issue is the existence of numerous different preparations of cannabis, without appropriate comparator data among them, leaving the women with the need for trial and error. Other important issues that must be adequately addressed are the fetal safety of cannabis (Sharapova et al., 2018) and balancing it with the fetal risks of undertreated HG (El Maroun et al. 2019).

While more research is needed before cannabis can be considered for use in HG, this report suggests that cannabis should be tested in appropriately- powered control trials for this severe and protracted maternal condition, addressing both maternal effect and potential adverse fetal effects.

In our cases, three of the four children had evidence of growth restriction which is a typical outcome of the HG- induced severe calorie and protein restriction, in parallel to missing numerous micronutrients (Koren et al., 2018). All 4 children appeared to have developed normally although no formal testing were performed on them and no control group was available. Concerns about long term child development have been a major reason for the ACOG to warn about cannabis use in pregnancy, (Committee on bostetric practice, ACOG, 2017). Previous studies were all done among recreational users who have numerous confounders for developmental delay. This may not be the case in women using cannabis for HG. In contrast, women with HG may be needing larger doses of cannabis for longer durations than are used by recreational users. To date, after large numbers of follow up studies, there is still controversy whether fetal cannabis exposure is associated with independent developmental delays. Associations between cannabis use and offspring achievements among recreational users has been affected by residual environmental and parental confounders (Sharapova et al., 2018). In a recent review, Metz and Borgelt (2018) documented that there are many legitimate concerns regarding the safety of marijuana in pregnancy, including animal studies and biological plausibility.

She experienced HG starting at 7 weeks of gestation. Her PUQE score was 15. The use of cannabis was associated with major improvement in nausea and vomiting. Her PUQE score improved to 8. For religious reasons she did not used cannabis on Saturdays, resulting in nausea and lack of appetite. She was also treated with 5 amino salycilic acid and citalopram for her colitis and fibromyalgia. Her Quality of Life scale improved from 1 to 6.

Discussion

Presently the safety of marijuana in pregnancy has not been demonstrated and its use is advised against by many professional societies. While it is possible that risks of untreated HG are higher than previously thought (Koren et al., 2018), this issue will have to be addressed by future research and fetal cannabis exposure cannot be assumed to be safe for HG.

We evaluated 4 women with HG counseled by the Motherisk Program, before and following the use of cannabis. Using the validated Pregnancy Unique Quantification of Emesis (PUQE) scoring system and employing the Student’s paired t test, we compared changes in symptoms following initiation of cannabis.

In all 4 cases, the women experienced weight loss prior to using cannabis, which was reversed following cannabis. In 4 cases there was improved appetite. One woman reported hypotension and sedation while on cannabis.

Conclusions

This retrospective study was approved by Shamir Hospital Research ethics board in Israel. All women consented to including their cases in the article, based on anonymous presentation. The study was conducted by the Motherisk Program, an academic counseling and follow- up service for women experiencing NVP and HG. Counseling and follow up telephone interviews are conducted by a trained counselor who has expertise in pharmacy and business administration. The counselor is backed by two pediatric pharmacologists/ reproductive toxicologists and a large team of drug information specialists. The counseling sessions include advice on nutrition, fluid intake, medicinal and non –medicinal therapeutic interventions. In this study, we analyzed cases followed up by us after using cannabis, which was initiated by the women, with support of their physicians (who did not prescribe to cannabis). For each woman we recorded the symptoms of nausea (length and strength) vomiting (numbers) and retching (number) and scored them based on the validated PUQE score (Koren et al. 2002) (Table 1). We scored the PUQE score and its Quality of Life scale reported before cannabis was started, and subsequently after at least 3 days of use. The PUQE score ranges from 3 (no symptoms) to 15 (maximal symptoms). The Quality of life scale is based on a visual analogue scale, ranging from 0(the worst possible) to 10 (best) PUQE Score (from Koren et al., 2002).

A 32 year old physician in her third pregnancy. Her first pregnancy was characterized by HG between weeks 6–20, with no response to Diclectin (doxylamine and pyridoxine) and partial response to intravenous ondansetron. A healthy 3.4 Kg baby boy was born at 40 weeks. Her second pregnancy was also complicated by HG between weeks 6–16, again with no response to Diclectin and partial response to ondansetron. A healthy 3.14 Kg aby girl was born at 40 weeks.