"Having a new baby is stressful, and some may wish to turn to cannabis products," Dr. Gersh notes. But the limited data on its safety—and the fact that it will pass into breast milk—makes it difficult for many experts to advise its use for nursing parents. "Unfortunately, there is no safety data to allow a doctor to recommend the use of cannabis or CBD," says Dr. Gersh.
Granted, this research was done on marijuana and THC, not hemp and CBD. But experts are concerned about the effect of any cannabinoid on an infant's brain development.
Ultimately, because CBD "has been shown to be little risk to both adults and children" and therefore, "may not pose a problem," it is important to weigh the risk versus benefits for the breastfeeding parent and the infant, says Hilary Peckham, the co-founder of Etain Health, the only all-women, family owned medical marijuana dispensary company in New York.
Is CBD Safe While Breastfeeding?
Pregnancy is one thing, but postpartum life often comes with a variety of mental and physical challenges. As many as one in five women suffer from postpartum depression, according to the Centers for Disease Control and Prevention (CDC). Other concerns include anxiety, chronic pain, and insomnia, all compounded by the lack of sleep and hormonal shifts that naturally occur after giving birth. It's no wonder more new parents are gravitating to CBD, or cannabidiol, a component of either a marijuana or hemp plant that is non-psychoactive (unlike THC, or tetrahydrocannabinol, which only comes from marijuana).
Mary Clifton, M.D., an internal medicine doctor in New York City agrees, stating, "If a new parent is breastfeeding, it's probably not wise to use CBD. The medical community doesn't support the use of CBD in these settings, because proper studies can't be completed on the effect on the baby or infant."
What the Science Says About Using CBD While Breastfeeding
"We do not have enough research to make claims one way or another on how that breast milk would affect the milk-fed babies," says Dr. Flannery. "Cannabis is a medicine that has been used specifically for pregnant and breastfeeding parents for millennia. I will never make a claim without the science to back it up, but we should understand that anecdotal evidence can be used to formulate testable hypotheses to validate the use of cannabis at this time in a one's life."
Despite the lack of published research, new parents have used cannabinoids for thousands of years, notes Robert Flannery, Ph.D, owner of Dr. Robb Farms. "Yes, THC and CBD are expressed in small quantities in breast milk," Dr. Flannery says. And while he doesn't feel comfortable suggesting CBD for a new parent who is breastfeeding, he acknowledges the use of cannabis in the past.
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."
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."
Risks of Using CBD When Breastfeeding
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."
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."
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.
Topical vs. Ingestible Use of 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."
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.