CBD and Breastfeeding: Is It Safe?

Curiosity around the therapeutic uses for CBD has reached a fever pitch, but is it safe when you're nursing? Here's what experts say.

Key takeaways.

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Pregnancy is not easy, but neither is being a new parent; after giving birth, you're immediately met with a host of new physical and mental challenges. According to a Statistics Canada survey on postpartum depression in Canada, 23% of new mothers—that's nearly 1 in 4 mothers!—will experience postpartum depression or an anxiety disorder in the months following birth. Younger mothers, ages 25 and below, are more likely to develop postpartum depression or anxiety than older mothers. Other concerns include chronic pain and insomnia, all worsened by the lack of sleep and hormonal shifts that happen naturally after delivery. It's no wonder more new parents are gravitating to CBD, or cannabidiol, a non-psychoactive component of either a cannabis or hemp plant (unlike THC, or tetrahydrocannabinol, which only comes from cannabis).

Aptly dubbed nature's Xanax, CBD has demonstrated real clinical applications for pain, anxiety, depression, and insomnia. It follows that nature's medicine molecule seems like an attractive option for sleepless, delirious new mothers, especially those who are breastfeeding and feeling energetically depleted. It may be tempting to turn to CBD; after all, it's not intoxicating, so it probably safe, right?

Health Canada states that "it is not known whether cannabidiol (CBD), another substance in cannabis, passes into the breastmilk of women using cannabis or CBD-containing products. However like THC, CBD is likely to accumulate in fatty tissues, such as breast tissue." The Canadian Center on Substance Use and Addiction states that "the effects of cannabidiol (CBD) use during pregnancy or breastfeeding are unknown. Both clinical and preclinical studies are urgently needed to evaluate the safety of CBD use during pregnancy."

Here's what we do know:

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 also experience benefits, such as a lowered risk of disease, including hypertension, type 2 diabetes, and ovarian and breast cancer, according to the 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 has 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 cannabis. 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 long-term effects might be to a baby exposed to CBD through breastmilk.

Ahead, Will, My Supply Co.'s Co-Founder and Head of Product Education, helps us sift through what we do know about using CBD when breastfeeding, so nursing mothers can make informed choices. Here's what nursing parents need to know about CBD.

Can You Take CBD While Breastfeeding? Studies You Should Know About by @MySupplyCo

The science of CBD and breastfeeding.

There is a lack of published research on the safety of using CBD while breastfeeding. Instead, most of the data focuses on the maternal use of tetrahydrocannabinol (THC), the primary psychoactive compound found in cannabis. The conclusion is that it is possible to pass low levels of the psychoactive ingredient to your baby while nursing. Since THC enters breast milk after maternal consumption, and both CBD and THC are fatty-loving cannabinoids, there's a chance CBD could also enter breast milk.

A study published in the journal Obstetrics and Gynecology looked at samples of breast milk from eight anonymous test subjects who regularly used cannabis and found that babies who were three to five months old and who were breastfed exclusively ingested an estimated 2.5% of the mom's dose of THC. Researchers didn't, however, take blood samples from the infants to see if they had measurable levels of THC in their bodies.

A 2018 study surrounding THC and breastfeeding, published in the Journal of the American Academy of Pediatrics, suggests that THC is measurable in breast milk for up to six days after smoking cannabis or eating an edible. Cannabinoids love to adhere to fat, and breast milk is viscous as it contains long-chain polyunsaturated fatty acids.

And trying to "pump and dump" as you might after, say, a glass of wine doesn't work for cannabis products, as cannabinoids that entered the body days or weeks before breastfeeding can make their way into breast milk, according to Medical News Today. "CBD takes longer to metabolize and process through the body than alcohol," says Will. "We know that cannabinoids stick to the fatty parts of breast milk and hang out there for longer."

Will adds, "Every mother's metabolism is different; the absorption into the bloodstream is different, and the actual dosage of the CBD listed is not considered accurate or reliable." He also brings up a point about the lack of regulation surrounding CBD oils and products. Our CBD products are all third party lab tested to ensure quality, safety, and potency.

Granted, all of this research was done on cannabis and THC, not hemp and CBD. But some experts are concerned about the effect of any cannabinoid on an infant's brain development. We truly do not know what impact it will have, even if all signs seem to indicate a high safety profile.

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.

Is it safe to use CBD while breastfeeding?

Having a new baby is stressful, and some may wish to turn to cannabis products. But the limited data on its safety—and the fact that it will pass into breast milk—makes it difficult for some to advise its use for nursing parents. Unfortunately, there is no clinical safety data to allow a doctor to recommend the use of cannabis or CBD while breastfeeding.

Despite the lack of published research, new parents have used cannabinoids for thousands of years. Yes, THC and CBD are expressed in small quantities in breast milk, and while we don't feel completely comfortable suggesting CBD for a new parent who is breastfeeding, we acknowledge the use of cannabis in the past.

We do not have enough research to make claims one way or another on how that breast milk would affect the milk-fed babies. 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 during the post-artum period of one's life.

Read: CBD (Cannabidiol): Side Effects and Possible Interactions

Topical vs. Ingestible CBD when breastfeeding.

When it comes to topical versus ingestible use of CBD, again, there's a dearth of data on the long-term effects. However, 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—just make sure to clean nipples before your baby latches.

It's crucial, however, that you bring the CBD topical to your healthcare provider and discuss its use before trying it out.

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.

Risks of using CBD while breastfeeding.

One reason that CBD might be safe for nursing mothers is the fact that mother's milk naturally contains cannabinoids, called endocannabinoids, similar to CBD. These endocannabinoids are produced by the mother's body and 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.

But don't assume a case of "the more the merrier." There's a big difference between what the body produces naturally and CBD. Women have been breastfeeding forever. Mother's milk contains no impurities, no chemicals or pesticides, and no chance of an overdose. CBD is an added element, so it's unknown what type of effects this cannabinoid may have on the child's endocannabinoid system, which has been called the "gateway of all neural development."

Benefits of using CBD while breastfeeding.

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.

For instance, many new parents suffer from postpartum depression, anxiety, fatigue, mood swings, and detachment from the infant. Many sufferers start a treatment of antidepressants which may not be appropriate for breastfeeding and may need to be discontinued. Starting CBD may still allow the parent to breastfeed and prolong the bonding time with the infant. That said, you should speak to your doctor before starting CBD, especially if you are breastfeeding.

The bottom line.

The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) recommend physicians counsel parents to abstain from all cannabis products—including CBD—if they wish to breastfeed. However, given the minimal amount of the substance that makes its way into breast milk, the fact that humans have been using cannabis for pregnancy and nursing for thousands of years, and the fact that research has yet to confirm the exact effects on an infant, anyone interested in trying CBD while breastfeeding would do well to speak to their doctor.

Read: CBD And Cannabis For Endometriosis

Read: Treating PCOS With Cannabis: Does It Work?

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