health & science
You’re a mom who breastfeeds. Should you be using Cannabis? The science is divided. There are possible legal ramnifications. But studies showing positive health benefits means that this is one debate far from over.
BY NORTHWEST LEAF SPECIAL CONTRIBUTOR DR. SCOTT D. ROSE
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ccording to The U.S. Preventive Services Task Force, Cannabis is the most commonly used “illicit drug” among pregnant and breastfeeding women. There is much to contemplate for females who can get pregnant, who are pregnant or are breastfeeding their child and also making the decision to use Cannabis. Some research has shown some seemingly positive effects or no effect at all, while other studies focusing mostly on adverse findings have shown negative side effects. Major academies, groups and governmental agencies on pediatric health, disease, and toxicology have issued policy statements against the use of Cannabis during pregnancy and breastfeeding. In states where laws are on the books for medical Cannabis patients, women find themselves
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in the crossfire and may even face criminal penCannabis, are found in the breast milk of womalties for using Cannabis during pregnancy and en who use Cannabis. The metabolites, or the or while breastfeeding. The same policy statebreakdown products of these active compounds ments advocating for breastfeeding infants due can be found in the blood, urine and feces of to breast milk’s superiority the infant after consumpFrom neural development and neuroproover infant formula, specifically tion of the Cannabinoid tection to the development of memory, names Cannabis use as a concontaining milk. This and the development of motor skills, the traindication (read: dealbreakinformation establishes Endocannabinoid system is clearly integral. that when mom uses, baby er) for breastfeeding. Studies on infants fed with uses too. Now the question breast milk are few and far between. The pubis, is this necessarily a bad thing? lished data is old and limited to random breast The Endocannabinoid system is a complex milk screening rather than controlled studies beset of receptors and molecules found within the cause of ethical considerations in administering human body. These receptors are like docking Cannabis to nursing mothers. stations that only recognize the right molecule The screenings show that THC and other Canand when binding occurs then there is physinabinoids, the active plant compounds found in ological activity — an effect. This activity can
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be brought about by the binding of what is naturally made in the body, or through the use of Cannabis. There are two types of Cannabinoid receptors found in different tissues and a handful have been found in the human body. Cannabis contains upwards of 100 Cannabinoid compounds that have been identified and only several that have been studied at all. The Endocannabinoid system is important in all animal physiology from the spark of life through the last breath perhaps. Dr. Ester Fride’s work at the Department of Behavioral Sciences at The Hebrew University of Israel notes that, in animals, the Endocannabinoid system fulfills many important developmental functions. From neural development and neuroprotection to the development of memory, and the development of motor skills, the Endocannabinoid system is clearly integral. It is even responsible for an infant’s suckling instinct. “A role for the Endocannabinoid system in the human infant is likely,” Dr. Fride wrote in a 2004 paper, entitled “The endocannabinoidCB receptor system: Importance for development and in pediatric disease.” Dr. Fride strongly recommends the use of Cannabinoids in pediatric medicine within the context of her work concerning non-organic failure to thrive, a rare condition where infants cannot grow because they cannot ingest food. Dr. Fride’s work has shown that there is a gradual development of the CB1 receptor type in the nervous system of young organisms. CB1 receptors are the binding site for THC, the main psychoactive compound in Cannabis. In other words, infants may naturally respond positively to the medical application of Cannabinoids without undesirable psychoactive effects. Melanie Dreher, RN, PhD has studied the Cannabis users of rural Jamaica for more than 30 years. Dreher and her team set out to identify the neurobehavioral effects of prenatal marijuana exposure on neonates and reported their findings in the Journal of Pediatrics in an article published February 1994. They compared the babies of moms who used Cannabis during pregnancy with those who didn’t. Their study compared the infants using standardized testing at three days old and at one month of age. At the three-day mark there were no significant differences shown between the two groups. At one month, however, the Cannabis exposed babies scored higher in areas of alertness, irritability and self-regulation and were judged to be more subjectively rewarding for caregivers, had better physiological stability and required less examiner facilitation to reach goals. Interestingly, at four weeks old, infants born
to Cannabis-using mothers had better scores on autonomic stability. These are AT ONE MONTH OLD, the Cannabis-exposed the basic functions of the body such as babies scored higher in areas of alertness, irritability blood pressure and breathing rates. These and self-regulation and were judged to be more mothers likely did not cease their use afsubjectively rewarding for caregivers, had better ter pregnancy, but they were likely breastphysiological stability and required less examiner feeding. University of Montreal researcher facilitation to reach goals, according to a 1994 study by Dr. Peter Fried has studied the chilMelanie Dreher, PhD, published in the Journal of Pediatrics. dren of middle-class mothers who Dreher studied Cannabis use in rural Jamaica for over 30 years. used only Cannabis during pregnancy alongside a control group of mothers who used no substances at all. Durat http://tinyurl.com/toxnetlact. For answers ing the first five years, Fried observed little effect. to this and other breastfeeding questions, call Soon, however, he started to notice a trend of the ADHS 24-hour breastfeeding hotline slightly increased intellect in the Cannabis-using at 1-800-833-4642. group. He called this the “earth-mother effect.” When women are confronted with the It seemed moms who used Cannabis spent more complex issue of deciding whether to use Cantime with their kids and read more to them than nabis during their pregnancy or while breastthe non-using control group. Breastfeeding and feeding their child, they should be open and continued Cannabis use again was not taken into honest with their medical team. It is widely account. These findings are positive and are comaccepted in general medicine that breast milk peling enough to warrant further investigation in is far superior to formula. the future. The comparison of breast milk containing Cannabis versus regular formula out of esearch since the early 1960s has focused on a can may be undeniable, but, many policy finding birth defects of prenatal Cannabis statements say formula cannot recreate nature. use. Mainly, they have looked for differences And if breast milk is available? However, there in birth weight, birth length, head circumare still no studies relating to the long-term ference, chest circumference, gestational age, neueffects of Cannabis exposure via breast milk. rological development and physical abnormalities. For ethical reasons, very little research has Most of these studies, including the largest study been done on the effects of Cannabis on a to date which involved more than 12,000 women, breastfeeding baby. Therefore, the longterm have found no differences between babies exposed effects remain widely unknown. Cannabis to Cannabis prenatally and those who were not. In has been used by many cultures worldwide some studies, the babies of Cannabis users appear for thousands of years rather safely, but is that healthier and hardier. In others, researchers have enough when it comes to a child? found adverse outcomes in the babies of Cannabis As Cannabis is the most widely used subusers. All of the research conducted has looked at stance during pregnancy and breastfeeding, smoked Cannabis, exclusively. moms must educate themselves of the legal The American Academy of Pediatrics and the implications and of the effects to their unborn Centers for Disease Control and Prevention advise or nursing child. A lot to contemplate, indeed. nursing moms to abstain from Cannabis use in any form while breastfeeding. They tell mothers that formula must be introduced to baby instead of the “tainted” breast milk as soon as possible. These recommendations have been wholly based on research For more information focusing on birth defects, but not how Cannabis about the effects of Cannabis and other medicamay actually prove beneficial to the health and tions, go to the National Libraries of Medicineʼs well-being of the baby. LactMed database at www.tinyurl.com/toxnetlact. The Academy of Breastfeeding Medicine has a For answers to this and other breastfeeding protocol that moms can use to make breastfeeding questions, call the ADHS 24-hour breastfeeding decisions. For more information about the effects hotline at 1-800-833-4642. of Cannabis and other medications, go to the National Libraries of Medicine’s LactMed database
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ABOUT THE AUTHOR Dr. Scott D. Rose is a Naturopathic Physician Acupuncturist specializing in pain management with a private practice in Kirkland.
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