Taking CBD While Breastfeeding Poses Risks—Here's What You Need to Know
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.
Postpartum Anxiety Or Depression
When it comes to not feeling like yourself after giving birth, postpartum depression isn’t the only diagnosis. You could have the baby blues, postpartum anxiety, or postpartum depression. Here’s a quick look at all three terms including a few suggestions on what to do next. This is not intended for self-diagnosis but for a better understanding of your symptoms.
What Is The Difference Between Postpartum Depression And Anxiety?
The Diagnostic and Statistical Manual of Mental Disorders (MMD) only distinguish between postpartum depression and major depressive disorders. However, most mental health professionals agree there are three conditions women could be struggling with post-pregnancy.
Baby Blues—this can last for about 2 weeks and is often caused by the rapid shift in post-pregnancy hormones. Also, the overwhelming experience of giving birth and the life change of having a baby at home.
Postpartum Depression (PPD)—this is an intense feeling of overwhelm that lasts more than 2 weeks. Symptoms include not feeling like yourself, feeling out of control, questioning being a parent, or feeling numb. Even thoughts of self-harm or harming your infant. Symptoms can vary and often last up to a year. Moms can have PPD even if they have never struggled with depression.
Postpartum Anxiety—also referred to as perinatal generalized anxiety disorder, is a loss of normalcy, balance, and calm. It can include overwhelming worry, agitation, and racing thoughts. For example, the “what if” worries of the dangers in the world or anxiety of leaving your baby with someone else. Moms can have postpartum anxiety if they’ve never struggled with anxiety. Symptoms can last a year or more.
Approximately, 15 percent of new moms experience perinatal anxiety, and up to 20 percent experience postpartum depression. Moms can experience both anxiety and depression at the same time.
Is Postpartum Anxiety A Disability?
If not treated, new mom anxiety can worsen, lead to OCD, and even depression. If your symptoms last more than 2 weeks, include thoughts of self-harm or harming your baby, or are extreme it is important to seek out postpartum anxiety help.
For example, although you know your baby is safe with your partner or parents while you go grocery shopping, you are unable to leave your baby.
If you are diagnosed with either PPD or perinatal anxiety, you may be eligible for disability benefits.
Is Postpartum Depression Covered Under FMLA?
You may be able to return to work during your postpartum recovery, but yes, postpartum depression and anxiety are covered under FMLA. This can provide you with up to 12 weeks of unpaid time off. However, this includes your maternity time. Keep in mind that you must work for a company large enough to qualify for FMLA, and you must qualify for FMLA.
General criteria are as follows:
- The company must have 50 employees or more within a 75 mile radius.
- You must be employed for at least 12 months.
- You must have worked at least 1,250 hours over the last 12 months.
- And more
However, many smaller companies that do not meet the FMLA criteria provide some type of unpaid maternity leave. Ask if you are unsure.
What Helps With Anxiety After Having A Baby?
If your symptoms last more than 2 weeks, it’s best to seek out treatment for postpartum anxiety. It’s important to note that anxiety can begin weeks or months before giving birth.
Also, every pregnancy is different. You are 50 percent more likely to have anxiety or depression if you experienced it with a previous pregnancy. So, even if you only had the baby blues during your last pregnancy, you could have anxiety or depression next time. Or only in 1 of 3 pregnancies.
Both obstetricians and pediatricians are capable of assessing the difference between baby blues, anxiety, and depression. However, they don’t provide treatment. So, request a referral or search online for “postpartum anxiety therapist near me”.
Search for a therapist who specializes in postpartum mental health and who is a cultural and ethnic match.
How Long Does Anxiety Last After Having A Baby?
Most new mom’s anxiety will gradually fade over the next 12 months, faster if working with a therapist. If left untreated, it’s possible for anxiety to last longer or transition into an anxiety disorder. Chronic anxiety also increases your risk for depression.
Some women put off seeking out help because their loved ones are dismissive. Statements like “oh it’s just the baby blues” or “every new mom feels that way” can leave you feeling frustrated, misunderstood, and confused. Yes, life will be different with a new baby at home, but if you don’t feel like yourself for more than 2 weeks—seek out help.
How Long Should You Rest After Giving Birth?
Even after a cesarian, you’ll be asked to begin walking after you’ve had a bit of time to rest. However, most physicians suggest that you wait for at least 6 to 8 weeks before returning to strenuous physical activity. In the meantime, you can take strolls with your new baby and perform assigned exercises and stretches. Assigned exercises and stretches are designed to be gentle and restorative. These often include Kegels, abdominal exercises, and pelvic-floor strengthening.
How Long Did It Take For Your Stomach To Go Down After Birth?
Your body has just created the miracle of life and some of your stress may be related to getting your body back. The fact of the matter is, your body may never be the same. That’s ok!
It takes the average woman between 6 to 12 months to lose their baby weight. Oftentimes longer. But, even after your stomach tones up, you may have a stomach pouch. The odds of a pouch are higher if you’ve had more than one baby. If you have diastasis recti the postpartum workout video may help.
Can You Take CBD Postpartum?
Pregnant and breastfeeding moms should not take CBD. Once you have given birth and completed breastfeeding, Holmes Organics CBD may help to soothe your anxiety. In the meantime, your therapist will suggest a personalized mix of activities and exercises.
Here’s How New Mothers are Using CBD to Combat Baby Brain
Stories of absent-mindedness, intense bouts of fear, periods of severe depression, and debilitating anxiety can make anyone fear postpartum life. While some may tease about “ baby brain,” pregnancy and childcare significantly alter a mother’s cognitive ability, which can end with stories that aren’t funny at all. The months following childbirth can make a woman feel like a stranger in her own body, and those feelings of detachment can be exacerbated by certain antidepressants and other pharmaceuticals.
Baby brain, mommy brain, momnesia, whatever colloquial term you want to use, the maternal brain begins to change during pregnancy and lasts through postpartum, which can lead to some dramatic lifestyle shifts.
There was no preparing for the lifestyle shift that came along with my baby, but I couldn’t have gotten through it without CBD and hemp products. During the whirlwind of change, I often didn’t feel like myself, because I would randomly experience a wild mood change or make obvious mistakes. I was lucky in that my mood swings never became dangerous, and I didn’t experience severe bouts of depression, but many women do experience serious postpartum difficulties.
An estimated 85 percent of women experience some type of mood disturbance during the postpartum period. Lack of sleep, chronic pain, hormone imbalances and other physical changes, coupled with the sudden intense responsibility of a new life, can result in significant damage to a woman’s mental health. This can make a new mother feel helpless and detached, especially when there is little in the way of support.
One study showed that women previously undiagnosed with OCD experienced obsessions and compulsions during the postpartum period, which correlated with higher levels of depression and anxiety. Another study showed a significant change in the gray matter of new mother’s brain, which can impact social cognition and last up to two years after childbirth.
To mitigate these feelings of despair and to increase mindfulness, some women are turning to CBD and other cannabis products in the postpartum phase. Maggie May Wilson , a metaphysical healer and reiki practitioner, was prescribed antidepressants after the birth of her first child. She quit them almost immediately because of how they made her feel. Instead she discovered reiki and began incorporating cannabis into her daily lifestyle. Wilson says that by the time she gave birth to her second child, cannabis was a big part in how she approached childbirth and postpartum.
“ Using natural plant medicines guided me to work with a team of midwives and to give birth at home, no epidural this time, no hospital, just pure faith in the universe and myself,” Wilson told Civilized . “ Cannabis helped me during my entire pregnancy and especially in my postpartum period by helping me release patterns of fear that bring on unwanted circumstance.”
During pregnancy, Wilson used both THC and CBD (through vaporization and edibles) to fight nausea and sleeplessness. With the use of THC and CBD edibles through delivery, she was able to relax her muscles and have a quick (under three hours) and happy homebirth. Postpartum, she says using a combination of THC, CBD, and placenta encapsulation (prepared by her midwife), she was able to rebuild her appetite, balance her hormones, and keep her milk supply topped.
“ My midwife came to my home on the fourth day (after delivery) and was so surprised at how good I felt, how much I was able to do, and how happy I was,” said Wilson, who experienced irregular moods and depression during her first postpartum experience. “ I was using CBD and cannabis every day and it was making a huge difference.”
For new mothers, Wilson suggests rubbing CBD topicals onto your temples and forehead if you are experiencing a headache from fatigue or are having trouble staying asleep. Because the mood disturbances and sleep deprivation can cause detachment from your newborn, she suggests using a CBD bath bomb with the baby to connect in a mindful way.
“ Bathing together with your new baby is a ritual bonding exercise that can help you relax and bring your energy stores back up,” she added.
There are a number of online resources, like CannaMommy.org , for mothers who are looking for ways CBD and other cannabis products can improve baby brain. For instance, Tokeativity, an international networking community for women in cannabis, offers online seminars and in-person events to educate mothers who want to use the plant. Another option called Splimm , a digital publication geared toward parents who consume cannabis, provides a wide variety of educational and entertaining content for new or timid cannabis users.
“[Cannabis] can help a new mother manage the waves of emotions that come with a new baby and can assist her with a lack of energy and focus due to negative amounts of sleep,” said Kelly Bruce, co-founder and executive director of CannaMommy. “ It can help manage the ‘ baby blues’ by supporting your endocannabinoid system to stay regulated.”
For me, CBD helped significantly with my chronic pain (from which I suffered before pregnancy, as well), and that, in turn, improved my mood and my focus. Postpartum, CBD topicals and edibles helped with neuropathy, concentration, emotional state, and energy in a safe and reliable way that I never found with pharmaceuticals. Even though I was beyond exhausted, I could feel myself being more present and mindful in those beginning weeks.
Dr. Lakisha Jenkins says that pregnancy does not impact the endocannabinoid system, but that the endocannabinoid system impacts pregnancy. “ Considering the fact that the endogenous cannabinoid system is a regulatory system and it is formed very early in gestational age, pregnant women should take care to ensure there is proper support and supplementation of the system during their entire pregnancy,” she said, adding that because endocannabinoids are found in breast milk, proper supplementation for nursing mothers is also paramount
While it isn’t a miracle cure, and there certainly remains a lot of research to be done, I felt confident in using CBD and hemp products. Cannabis has been used for in obstetrics for centuries : Before prohibition, physicians would prescribe it for PMS, difficult childbirth, menopause, cramps, nausea, and more. Using CBD helped alleviate many of my symptoms and helped me avoid further side effects from pharmaceutical pain and anti-anxiety medicine. Having been prescribed them for years before finding CBD, I was all too aware of the side effects, and knew I couldn’t be a present or mindful mother if I took that path.
Still, mothers need to be cautious in their approach to cannabis treatment, especially when child safety is a factor. Jessie Gill, cannabis nurse and founder of MarijuanaMommy.com , says that it is important to proceed as you would with any medication.
“ I think there are two big contradicting misconceptions about using cannabinoid therapeutics postpartum. Some believe it’s perfectly safe, and others believe it’s extremely dangerous,” Gill said. “ The truth is, like all medications there are an array of risks and benefits.” She points out that cannabis has a slight risk for addiction, a possibility to act as a mild blood thinner (which is especially important for those delivered by cesarean), and may cause adverse reactions to certain medications.
“ Most of all, the biggest risk is the law and the stigma. Just the smell of cannabis can trigger an investigation by child protective services,” gill said. “ The potential risks get more complex when we explore cannabis use by nursing mothers, because we really don’t know how cannabinoids affect a developing baby’s brain.”
Cannabis prohibition keeps many parents from experimenting with it as medication, with stories of Child Protective Services taking away children given CBD by their parents. (By the same token, however, there’s little history of CPS showing up because a parent was heard to have been taking opioid painkillers, or other dangerous pharmaceuticals.)
“ You look at the other medical options to help support new mothers and every single one of them has caused at least one death (most are in the thousands), hundreds of birth injuries, and serious side effects including death,” said Kelly Bruce from CannaMommy.
While memes and movies continue to portray mothers drinking copious amounts of alcohol and abusing pharmaceuticals, cannabis users nonetheless risk legal consequences for sharing stories of self-medicating, even in states where cannabis is legal for adult use.
Postpartum should be a time of happiness, not turmoil, and anything that can safely promote a better quality of life during that crucial stage should be considered seriously.