Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Oct;90(4):861-868.
doi: 10.1038/s41390-020-01332-2. Epub 2021 Jan 19.

Cannabis use and measurement of cannabinoids in plasma and breast milk of breastfeeding mothers

Michael J Moss  1   2 , Ittai Bushlin  3 , Steven Kazmierczak  4 , Dennis Koop  5 , Robert G Hendrickson  6 , Katharine E Zuckerman  7 , Tamara M Grigsby  7
Affiliations
Observational Study

Cannabis use and measurement of cannabinoids in plasma and breast milk of breastfeeding mothers

Michael J Moss et al. Pediatr Res. 2021 Oct.

Abstract

Background: Information on cannabinoids in breast milk and maternal cannabis use is limited. We quantified cannabinoids in plasma and breast milk of breastfeeding mothers and assessed cannabis use patterns.

Methods: This is a prospective study at a university hospital in a state with legal medical and recreational cannabis. Breast milk and plasma samples along with survey data were collected from volunteers using cannabis in the last 48 h at 2 weeks and 2 months postpartum.

Results: Twenty subjects were enrolled. Median age (IQR) was 27 (24-34) years. Median (IQR) instances of cannabis use in the last 7 days were visit 1: 17 (6-29) and visit 2: 23 (15-45). Median (IQR) tetrahydrocannabinol (THC) concentrations were: plasma 3.7 ng/ml (0.8-56.8) and breast milk 27.5 ng/ml (0.8-190.5). Median (IQR) cannabidiol (CBD) concentrations were: plasma 0.6 ng/ml (0.5-6.4) and breast milk 1.2 ng/ml (0.5-17.0). Median (IQR) THC M/P: 7.0 (1.8-34.6) and CBD M/P: 2.6. Median breast milk THC concentration increased from visit 1 to visit 2 by 30.2 ng/ml (95% CI 3.05-69.3 ng/ml).

Conclusions: THC and CBD accumulate in breast milk. Breastfeeding mothers used cannabis frequently and increased use in the early postpartum period. Research on the effects of infant exposure to cannabinoids in breast milk is urgently needed.

Impact: Cannabis use is increasing in the general population and many nursing mothers use cannabis. THC has been previously detected in breast milk but little is known on how it concentrates relative to plasma. Data on cannabinoids other than THC, reasons for cannabis use, and patterns of use in breastfeeding women are also limited. We detected THC and CBD in breast milk. Both concentrate in breast milk relative to plasma. We showed that breastfeeding mothers increased cannabis use in the weeks after childbirth. Further research is needed to evaluate infant exposure to cannabinoids via breast milk and effects on infant health.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization. The optimal duration of exclusive breastfeeding: report of the expert consultation https://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_01.09/en/ (2001).
    1. American Academy of Pediatrics. Breastfeeding and the use of human milk. Pediatrics 129, e827–e841 (2012).
    1. Metz, T. D. & Stickrath, E. H. Marijuana use in pregnancy and lactation: a review of the evidence. Am. J. Obstet. Gynecol. 213, 761–778 (2015). - DOI
    1. Young-Wolff, K. C. et al. Self-reported daily, weekly, and monthly cannabis use among women before and during pregnancy. JAMA Netw. Open 2, e196471 (2019). - DOI
    1. Centers for Disease Control. Is it safe for mothers who use marijuana to breastfeed? https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/va... (2020).

Publication types