marijuana use during pregnancy and lactation.. How does marijuana affect brain development?

Marijuana drug use during pregnancy and lactation:

If you're pregnant, you may have read that marijuana can help with nausea. After the baby is born, you may even think about using marijuana to relieve stress.

Should you still breastfeed if you smoke marijuana? These are all tricky questions, especially as more and more states legalize marijuana for adult use or medical use. 

The American Academy of Pediatrics (AAP) recommends that women who are pregnant or breastfeeding avoid using marijuana.

Also, the American College of Obstetricians and Gynecologists (ACOG) recommends that obstetricians and gynecologists advise women not to use marijuana while trying to get pregnant, during pregnancy, and while breastfeeding.

No amount of marijuana has been shown to be safe for use during pregnancy or lactation. 

How does marijuana affect brain development?

Studies show that marijuana use during pregnancy and lactation may have negative effects on the developing brain.

Tetrahydrocannabinol (THC), the compound in marijuana that is primarily responsible for its psychoactive effects, has been shown to cross the placenta and enter the brain of the developing fetus during pregnancy.

Once it enters a baby's system, it can affect the normal growth of nerve cells that occurs in the developing brain. In some studies, for example, prenatal marijuana exposure has been linked to increased tremors and the startle reflex in newborns and possibly an increased risk of substance use disorders and mental illnessbetween adolescents and adults.

In other studies, marijuana use during pregnancy was associated with problems with problem-solving ability, memory, visual perception, behavior, attention, executive function, and impulse control in children, in especially as they become adolescents and young adults.

Is marijuana today stronger than that of years ago?

The concentration of THC in marijuana has quadrupled since the 1980s, when studies were conducted linking marijuana use during pregnancy to infant growth and behavioral differences.

Whether marijuana is smoked, vaped via e-cigarettes, or consumed in edible or drinkable form, the amount of THC reaching a fetus and newborn can be much higher than ever before.

If I smoke marijuana, can it pass into my breast milk?

Yes. You can pass the chemicals in marijuana to your baby through your breast milk. A study published in the journal Pediatrics in September 2018 confirms previous results that THC can pass through breast milk.

The AAP also reminds that a mother's ability to care for a baby may be impaired if she uses marijuana. Bottom line: If you're breastfeeding, don't use marijuana.

Is marijuana safer than tobacco?

No. Studies show that between 48% and 60% of users continue to use throughout their pregnancy, thinking it is safer than tobacco .

However, research also shows that when marijuana is smoked, carbon monoxide concentrations in the blood of pregnant women are 5 times higher than when tobacco is smoked. This may mean that the fetus has less oxygen available.

What should I know about secondhand marijuana smoke?

Secondhand or passive smoke can be as much of a concern with marijuana as it is with tobacco. Studies show that people can be exposed to marijuana by inhaling it when it is smoked near them.

It can cause a urine test to come back positive for THC, meaning THC was in the blood. This means that if a pregnant or breastfeeding woman is exposed to marijuana smoke, THC can enter the mother's blood and from there pass to the fetus or breast milk.

Does morning sickness justify the use of medical marijuana?

No. Nausea from chemotherapy qualifies for medical marijuana use in most states where it is legal. Although many women experience nausea during pregnancy, the use of medical marijuana in this specific situation has never been studied or rated as safe.

Are pediatricians required to report mothers who use marijuana while pregnant or breastfeeding to child protective services?

Yes. The Child Abuse Prevention and Treatment Act (CAPTA) requires all states to have reporting policies and procedures for newborns and other children exposed to illegal substances.

Because marijuana remains illegal under federal law, CAPTA applies to marijuana exposure in all states regardless of the legality of adult marijuana use in each state. Each individual state may have its own policies on reporting marijuana exposure during pregnancy and lactation.

Remember: If you are pregnant or breastfeeding, the safest option for your child is to avoid marijuana.

Your pediatrician is a good source of information about the possible risks of marijuana use on the developing fetus, infants, and children. Conversations may occur during talk about alcohol use , other drug use, or contraception. 

Just because marijuana is legal for medical or recreational use in some places for people over the age of 21 doesn't mean it's safe, especially for children exposed to the substance while pregnant or nursing. There's a lot we don't know about the ways it might affect children.