Before she got pregnant, cannabis advocate and Founder of cannabis-based wellness brand OM, Maya Elisabeth, wanted to do her research. As states reform their marijuana laws, self-reported and collected data indicate that more and more pregnant women are using cannabis, (it is the most used illicit substance by pregnant patients). Many licensed dispensaries are prepared to make recommendations to pregnant people. She was a regular and heavy weed user, and her brand, founded in 2008, emphasized cannabis use for womb health and mitigating symptoms associated with menstruation; what implications could that have for her baby? Unfortunately, no one could really say.
“Since cannabis is a federally illegal plant, there are no reputable studies around this subject that are done in America,” she says. “Maybe that’s happening recently, but for forever that’s how it’s been—you can’t get any funding for something that’s federally illegal. So already the information around this topic is pretty taboo. When people talk about this subject they feel scared and worried; maybe they could jeopardize having their child taken away, so it’s a pretty loaded subject.”
Currently, the CDC has no set recommendation on the subject of cannabis use during and after pregnancy; “Data are insufficient to say yes or no.”
According to the Guttmacher Institute, 24 states plus D.C. consider the use of a controlled substance (including cannabis) during pregnancy grounds for pursuing charges of child abuse, even (though not all) in states where it is medicinally and recreationally legal. As Leafly has previously reported, studies on cannabis’ impact on developing fetuses and newborn babies only date back to the 1980s, and due to the ethical concerns of the research, “scientists are left to rely on self-report surveys and biochemical analyses. These are the two least invasive research methodologies, but both methods introduce complications in the study data that can produce inconsistent or downright misleading results.”
So Elisabeth, whose brand OM has won more than 40 cannabis competition awards and was the first licensed adult-use manufacturer in California, turned to online mom forums. Here, hundreds of women from all over the country were sharing their experiences with the intersection of cannabis use and motherhood, including breastfeeding. Her son was born healthy in early 2021, and Elisabeth chose to breastfeed him. Her partner, who is not a cannabis user, was concerned about the possibility of THC transference for mother to baby through the milk.
“I was a couple of months postpartum, and I had the opportunity to be a judge in a competition where I ended up inhaling a lot of organic cannabis at a super low temperature,” she says. “My [partner] had raised concern with me that ‘Hey, I’m nervous that your breast milk might be getting the baby high.’ I did all this research because I was like, ‘Oh shoot, am I getting the baby high? I was super nervous. I also felt defensive and scared.”
Because cannabinoids are fat-soluble, THC can impact a parent’s milk supply, and “can be detected in breast milk for up to six days after smoking.”
This doesn’t guarantee, however, that any THC will actually transfer to the milk supply and baby. For Elisabeth, who lives in the Bay Area, she wanted to be sure her cannabis use wasn’t reaching her baby while providing him the nutrients and good bacteria breastfeeding offers.
“I had this lightbulb moment. I was like ‘Oh, I could get my breast milk tested at the cannabis lab!’”
In all states and Canada where marijuana is legal for adult use, all products must be tested by an independent lab for accurate potency and dosage, as well as potential traces of solvents, pesticides, molds, and contaminants. She already had good relationships with labs for her products, so she pumped some milk, labeled it “BM,” and sent it off to a California cannabis lab without disclosing what it was.
Her results were “non-detectable” for all cannabis-derived compounds. She has since posted the results publicly on her company’s Instagram page where it has accrued over 7,200 likes and 620 comments as of publication.
“It got so many comments and it was all people tagging new moms. It’s such a common belief that somehow it’s harmful to smoke cannabis when you’re breastfeeding, but there’s actually not really the data to support that. To have access to a lab [where] we can test our own body, this is liberating.”
While her results were a relief, Elisabeth was right to be worried. Dr. Natalie Davis, who is both a neonatologist and associate professor of pediatrics at the University of Maryland School of Medicine, has seen patients come to her after being rejected for lactation consultations and breastfeeding guidance at other hospitals due to testing positive for THC. She has worked at the University of Maryland Children’s Hospital since 2013 and is regularly in the NICU. The hospital screens every mother who comes to give birth for substance use, including cannabis, which is not recreationally legal in Maryland.
She is currently leading an ongoing study, with initial findings presented at the American Academy of Pediatrics national conference last fall, about the potential impacts of THC-positive mothers breastfeeding their preterm infants.
“This stems from a family I took care of; the mom tested positive at another hospital and she felt judged and traumatized,” she tells Leafly. “What we did not find is that babies who were exposed to marijuana did worse. They didn’t do better, but no major illnesses [were found] when we controlled for things in our analysis. I can’t say it’s safe; this is just one part we’re trying to chip away at. Much more needs to be done. I want moms to be able to make informed choices without unnecessary guilt.”
With guilt also comes fear. Stigma is still a powerful tool wielded against parents who are curious about cannabis use, and many parents continue to omit their cannabis use when consulting their doctors, even in legal states. In some of those states where substance use can be grounds for an investigation to remove children from their parents, the laws around child welfare have not been updated even as cannabis has become legal. As with other discriminatory practices related to cannabis, the women and parents who are most vulnerable are Black women, Latinas, and low-income women.
Melanie Julion, certified doula and founder of The Cannabis Doula, a 501(c)3 nonprofit based in D.C., says that while it’s great to see more “cannamoms” publicly embracing their use, most of them are white. In her work as a doula, she does not push for cannabis use but helps families find resources to make informed decisions that lower risk factors, like accessing tested, pesticide-free cannabis, and finding compassionate doctors.
“Parents are criminalized for their use of cannabis, especially Black and Latino families. They are denied care and have fear of having their children taken away,” she says. “It’s important to know how to navigate that system. The stigma is really, really bad.”
Julion herself used cannabis during her pregnancy in 2015, after working at a licensed medical cannabis cultivation facility and learning about the endocannabinoid system. The Cannabis Doula was officially founded in 2018 to reconnect birthing parents with the legacy of cannabis and its potential for medicinal uses, which date back thousands of years. She has worked with families whose parents and grandparents used cannabis during pregnancy, and has yet to see the anti-cannabis talking points, such as cognitive issues and low birth weight, manifest in the babies born to THC-positive mothers in her care.
“‘Is it safe?’ That’s the question I get the most often. And that answer depends on so many factors. I encourage families to seek out and individualize with cannabis consultants, physicians, and their care providers. We’re all so different, and all pregnancies are different. I understand both sides, and I educate families on both sides.”