Should You Breastfeed if You Smoke Pot?

When I was eighteen, I met the woman who remains in my memory as one of the worst mothers I've ever encountered. She was visiting a few friends of mine and talking to me in detail about her "triumphs" as a mom -- her flawless, drug-free home birth, her determination to cosleep with her kids until they were "at least seven," and her eagerness about breastfeeding. I was (and remain) a strong advocate for breastfeeding, but I literally jumped with alarm when I saw this woman casually roll a joint while in the process of nursing her one-year-old. "It doesn't hurt her," she condescendingly explained to me, lighting the cigarette as if by some willful display of defiance.

In the many years that have passed since I encountered her, I've become a mom myself, and I've spent much time reading, researching, and writing about the many benefits of breastfeeding. Lactivism remains a passion of mine, and I'm proud of the fact that I nursed my own daughter until she was two and a half. But my feelings (and judgments) about this mom's parenting choices still burn in my mind. I'm sure that she is not the only mother who honestly believes that marijuana is harmless to a nursing baby -- and, frankly, that terrifies me.

The question of whether or not pot will hurt your baby isn't entirely simple to answer, but experts do agree unanimously on one point: it can't be good for the baby, and it's best to avoid it. However, in "The Ultimate Breastfeeding Book of Answers," Dr. Jack Newman does encourage moms who smoke pot occasionally to continue breastfeeding. Noting that infant formula is itself dangerous to babies, he states that "a mother who smokes a marijuana cigarette or two from time to time" should continue breastfeeding, but should "take it easy" to minimize the risks to the baby.

An analysis by the College of Family Physicians of Canada offers a similar conclusion: "Advising mothers to discontinue breastfeeding if they cannot stop using cannabinoids must incorporate the known risks of formula feeding. " In other words, if a woman absolutely must continue smoking pot while nursing (whether because it is a compulsive behavior or because it offers relief from certain medical conditions), she shouldn't automatically assume that formula is a better option. Breast milk is the best possible food for babies, so occasional, light use of marijuana may not outweigh the risks associated with formula.

A 1997 report by the World Health Organization, published in "Drugs and Human Lactation," found that, in one feeding, a baby ends up with about 1% of the THC (the active compound in marijuana) in his body that his mother gets from smoking one marijuana cigarette. In other words, if you smoke one joint and then breastfeed an hour later, your nursing baby gets about 1% as "high" as you get. Very occasional exposure to these mind-altering chemicals certainly isn't good, but it probably isn't worth it to switch to the significant risks associated with infant formula, considering the small doses that the baby gets from occasional, light exposure.

But heavy pot-smoking-- more than once a week-- is another story entirely. While occasional use doesn't cause much THC to pass into breast milk, regular use does, especially for moms who use the stuff daily. One study found that moms who are heavy pot-smokers have significant, measurable amounts of THC in their breast milk: a whopping eight times the amount found in their own blood streams. Although no studies have evaluated the effects that heavy use might have on a baby, it's very likely that chronic exposure to this mind-altering drug could cause serious problems, including brain damage that may be irreversible.

The bottom line: breastfeeding and drug use don't mix. If you smoke pot on a regular basis while nursing, the psychoactive compounds in the drug will pass to your baby through your milk, and the effects of this could be serious. It's best to err on the side of caution and not smoke anything while nursing your child. However, if you only partake once in a blue moon, it's still in your child's best interest to continue nursing.

If you are pregnant or nursing and use marijuana for any reason, be sure to tell your health care provider and your baby's pediatrician -- don't let the guilt or shame block you from doing what's in the best interest of your child. Your health care provider can put you in touch with resources to overcome substance abuse (or, if you use marijuana for medical reasons, she can help you find safer alternatives), and your pediatrician can closely monitor your baby's development to help minimize the chances of long-term problems from exposure to the drug. As a mom, you have a responsibility to do what it takes to keep your baby safe and healthy. Whether that means quitting pot, cutting back, or choosing not to breastfeed, make the decision with your child's best interest in mind.