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.
Dieterich CM, Felice JP, O'Sullivan E, Rasmussen KM. Breastfeeding and Health Outcomes for the Mother-infant Dyad. Pediatr Clin North Am. 2013;60(1):31-48. doi:10.1016/j.pcl.2012.09.010
Centers for Disease Control and Prevention. Breastfeeding Benefits Both Baby and Mom. Updated July 27, 2021.
Centers for Disease Control and Prevention. Nutrition, Physical Activity, and Obesity: Data, Trends, and Maps.
Bertrand KA, Hanan NJ, Honerkamp-Smith G, Best BM, Chambers CD. Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk. Pediatrics. 2018;142(3):e20181076. doi:10.1542/peds.2018-1076
U.S. Food and Drug Administration. FDA Advances Work Related to Cannabidiol Products with Focus on Protecting Public Health, Providing Market Clarity. Updated March 5, 2020.
Datta P, Melkus MW, Rewers-Felkins K, et al. Human Milk Endocannabinoid Levels As a Function of Obesity and Diurnal Rhythm. Nutrients. 2021;13(7):2297. doi:10.3390/nu13072297
Uvnäs Moberg K, Ekström-Bergström A, Buckley S, et al. Maternal Plasma Levels of Oxytocin During Breastfeeding - A Systematic Review. PLoS One. 2020;15(8):e0235806. doi:10.1371/journal.pone.0235806