Can a breastfed infant become intoxicated from a lactating mother who is smoking cannabis (marijuana)?

From the Guidelines

Breastfeeding mothers should completely abstain from marijuana in any form, including smoking, edibles, or oils, as THC can pass into breast milk and affect the baby's development and health. According to the U.S. Surgeon General and the FDA, cannabis may have a negative effect on fetal brain development and increase the risk for premature birth, and therefore, advise pregnant and breastfeeding people to avoid using cannabis in any form, including CBD products 1. The American Academy of Pediatrics and other medical organizations also strongly recommend that breastfeeding mothers avoid all marijuana use. THC, the psychoactive component in marijuana, can remain in breast milk for up to six days after use and may cause drowsiness, poor sucking, delayed development, and potentially long-term neurodevelopmental effects in babies. Some key points to consider include:

• The number of pediatric cases of edible cannabis exposure has increased significantly, causing central nervous system depression, vomiting, and tachycardia 1
• Cannabis use in early youth is associated with conditions that include neuropsychological and neurodevelopmental decline, elevated risk for psychotic disorders in adulthood, higher risk for later depression, and suicidal ideation or behavior 1
• The developing infant brain is particularly vulnerable to substances like THC, and there is no known safe amount of marijuana exposure for infants
• If a mother is using marijuana for medical reasons, she should discuss alternative treatments with her healthcare provider that are compatible with breastfeeding. The safest approach for breastfeeding mothers is to completely abstain from marijuana in any form.

From the Research

Cannabis Use and Breastfeeding

• Cannabis use during breastfeeding can result in the presence of delta-9-tetrahydrocannabinol (THC) in breast milk, with concentrations detectable up to 6 days after last reported use 2.
• The frequency and mode of cannabis use can impact the risk to the infant, with smoking being the most common mode of consumption among breastfeeding mothers 3.
• THC can be transferred to the infant through breast milk, potentially causing alterations in the newborn's behavior, cognitive development, and emotional response 4.

Effects on the Infant

• Perinatal cannabis exposure has been associated with low birth weight, reduction in head circumference, cognitive deficits, and disturbances in emotional response 4.
• Infants exposed to cannabis through breast milk may be at risk of developing substance use disorders, attention deficits, and affective disorders later in life 4.
• The exact effects of cannabis exposure through breast milk on infant development are not yet fully understood and require further research 5.

Maternal Knowledge and Practices

• Many breastfeeding mothers are aware of the potential risks of cannabis use while breastfeeding, but a significant proportion do not receive counseling on the topic 6.
• Maternal knowledge and attitudes towards cannabis use during breastfeeding can be influenced by prenatal and postnatal counseling, as well as awareness of the potential harmful effects of cannabis on the infant 6.
• Strategies to address maternal mental and physical health may be key to reducing cannabis use among breastfeeding mothers 3.