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Tetrahydrocannabinol (THC) and Cannabidiol (CBD) Use while Breastfeeding: Results from the COVID-19 Cannabis Mom Study

Morgan McLaurin
University of Miami

Co-Authors: Bria-Necole Diggs1, Amrit Baral1, Ranya Marrakchi El Fellah1, Cynthia Lebron1, Sarah Messiah2, Denise C Vidot1
1University of Miami, 2University of Texas

Background: The increasing prevalence of cannabis use among breastfeeding individuals underscores the necessity for a better understanding of the specific cannabinoids consumed, including tetrahydrocannabinol (THC) and cannabidiol (CBD), during this important time period. Given that THC and CBD can be passed from mother to infant through breast milk and their effects on neurodevelopmental processes have been documented, our analysis aims to describe the prevalence of these cannabinoids in breastfeeding individuals.

Methods: Data are from the COVID-19 Cannabis Mom Study (N=221), a cross-sectional study utilizing REDCap for consenting and survey distribution. The study collected self-reported information on cannabinoid use and breastfeeding history. Descriptive statistics and Chi-squared/Fisher’s exact tests examined patterns of cannabinoid use by route of consumption and reason for use.

Results: Among the participants currently breastfeeding (N=78), mean age was 31.0 years (SD=5.3), 62.8% were Non-Hispanic White, 18.0% Hispanic, 87.2% born in the United States, and 2.6% currently pregnant. The majority (92.3%) reported currently consuming cannabis while breastfeeding, of which 34.7% reported an increased change in their cannabis use while breastfeeding. Most (79.5%) reported cannabis use for medical reasons while breastfeeding. Regarding the self-reported dominant cannabinoid in the cannabis consumed by respondents currently breastfeeding, 52.7% reported THC dominant, 37.8% reported a THC and CBD ratio, while none (0.0%) reported CBD as their dominant cannabinoid. There was a difference in dominant cannabinoid by report of cannabis use for medical reasons (p=0.047).  Specifically, among those consuming cannabis for medical reasons while breastfeeding, 51.6% reported THC dominant, 41.9% THC and CBD ratio, 3.2% CBD, and 3.2% did not know the dominant cannabinoid in the cannabis consumed. Among those breastfeeding using cannabis for non-medical reasons, 58.3% reported THC dominant, 16.7% THC and CBD ratio, 0.0% CBD, and 25.0% were unsure of the dominant cannabinoid in their cannabis.

Conclusions: Findings here showed a high prevalence of cannabis use while breastfeeding and significant differences between dominant cannabinoid and self-reported medical cannabis use status while breastfeeding. Only 3.2% of medical cannabis consumers reported the use of CBD dominant cannabis. Considering the differential effects of cannabinoids on receptors of the endocannabinoid system, these findings highlight the necessity for cannabinoid-specific education for those planning to and currently breastfeeding. Further research on the short and long-term impact each cannabinoid has on mother and breast-fed babies, for healthcare providers and mothers to make more informed decisions regarding cannabis use during breastfeeding.