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U.S. Food and Drug Administration

What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding

FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.

A mother holding an infant, a pregnant woman holding baby shoes, a marijuana leaf and the letters CBD and the word WARNING

Cannabis and Cannabis-derived products have become increasingly available in recent years, with new and different types of products appearing all the time. These products raise questions and concerns for many consumers. And if you are pregnant or breastfeeding, you might have even more questions about whether these products are safe for you.

FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.

What are cannabis, marijuana, hemp, THC and CBD?

Cannabis is a plant of the Cannabaceae family and contains more than eighty biologically active chemical compounds. The most commonly known compounds are THC and CBD. One type of cannabis plant is marijuana, which contains varying levels of THC, the compound that produces the “high” that is often associated with marijuana. Another type of cannabis plant is hemp. Hemp plants contain extremely low amounts of THC. CBD, which does not produce a “high,” can be derived from either marijuana or hemp.

We are now seeing CBD-containing products everywhere. CBD can be found in many different products, like drugs, foods, products marketed as dietary supplements, and cosmetics. These products often make questionable health promises about CBD.

FDA wants you to know there may be serious risks to using cannabis products, including those containing CBD, if you are pregnant or breastfeeding.

What do we know about the effects of marijuana use during pregnancy and while breastfeeding?

There are many potential negative health effects from using marijuana and other products containing THC during pregnancy and while breastfeeding. In fact, the U.S. Surgeon General recently advised consumers that marijuana use during pregnancy may affect fetal brain development, because THC can enter the fetal brain from the mother’s bloodstream. The Surgeon General also advised that marijuana may increase the risk of a newborn with low birth weight. Research also suggests increased risk for premature birth and potentially stillbirth 1 .

While breastfeeding, it is important to know that breastmilk can contain THC for up to six days after use. This THC may affect a newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences.

Additionally, marijuana smoke contains many of the same harmful components as tobacco smoke. Neither marijuana nor tobacco products should be smoked around a baby or children.

What do we know about the effects of CBD use during pregnancy and while breastfeeding?

There is no comprehensive research studying the effects of CBD on the developing fetus, pregnant mother, or breastfed baby. FDA is continuing to collect and study the data on the possible harmful effects of CBD during pregnancy and while breastfeeding. However, based on what we do know, there is significant cause for concern.

High doses of CBD in pregnant test animals have caused problems with the reproductive system of developing male fetuses 2 . In addition, based on what we already know about CBD, we expect that some amount of CBD will be transferred to babies through breast milk.

We also know that there is a potential for CBD products to be contaminated with substances that may pose a risk to the fetus or breastfed baby, including THC. We have also heard reports of CBD potentially containing other contaminants (e.g., pesticides, heavy metals, bacteria, and fungus); we are investigating this.

Moreover, CBD has known risks for people in general. Based on clinical studies in humans, risks can include the following:

  • liver toxicity (damage)
  • extreme sleepiness
  • harmful interactions with other drugs

FDA is studying the effects of CBD use from different angles, such as: (1) the use of CBD-containing products, like food, cosmetics, or supplements, over a person’s entire life; and (2) the effects of using these various products in combination. There are many unanswered questions about the science, safety, and quality of products containing CBD.

We especially want to learn more about the effects of CBD during pregnancy and while breastfeeding, including, for example, whether and to what extent the presence of CBD in human milk harms the breastfed baby or the mother’s milk production.

Has FDA approved any CBD products and are there any benefits?

FDA has not approved any CBD products except for one prescription drug to treat rare, severe forms of seizure disorders in children. It is still unclear whether CBD has any other benefits.

Other than the one approved prescription drug, CBD products have not been evaluated or approved by FDA for use as drug products. This means that we do not know:

  • if they are safe and effective to treat a particular disease
  • what, if any, dosage may be considered safe
  • how they could interact with other drugs or foods
  • whether they have dangerous side effects or other safety concerns

The clinical studies that supported the approval of the one available CBD drug product identified risks related to the use of CBD, including liver toxicity (damage), extreme sleepiness, and harmful interactions with other drugs.

What about hemp seeds?

FDA recently completed an evaluation of some hemp seed-derived food ingredients and had no objections to the use of these ingredients in foods. THC and CBD are found mainly in hemp flowers, leaves, and stems, not in hemp seeds. Hemp seeds can pick up miniscule amounts of THC and CBD from contact with other plant parts, but these amounts are low enough to not raise concerns for any group, including pregnant or breastfeeding mothers.

What should you remember about using cannabis or cannabis-derived products?

If you are considering using cannabis, or any products containing THC or CBD, you should be aware of the following:

  • FDA strongly advises that during pregnancy and while breastfeeding, you avoid using CBD, THC, or marijuana in any form.
  • Although many of these products are being sold, FDA has not approved these products, other than one prescription CBD drug product and two prescription drug products containing dronabinol, a synthetic version of THC (which are approved to treat certain side effects of HIV-AIDS or chemotherapy). All three of these prescription products have associated risks and side effects.
  • Always talk with your doctor, nurse, or pharmacist before taking any medicines, vitamins, or herbs while pregnant or breastfeeding.

Do not put yourself or your baby at risk by using cannabis products while pregnant or breastfeeding. Check out these links to learn more about cannabis, marijuana, CBD, and THC, and about taking medicines while you are pregnant.

FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.

CBD and Breastfeeding: Is It Safe?

Curiosity around the therapeutic uses for CBD has reached a fever pitch, but is it safe when you’re nursing? Here’s what experts say.

Pregnancy is one thing, but life postpartum often comes with a variety of mental and physical challenges. As many as one in five women suffer from postpartum depression, according to the Centers for Disease Control and Prevention (CDC). Other concerns include anxiety, chronic pain, and insomnia, all compounded by the lack of sleep and hormonal shifts that naturally occur after giving birth. It’s no wonder more new parents are gravitating to CBD, or cannabidiol, a component of either a marijuana or hemp plant that is non-psychoactive (unlike THC, or tetrahydrocannabinol, which only comes from marijuana).

CBD has been touted as the active ingredient in a variety of therapeutic products that boast anti-inflammatory, antioxidant, anti-psychotic, anti-convulsant, and antidepressant properties. But is it safe if you’re breastfeeding your child?

Here’s what nursing parents need to know about CBD.

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What the Science Says About Using CBD While Breastfeeding

Research has focused primarily on THC, as opposed to CBD, in breast milk, and the conclusion is that it is possible to pass low levels of the psychoactive ingredient to your baby this way. A study published in the journal Obstetrics and Gynecology looked at samples of breast milk from eight anonymous test subjects who regularly use cannabis and found that babies who were three to five months old and who were breastfed exclusively ingested an estimated 2.5 percent of the maternal dose of THC. (Researchers didn’t, however, take blood samples from the infants to see if they had measurable levels of THC in their bodies.)

And trying to “pump and dump” doesn’t work for cannabis products, as chemicals from cannabis that entered the body days or weeks prior to breastfeeding can make their way into breast milk, according to Medical News Today. In fact, other research published in the journal Pediatrics found that low levels of THC may be found in breast milk for up to six days after smoking cannabis or eating an edible.

Granted, this research was done on marijuana and THC, not hemp and CBD. But experts are concerned about the effect of any cannabinoid on an infant’s brain development.

“We truly do not know what short- or long-term impact on the baby it may have,” says Felice Gersh, M.D., a board-certified obstetrician and gynecologist and author of PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones, and Happiness.

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Is CBD safe while breastfeeding?

“Having a new baby is stressful, and some women may wish to turn to cannabis products,” Dr. Gersh notes. But the limited data on its safety—and the fact that it will pass into breast milk—makes it difficult for many experts to advise its use for nursing parents.

“Unfortunately, there is no safety data to allow a doctor to recommend the use of cannabis or CBD,” says Dr. Gersh.

Mary Clifton, M.D., an internal medicine doctor in New York City agrees, stating, “If a new mom is breastfeeding, it’s probably not wise to use CBD. The medical community doesn’t support the use of CBD in these settings, because proper studies can’t be completed on the effect on the baby or infant.”

Despite the lack of published research, new parents have used cannabinoids for thousands of years, notes Robert Flannery, PhD, owner of Dr. Robb Farms. “Yes, THC and CBD are expressed in small quantities in breast milk,” Flannery says. And while he doesn’t feel comfortable suggesting CBD for a new parent who is breastfeeding, he acknowledges the use of cannabis in the past by breastfeeding mothers.

“We do not have enough research to make claims one way or another on how that breast milk would affect the milk-fed babies,” says Flannery. “Cannabis is a medicine that has been used specifically for pregnant and breastfeeding moms for millennia. I will never make a claim without the science to back it up, but we should understand that anecdotal evidence can be used to formulate testable hypotheses to validate the use of cannabis at this time in a mom’s life.”

  • RELATED:Coping With Anxiety and Depression During Pregnancy

Consider the risks vs. benefits

Ultimately, because CBD “has been shown to be little risk to both adults and children” and therefore, “may not pose a problem,” it is important to weigh the risk versus benefits for the mom and infant, says Hilary Peckham, the co-founder of Etain Health, the only all-women, family owned medical marijuana dispensary company in New York.

For instance, many new parents suffer from postpartum depression suffer from anxiety, fatigue, mood swings and detachment from the infant. “Many sufferers usually start a treatment of antidepressants which may not be appropriate for breastfeeding and may need to discontinue,” Peckham says. “Starting CBD may still allow the mother to breastfeed and prolong the bonding time with the infant. Speak to your doctor before starting CBD, especially if you are a new mother.”

The Bottom Line

The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) recommend physicians counsel moms to abstain from all cannabis products—including CBD—if they wish to breastfeed. However, given the minimal amount of the substance that make its way into breast milk, and the fact that research has yet to confirm the exact effects on an infant, anyone interested in trying CBD while nursing would do well to speak to their doctor.

Curiosity around the therapeutic uses for CBD has reached a fever pitch, but is it safe when you're nursing? Here's what experts say.