Dear Lactnet Friends:

Debbie shares a number of different studies that show risks of cannabis
use, to the user. This is fun, Debbie, where one professional inspires
another to dive into the research. Thank you!

Seems like smoking anything in the home increases the risk of SIDS to the
infant.

Many of the drugs we use today have their derivations from the animal or
plant world.

It is fascinating to me that Melanie Dreher's research from the 90s,
looking at the children of Rastafarian families who use high potency
cannabis in a chronic way, is ignored. Talk about value based practice!

Religious beliefs of the Rastafarian practice (both a religion and a social
movement)  preclude the use of any other substance, save cannabis,
considered to be a holy sacrament. What an ideal sample for research, folks
using only one thing and nothing else, no tobacco or alcohol.

Her first study, published in Pediatrics, found:

ABSTRACT. Objective. To identify neurobehavioral
effects of prenatal marijuana exposure on neonates in rural
Jamaica.

Design. Ethnographic field studies and standardized
neurobehavior assessments during the neonatal period.

Setting. Rural Jamaica in heavy-marijuana-using
population.

Participants. Twenty-four Jamaican neonates exposed
to marijuana prenatally and 20 nonexposed neonates.
Measurements and main results. Exposed and nonexposed
neonates were compared at 3 days and I month old,
using the Brazelton Neonatal Assessment Scale, including
supplementary items to capture possible subtle effects.
There were no significant differences between exposed
and nonexposed neonates on day 3. At 1 month, the
exposed neonates showed better physiological stability
and required less examiner facilitation to reach organized
states. The neonates of heavy-marijuana-using mothers
had better scores on autonomic stability, quality of alertness,
irritability, and self-regulation and were judged to
be more rewarding for caregivers.

Conclusions. The absence of any differences between
the exposed on nonexposed groups in the early neonatal
period suggest that the better scores of exposed neonates
at 1 month are traceable to the cultural positioning and
social and economic characteristics of mothers using marijuana
that select for the use of marijuana but also promote
neonatal development.

Pediatrics 1994;93:254-260; prenatal
marijuana exposure, neonatal outcomes, Jamaica, Brazelton
scale supplementary items.
ABBREVIATIONS. NBAS, Neonatal Behavior

----------------------------------------------------------------------------------
Very interesting, no?


A 5-year follow-up found this:

Five-year Follow-up of Rural Jamaican Children whose Mothers used
Marijuana during Pregnancy
1.S. H,ycs. Ph.D .. R.N.. R. Lampart. M.P.H .. F .R.C.S.. M.e. Dreher, Ph.D
.. R.N. and L. Morgan. S.R.N.
Mi;;mi Children'5 Hospital, Florida, U.S.A .. Princes!>. Margaret Hospital.
St. Thomas, Jamaica . and
Universi ty of Massachuse tts. Amherst, U.S.A.
AHSTR.4CT
This research provides data on the development o[ 59 Jamaican children,
from biT/h to age 5 years whose mothers used marijuana during
pregnancy. Approximately
one-half of the sample used marijuana. during pregnancy and were matched with
non-users according to age, parity, and socioeconomic status.

Testing of the. children was done at 1, 3. and 30 days of age with the
Brazelton Neonatal Behavioral Assessment Scales and at ages 4 and 5 years
with the McCarthy Scales of Children's Abilities. Data about the child's home
environment and temperament were collected from direct observations as well
as from  standardized questionnaires. The results show 110 significant
differences in developmental testing outcomes between children uf
Illarljuana-usillg and non-using mothers except at 30 days of age when
the babies
of users had more favourable scores all two clusters of the Brazelton
Scales: autonomic stability and reflexes.

The developmental scores at ages 4 and 5 years were significantly
correlated to certain
aspects of the home environment and to regularity of basic school
(preschool) attendance.

Discussion:  DISCUSSION
The lack of negative findings related to prenatal marijuana exposure tn
this study at birth , one month, four and five years of age must be
interpreted with the realization that the
HOME scores and regularity of basic school attendance were very powerful
variables in the statistical analysis. Whether marijuana effects were
absent , so subtle as to be
overpowered or compensated by the variables related to the child's
environment and school attendance, or whether the outcome measures did not
tap abilities which might be
affected by marijuana use has not been determined"

_________________________________________________________

Dr. Dreher did publish another study:

LESTEH, HAI\IIY M ., and DHI.£HEII, MELANIE. Effects of Marijuana Use
during Pregnancy a ll Newham Cry. CHILD DEVELOPMENT, 1989,60, 765-771. The
effects of maternal marijuana use on the newborn cry were studied in
Jamaica, where it was possible to rule out confounding factors such as the use
of other substances and demographic variables that have clouded previous
studies and wher4
higher dosages may make the effects more visible. The acoustic
characteristics of the cries of 20 infants of marijuana users and 20
controls were analyzed.

The cries of the infants of marijuana users were shorter, had a higher
percentage of dysphonation, a higher and more variable fundamental
frequency, and a lower first fomant than controls. There was also a dose
response relation between the first fomant and marijuana use. We suggest
that heavy marijuana use affects the neurophysiological integrity of the
infant.


_________________________________________________________________

Why has Dr. Dreher's research been ignored?

My opinion is that her research was ignored for the same reason that Dr
Hallum Hurt's research on cocaine use prenatally and its impact on babies
was ignored; the findings were not congruent with attitudes and beliefs
about substance use in the US. (Dr. Hurt found that the impact of poverty
on infants was the real problem, not the impact of prenatal cocaine use.
Not a popular conclusion.

So the take way?? To my mind, the research says there is no substitute for
the primary relationship of parent, baby and family in an environment where
their needs are supported.  That the negative findings of substance use are
complicated by the most dreadful impact of the lack of paid parental leave
after the birth of a child, the dreadful impact of the lack of community
and the dreadful impact of poverty on every social outcome (murder and
other violence, including domestic, and substance use), and a general
failure of the social network in the US.

The Rastafarian mothers lived in community, where they were supported in
parenting; they and their babies benefitted.  We've all heard the phrase,
"it takes a village to raise a child".....the US lacks village.

sigh....

warmly,




Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC, RYT
www.nikkileehealth.com
Pronouns: she/her/hers
*Communications are confidential and meant only for whom they are
addressed.*

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