Thank you!
In the states where cannabis is legal, I understand there is an age restriction, as with alcohol. 
I’ve heard some argue that using cannabis while nursing, knowing that it passes through breastmilk, is like giving it to an underage child. 
I guess the same goes for alcohol……….and we allow mothers to have an occasional drink.
Thoughts?
Kay Anderson, MD, IBCLC

> On Jan 18, 2019, at 9:08 AM, Elizabeth Brooks <[log in to unmask]> wrote:
> 
> The question is posed: "Are there any legal ramifications for an IBCLC that
> helps a mother breastfeed who tests positive for THC and/or another illicit
> drug ?"
> 
> The short answer is: Only if you **sold** the illegal drug to the patient,
> in a state that criminalizes its use.
> 
> The longer answer asks us to use a smidge of common sense.  Healthcare
> providers take their patients as they find them. If they have substances in
> their system that shouldn't be there, we have to deal.  Imagine what would
> happen if we failed to treat every opioid overdose that arrived in the
> Emergency Room, or drunk driving victim, or accidentally-poisoned child
> because they didn't know those pills in their big brothers' pockets were
> bought on the street.
> 
> There is considerable debate now, in Lactation Land, about cannabis use ...
> since many states in the USA are de-criminalizing social use.  And THC (the
> get-high ingredient) acts differently than CBD (with no psychotropic
> effects on the user).  Research in the area has historically been scant,
> and poor.  Newer research cautiously suggests that the impact on the baby
> of ingesting milk of a THC user is not as grave as we once surmised BUT the
> studies have been on small groups, are on smoked THC only -- we know bupkus
> about ingested cannabis -- and no one is willing yet to give cannabis a
> full thumbs up.
> 
> This should be approached like **any** risk-benefit discussion with **any**
> patient we work with.  We counsel folks not to smoke cigarettes, not to
> over-indulge in alcohol, not to eat bad-for-you foods if obesity or
> diabetes or heart disease is an issue.  We counsel folks to use a car seat
> when driving kids, to cover up electric outlets, to move poisonous cleaners
> out of reach.  And all day every day people don't heed the advice.  And
> that is the nature of autonomy.   In the states where it is
> de-criminalized, health care providers are (generally) telling parents not
> to use THC and BF -- but leaving the decision in the parents' hands of who
> they will feed their baby.
> 
> We don't "punish" folks for these failures of self-care by withholding
> best-practices health care, and we are not "responsible" for their
> actions/conduct.
> 
> Liz Brooks, JD, IBCLC, FILCA
> Wyndmoor, PA, USA
> Director, Human Milk Banking Assn of North America (2015-19)
> "IBCLCs empower women and save babies' lives!"-Ursuline Singleton
> 
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