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LACTNET Home

LACTNET Home

LACTNET  August 2011, Week 4

LACTNET August 2011, Week 4

Subject:

Re: marijuana

From:

"Jaye Simpson, IBCLC" <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Wed, 24 Aug 2011 09:19:38 -0700

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (127 lines)

I had one of my moms call me just last week asking the same question.  She
would not go to anyone else BUT me because she feared judgment and criticism
and apparently it is getting around that I am not judgmental.  I will give
my recommendation to her at the end of my response.   And, for those who may
disagree with my comments - no flames.  :)

After reading through Hale, it seems the reason cannabis is an L5 is likely
because 1) it is an illegal drug and 2) it stays in the system for several
weeks (2-3 wks of positive urine test).  However, in the studies cited,
there are few negative side effects for baby.  No differences in growth,
mental or motor development.  Noting that it stays in the system for a long
time and absorption is high and it is metabolized slowly the long term
sequela is conflicting.  One study showed NO effects on the nursing infant.
So - if this is the case, then realistically, HOW is it NOT Safe??  

With this information, I am professionally very hesitant to tell a mother
she absolutely cannot use cannabis.  Frankly there are prescription drugs
that are significantly more risky than marijuana.  If a mom is getting only
lightly high every now and again to ease her stressed out nerves it may
actually be safer or better than taking xanax or valium regularly...or some
other anti-anxiety drug that really can cause serious issue with the baby
and have even stronger effects on mom.  Taking a medication that stays in
your system and keeps you drowsy for several hours is a lot different than
catching a light high to chill out for 30 minutes.

Xanax for example: Baby can go through withdrawal and have many difficulties
if mom has been taking it regularly.  This does not happen with marijuana.
The family of medication that Xanax is in has an extremely long half-life is
not recommended for nursing mothers because of this and the likely
withdrawal issues...Valium is in the same family.

When a mom calls me to ask about this, I do explain a few things.  Besides
the obvious fact that it is still illegal and one can end up in jail if
caught with it, it does stay in her system and the baby's - they can be
tested positive and she can end up in deep doo-doo with the powers that
be...  So - if you are going to use it - be careful.  Also it depends on how
much she is using.  If mom is getting wasted regularly then she may want to
consider counseling and figure out why she has a need to get stoned out of
her mind.  If she is getting lightly high every now and again, then she
needs to know how long the drugs stay in her and baby's system and to make
sure there is someone who will NOT be impaired who can care for baby.
Discussing moderation is important.  We tell moms it is OK to drink alcohol
- in moderation.  We tell them how to smoke 'safely' and in moderation.  Why
not do the same with marijuana?

With this type of situation, we must be willing to take the time to
investigate why mom is using, how often and how much.  Taking one or two
drags from a joint is a lot different than smoking the whole damn thing.
And, if you know anything about marijuana, to be quite frank - making sure
that what she is smoking is safe is important too.  Accidentally getting pot
laced with something scary does happen - so know your source.  

Also, searching out the 'why' may give us opportunity to give other options.
For example:  The mom I mentioned above has an incredibly stressful life
right now - and I mean stressful.  She asked me about getting lightly high -
not stoned out of her mind - just a light (2 drags) high to calm down and
ease her anxiety - that is what she feels will help her cope with her
situation.  I told her the risks, gave her the details and discussed openly
the effects on baby.  We also talked about other less 'risky' ways to assist
with her anxiety - information no one else had bothered to give her.  By
giving her the information openly, honestly with no judgment and giving her
alternative options, she is fully informed and can make a decision that will
work for her.  

So - there you have it.  I took the time to give the client ALL the
information, and other options she could try in place of the marijuana.
Ultimately though, it is the mom who will decide what she will do.  I would
rather give her fully informed consent than to just shut her down.  And
whatever my personal feelings are on marijuana (this is one of those times
my personal and professional opinions disagree), it is my professional
responsibility to give her all the information.  

For Wendy, I would probably avoid telling mom she shouldn't smoke marijuana
as a blanket statement.  She will likely shut down and won't listen to
anything else you tell her.  Telling her it is not safe just isn't all that
accurate if you really read the literature.  Telling her it is illegal is
something she already knows.  :)  However, giving her all the information
and discovering why she is smoking and how much, may give you an opportunity
to give her other options, or may help her make a choice to tone it down a
bit (or maybe a lot).  There is a way to use marijuana in a safer manner.
Give her that information.  Let her know that, while it is an illegal
substance, and she could end up in legal trouble because of it, in reality
she doesn't have to give it up just because she is nursing.  There are ways
to do this in moderation and to be safer.  But we must go back to it is the
mother's choice.  Period.  If marijuana were legal, we would lose a lot of
the argument - we'd be discussing it as openly as we do alcohol and
cigarettes... 


Warmly,
Jaye



Jaye Simpson, IBCLC, CIIM
Breastfeeding Network
Sacramento, CA
www.breastfeedingnetwork.net

-----Original Message-----
From: Wendy Sherwood [mailto:[log in to unmask]] 
Sent: Wednesday, August 24, 2011 7:00 AM
Subject: marijuana

I have a mother that is known user of marjuana. She has not stopped while
pregnant. She does not plan to stop while nursing. I know that marajuanna is
a L5 but does anyone have any advice for me regarding teaching her. I know
that I will tell her it is not safe but other than that I am at a loss. I
have been told by a larger area hospital they do not watch infants any
closer than a smoking mothers infant.  This one is bothering me because
marijuana is not safe and I would like to tell her to not use while breast
feeding but I would imagine she will not listen if she has not stopped while
pregnant. Would appreciate some suggestions. 

             

             ***********************************************

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