I am an IBCLC in private practice in Washington State, USA. A pregnant woman was referred to me by a local midwife practice. Mom has spondylolisthesis and has been in chronic, excruciating pain for 9 years. She is low-income. She tried a host of pharmacological treatments with little success and many side effects. Chiropractic and acupuncture were helpful but very expensive. Ultimately, she obtained relief via medical marijuana, which is legal (sort of) in Washington State.  
She is nearing the end of her pregnancy. When she learned she was pregnant, she stopped using medical marijuana. The pain has diminished somewhat during pregnancy. 
She anticipates that once the baby is born, her pain will return. 
She contacted me to ask about the relative risks of THC in breastmilk. I read to her from Hale and sent her the relevant pages; sent her several articles I found online, and researched in the LactNet archives. I felt that I did not find a useful discussion about medical marijuana as opposed to social marijuana. I also asked a Dutch friend to do some research -- she found the same articles I did! The Dutch discussion boards seem to say "occasional use OK, don't use chronically," but, based on the same research we have in the US.

She would have access to purified THC in a suspension; or, a food-based product, so that she would not have to smoke.
Like many (most?) medical marijuana patients, she is able to maintain her life as a functioning adult while using the medication.

Here are some ways of looking at it:
--Mom in chronic pain, sacrificing herself to breastfeed her baby without medication/treatment.
--Mom treating her pain, using formula with known risks of formula.
--MOm treating her pain, using donor milk if possible (best case scenario?)
--Mom treating her pain, breastfeeding with unclear risks of medical marijuana in breastmilk 
--Mom breastfeeds for 6 weeks, then starts treating with medical marijuana, continues to breastfeed or not?
.... other choices?

She is not looking for me to tell her "yes or no." She is looking for data or information. She has done an enormous amount of research on her own and wondered if there was some hidden source of data she didn't have access to. And, it made me very curious.

I'm interested in the international perspective; in any new research/data; and, in any anecdotal/clinical experience any of you might have.

thank you so much.
From a lurker/newbie...
Betsy Hoffmeister, MPA, IBCLC

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