What You'll Learn

• Cannabis Use During Pregnancy And Breastfeeding
• Using CBD During Pregnancy And Nursing
• Cannabis Versus Alcohol While Pregnant And Nursing
• Moderate Alcohol Consumption During Pregnancy And Breastfeeding

Pregnancy is a time with lots of new restrictions, and it can feel like we’re losing our freedom. A lot of those new rules stick around during nursing too. With so many “Don’ts,” how do we know what’s okay? Can everything really be that bad for the baby? OB-GYN Dr. Jennifer Lincoln is going to help us unpack the effects of alcohol, CBD, and cannabis during pregnancy and nursing. 

Promoting A Discussion

I do weekly polls in my Instagram stories where followers can submit anonymous questions for the community.  Every week I get several submissions about the use of CBD or cannabis while pregnant or breastfeeding. Here in Canada, it’s legal, but I know in a lot of the U.S., it’s not legal.

Every time I post one of these polls, I’ll get a message, comment, or someone will inbox to let me know they’re unfollowing me because of my views on cannabis. I think it’s important before we begin to say Dr. Lincoln and I are both professionals. We’ve been trained to put our values and beliefs aside and do what’s best for our client or patient.

Promoting the discussion of it, isn’t promoting it.

Dr. Lincoln said it best when said, “Promoting the discussion of it, isn’t promoting it.” People are using it, and they need to have a full understanding of what they’re using and how to use it safely.

Alcohol Consumption During Pregnancy 

“If you want to be the safest you’re not going to consume alcohol while you’re trying to conceive or when you’re pregnant,” Dr. Lincoln said. But if you had a binge drinking episode before you knew you were pregnant, it may not be that big of a deal. A study out of Denmark actually showed having a binge drinking episode in that period didn’t cause complications for the fetus or during pregnancy.

Fetal alcohol syndrome runs along a continuum, so if you continued to drink during the pregnancy that might lead to complications. “Fetal alcohol syndrome affects a lot of kids, and it’s completely preventable,” Dr. Lincoln said. “Consuming alcohol during pregnancy puts you at risk for lots of other things.”

When people ask her if a glass of wine is safe, she reminds them that to be completely safe, it’s best to avoid alcohol. But the risks increase with consumption. A glass of wine probably isn’t the same as a bottle, and she wants every mom-to-be to know, it’s your choice. 

A good plan is to explore why that glass of wine is so important. Are you at a party and trying to have fun with friends? Are there other ways you can have fun and feel included? What is it you hope to gain from drinking and is there another way to achieve that without alcohol? Oftentimes it is more about being included, not feeling left out or feeling a sense of belonging.

Or perhaps you had been using alcohol as a coping mechanism. Pregnancy can be completely overwhelming and it makes sense that it may challenge your ability to cope.  You’re sacrificing lots of parts of your life, and your whole world is changing. It’s a lot to take in.

But fetal alcohol syndrome and risks to pregnancy aside, this might not be the best way to cope. What are some other ways we can self soothe? Pregnancy and postpartum are high risk times for the development of perinatal mood and anxiety disorders, and many find medications and therapy to be effective forms of coping and treatment. 

Alcohol Consumption During Breastfeeding

In pregnancy we’re measuring how much of the alcohol passes through to the baby. In breastfeeding, we’re talking about how much alcohol passes through to the breast milk. 

“You don’t need to pump and dump,” Dr. Lincoln said. “If you’re sober enough to hold your baby, you’re sober enough to nurse.” For the most part the “pump and dump” method is overly restrictive, but if you have a medically fragile baby, this could be an exception. You may want to talk to your doctor about that first.

If you’re sober enough to hold your baby, you’re sober enough to nurse.

There are a few other things to consider when consuming alcohol during the postpartum period. We need to be sober enough to parent a newborn and maintain safe sleeping arrangements. If alcohol makes you very sleepy, you don’t want to fall asleep on the couch with baby. That might be dangerous.

Using CBD During Pregnancy And Nursing

CBD isn’t the same as THC. These are two different substances. But many CBD products claim not to contain THC and about 1 in 5 do. 

This is another substance where we want to explore why we want it. Because a lot of people will use CBD for anxiety or insomnia and may see CBD or cannabis as a natural alternative to taking a medication such as an SSRI. While prescription drugs often have a bad rap, we know all of the ingredients and in what amounts.

“Natural doesn’t mean better,” Dr. Lincoln said. “The dose makes the poison.” 

Cannabis Use During Pregnancy And Breastfeeding

“We know that THC crosses the placenta, so once again the use in breastfeeding is very different than the use in pregnancy,” Dr. Lincoln said.

It’s hard to get a randomized control study on marijuana, because people are worried about the liability of being sued if it causes birth defects, and moms are unlikely to report using it if they’re in a state where marijuana is illegal. However, Thomas Hale at the Infant Risk Center at Texas Technical University is collecting data.

“This is a newer thing,” Dr. Lincoln said. There just isn’t much research at all. “We do not recommend use in pregnancy or in breast feeding, because of the lack of data,” she explained.

But the emerging data shows long term effects like disruptions in motor and emotional skills, and long and short term memory issues. “There is no room for judgment,” Dr. Lincoln said. Cannabis consumption during pregnancy isn’t great, but if you’re a heavy user, can we decrease it?

Is there another way we can get you some relief?

And if you’re using cannabis for some of the benefits people find like decreasing nausea or anxiety, is there another way we can get you some relief? If you’re experiencing anxiety, reach out to Momwell Therapy Support. We’ll help support you. If it’s the nausea, can you talk to your provider? There are things they can give you to help curve vomiting and nausea. 

Using Marijuana during breastfeeding is different than in utero. “According to the data that Thomas Hale has about 9% of THC will get into the milk and the baby only absorbs about 1% of that,” Dr. Lincoln said. This is probably lower risk than smoking marijuana during pregnancy, but this could be different for medically fragile babies.

Understanding the risks is important. If you need to use marijuana, can you avoid using it around nursing times? Or delay the use until after you’re pregnant? Even minimizing the usage is an improvement.

Adjusting to all the changes and restrictions of pregnancy and nursing can be hard. Moms often feel like they’re losing pieces of who they are, and that’s a lot to handle. If you’re struggling with overwhelm and frustration, the All The Rage Workshop can offer you ways to cope and manage it.