What you should know about using cannabis while pregnant or breastfeeding

U.S. Food and Drug Administration (FDA)

The FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.

Cannabis and cannabis-derived products have become increasingly available in recent years, with new and different types of products appearing all the time. These products raise questions and concerns for many consumers. And if you are pregnant or breastfeeding, you might have even more questions about whether these products are safe for you.

The FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.

What are cannabis, marijuana, hemp, THC and CBD?

Cannabis is a plant of the Cannabaceae family and contains more than eighty biologically active chemical compounds. The most commonly known compounds are THC and CBD. One type of cannabis plant is marijuana, which contains varying levels of THC, the compound that produces the “high” that is often associated with marijuana. Another type of cannabis plant is hemp. Hemp plants contain extremely low amounts of THC. CBD, which does not produce a “high,” can be derived from either marijuana or hemp.

We are now seeing CBD-containing products everywhere. CBD can be found in many different products, like drugs, foods, products marketed as dietary supplements, and cosmetics. These products often make questionable health promises about CBD.

The FDA wants you to know there may be serious risks to using cannabis products, including those containing CBD, if you are pregnant or breastfeeding.

What do we know about the effects of marijuana use during pregnancy and while breastfeeding?

There are many potential negative health effects from using marijuana and other products containing THC during pregnancy and while breastfeeding. In fact, the U.S. Surgeon General recently advised consumers that marijuana use during pregnancy may affect fetal brain development, because THC can enter the fetal brain from the mother’s bloodstream. The Surgeon General also advised that marijuana may increase the risk of a newborn with low birth weight. Research also suggests increased risk for premature birth and potentially stillbirth.

While breastfeeding, it is important to know that breastmilk can contain THC for up to six days after use. This THC may affect a newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences.

Additionally, marijuana smoke contains many of the same harmful components as tobacco smoke. Neither marijuana nor tobacco products should be smoked around a baby or children.

What do we know about the effects of CBD use during pregnancy and while breastfeeding?

There is no comprehensive research studying the effects of CBD on the developing fetus, pregnant mother, or breastfed baby. The FDA is continuing to collect and study the data on the possible harmful effects of CBD during pregnancy and while breastfeeding. However, based on what we do know, there is significant cause for concern.

High doses of CBD in pregnant test animals have caused problems with the reproductive system of developing male fetuses. In addition, based on what we already know about CBD, we expect that some amount of CBD will be transferred to babies through breast milk.

We also know that there is a potential for CBD products to be contaminated with substances that may pose a risk to the fetus or breastfed baby, including THC. We have also heard reports of CBD potentially containing other contaminants - such as pesticides, heavy metals, bacteria, and fungus; we are investigating this.

Moreover, CBD has known risks for people in general. Based on clinical studies in humans, risks can include the following:
• Liver toxicity (damage).
• Extreme sleepiness.
• Harmful interactions with other drugs.

The FDA is studying the effects of CBD use from different angles, such as:
(1) The use of CBD-containing products, like food, cosmetics, or supplements, over a person’s entire life.
(2) The effects of using these various products in combination. There are many unanswered questions about the science, safety, and quality of products containing CBD.

We especially want to learn more about the effects of CBD during pregnancy and while breastfeeding, including, for example, whether and to what extent the presence of CBD in human milk harms the breastfed baby or the mother’s milk production.

Has the FDA approved any CBD products, and are there any benefits?

The FDA has not approved any CBD products, except for one prescription drug to treat rare, severe forms of seizure disorders in children. It is still unclear whether CBD has any other benefits.

Other than the one approved prescription drug, CBD products have not been evaluated or approved by FDA for use as drug products. This means that we do not know:
• If they are safe and effective to treat a particular disease.
• What, if any, dosage may be considered safe.
• How they could interact with other drugs or foods.
• Whether they have dangerous side effects or other safety concerns.

The clinical studies that supported the approval of the one available CBD drug product identified risks related to the use of CBD, including liver toxicity (damage), extreme sleepiness, and harmful interactions with other drugs.

What about hemp seeds?

The FDA recently completed an evaluation of some hemp seed-derived food ingredients and had no objections to the use of these ingredients in foods. THC and CBD are found mainly in hemp flowers, leaves, and stems, not in hemp seeds. Hemp seeds can pick up miniscule amounts of THC and CBD from contact with other plant parts, but these amounts are low enough to not raise concerns for any group, including pregnant or breastfeeding mothers.

What should you remember about using cannabis or cannabis-derived products?

If you are considering using cannabis, or any products containing THC or CBD, you should be aware of the following:
• The FDA strongly advises that during pregnancy and while breastfeeding, you avoid using CBD, THC, or marijuana in any form.
• Although many of these products are being sold, the FDA has not approved these products, other than one prescription CBD drug product and two prescription drug products containing dronabinol, a synthetic version of THC (which are approved to treat certain side effects of HIV-AIDS or chemotherapy). All three of these prescription products have associated risks and side effects.
• Always talk with your doctor, nurse, or pharmacist before taking any medicines, vitamins, or herbs while pregnant or breastfeeding.
• Do not put yourself or your baby at risk by using cannabis products while pregnant or breastfeeding.

Check out the links below to learn more about cannabis, marijuana, CBD, and THC, and about taking medicines while you are pregnant.

• What You Need to Know About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD:
https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

• Medicine and Pregnancy:
https://www.fda.gov/consumers/womens-health-topics/medicine-and-pregnancy

• FDA Regulation of Cannabis and Cannabis-Derived Products: Questions and Answers:
https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd

• U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain:
https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-marijuana-use-and-developing-brain/index.html