Can I use CBD during pregnancy & breastfeeding?

With the rise in popularity of cannabidiol (CBD) and its wide range of applications for a myriad of different symptoms and conditions, a lot of pregnant women and new mothers are considering using it to treat everything from breast tenderness to post partum depression.

However, as a pregnant woman or breastfeeding mother, you are very much aware of what you put into your body because of the effect it can have on your unborn child or newborn baby, begging the question: “Is CBD safe? And is it safe to use CBD during pregnancy and/or while breastfeeding?”

The warnings & Concerns of FDA about cannabinoids use during pregnancy

The United States Food and Drug Administration (FDA) is probably the most outspoken in its anti-cannabis and anti-CBD views, having released several statements with regard to using cannabis-derived products while pregnant and/or breastfeeding that strongly advises against doing so. They site recent statements made by the U.S. Surgeon General (USGS) that forewarned women of the dangers of using tetrahydrocannabinol (THC) during pregnancy and/or while breastfeeding.

As it turns out, research suggests that THC, a compound found in cannabis, can enter the fetal brain from the mother’s bloodstream which may increase the risk of premature birth, potential stillbirth, lowered birth weight as well as negatively affect fetal brain development. Similarly, research also shows that breastmilk can contain THC for up to six days, and breastfeeding while using cannabis may affect a newborn’s brain development that can result in long-term, negative developmental consequences such as hyperactivity and poor cognitive function.

But Are these warnings legitimate?

Because of the essential involvement of the endocannabinoid system in pre- and post-natal development, there are of course a legitimate concerns about introducing phytocannabinoids into the fragile system. But, are the warning and concerns over the use of cannabinoids during pregnancy and while breastfeeding legitimate? Is CBD really the same as THC and is it fair to draw direct parallels between these two cannabinoids regarding their safety?

The one thing that the majority of the concerns and warnings by watchdog organizations like the FDA and USGS have in common is that they are related to cannabis and cannabis-based products that contain THC. In fact, the only (legitimate) warning voiced by the FDA are not regarding CBD per se, but the safety and quality of certain CBD products that can include potentially harmful substances like synthetic CBD and THC, as well as contaminants such as pesticides, heavy metals, bacteria, and fungi - all of which may pose a risk to the fetus or breastfed infant. However, these concerns are easily mitigated by using a high quality, natural and pure CBD product.

When it comes to the safety profile of CBD as a compound on the pregnant mother, developing fetus or breastfed baby, the FDA admits that there is no comprehensive body of research to date that has studied its effects exclusively. Instead, it seems that the FDA and others like them are basing their views on what we know about THC and simply painting CBD with the same brush. But is this justified?

How CBD is different from THC

The way in which THC produces its effects in the body is by rapidly binding to the CB1 and CB2 cannabinoid receptors in the endocannabinoid system (ECS), mimicking or blocking the actions of other neurotransmitters and preventing them from doing their job properly. It is this binding action of THC that causes many of the intoxicating effects of THC and also why it affects so many systems throughout the body - from motor skills to cognitive function.

In contrast, CBD is what is called a pleiotropic compound, referring to its ability to produce homeostatic (i.e., balancing and normalizing) effects through multiple molecular pathways. The reason why CBD is able to do this is because CBD modulates, but does not bind to the CB1 and CB2 cannabinoid receptors, or any of the several other non-cannabinoid receptors and ion channels it interacts with. CBD also has the ability to enhance, inhibit and/or delay the “reuptake” of neurotransmitters and certain G-protein coupled receptors that results in inducing a state of homeostasis within the body.

From just this basic explanation it is evident that THC and CBD are two very different compounds that work completely differently and produce completely different effects. Whereas THC binds to the cannabinoid receptors and potentially throw physiological systems out balance, CBD has little to no binding affinity, and instead balances and harmonizes various systems within the body.

Why This Difference should Matter to pregnant & breastfeeding women

As mentioned earlier, there seems to be this general idea in the medical community that can basically be boiled down to the following: Although we don’t know much about using CBD during pregnancy or breastfeeding, we do know that using THC during pregnancy could be dangerous. Because THC and CBD are both cannabinoids found in the cannabis plant, CBD must also therefore be potentially dangerous and not worth the risk.

However, this thinking is a bit like throwing the baby out with the bathwater and one should not, and cannot, simply draw direct parallels between what we know about THC and apply it to CBD as they are very different molecules that interact very differently with the physiological systems within the body. For instance, CBD also does not produce the intoxicating or harmful developmental effects associated with THC. Similarly and in contrast to THC, CBD has repeatedly been shown as a safe and highly tolerated compound in both children and adults - even at high dosages.

So, if we can’t equate the effects, safety profile and potential harms of THC with CBD when it comes to the human fetus or healthy human newborns, what do we know about CBD? And, is it safe to use while pregnant or breastfeeding?

What do we & don’t we know about CBD during pregnancy?

The truth of the matter is that there is very little research available on the effects and safety of CBD on fetal and neonatal development when used while pregnant or breastfeeding. That said, there are a handful of studies that have been done and from which we can make inferences as to whether or not CBD is safe to use by expectant and breastfeeding mothers.

CBD and Pregnancy

For instance, there are a couple of studies that have looked into the effects of CBD on placenta. Although the study found that CBD can cause placenta to become more malleable (which can potentially be dangerous to the fetus) the researchers were also applying large amounts of CBD constantly over a 24 to 72 hour period to placenta. This brings into question the validity of these results in a real world setting as expectant mothers would be taking CBD in much smaller doses, spaced out over a longer periods of time.

When considering the effects of cannabinoids on fetal development, to date, most of the research that is available focusses on cannabis use and THC. However, one study did investigate the effect of maternal CBD exposure during pregnancy in mice. The data indicated that high doses of CBD can produce long-term disruption of testicular function, a reduction in spermatogenesis as well as other steroidogenic components. However, one mouse study is not definitive, nor can it be generalized to humans. As the saying goes, mice are not men.

CBD and Newborns

Researchers have been investigating the use of CBD for the treatment of something called perinatal acute ischemic stroke, an acquired neonatal brain injury that causes unilateral cerebral palsy, learning difficulties and cognitive deficits later in life.

During their investigations, these scientists found that, 1mg/kg dosages of CBD in human newborns who suffered an acute hypoxic-ischemic brain injury proved safe, while also demonstrating neuroprotective effects, reducing excitotoxic damage, oxidative stress and inflammation for up to 7 days after injury. Similarly, newborn rats showed reduced peri-infarct brain-damage and restored neurobehavioral function when given a dose of 5 mg/kg of CBD, and that even at this high dose, it was also perfectly safe to do so.

CBD and Breastfeeding

Pregnancy recommendations with regard to what to eat or drink and what medications are safe to take, leave many women to be fraught with caution and fear as everything they consume has the potential to pass through their breastmilk and onto their baby. And, the same goes for CBD.

Unfortunately, we don’t know if CBD is passed through breast milk, and if it does, how long it remains present and detectable. However, considering that breastmilk contains natural endocannabinoids produced by the body’s own endocannabinoid system with CBD also proving as potentially safe for infants, using CBD while breastfeeding is probably not going to be an issue at all.

Final Thoughts:

What does All this mean for pregnant & Breastfeeding Women? Although some inferences can be made with regard to the safety of CBD during pregnancy and breastfeeding from what we do know about the way in which CBD interacts with the body, it is important to realize that the research simply does not exist to absolutely know how CBD affects a human fetus or healthy human newborns.

However, the studies that have been done suggest that CBD is likely to be safe for newborns and as such is probably safe to use by mothers while breastfeeding, if not during pregnancy. In addition, when considering the general safety profile of CBD in children and adults, the chances are that using a high quality, broad-spectrum CBD oil or product as directed will not be harmful to your developing fetus or newborn child.

That said, because there is no absolute or conclusive evidence to support an answer as to whether or not CBD is really safe during pregnancy and breastfeeding, coupled with the fact that we are all different and react to CBD differently, always speak to your doctor before using CBD oil, especially if you’re pregnant or a new mother.