Marijuana vs CBD in Pregnancy: What's Safer?
Neither marijuana nor CBD is proven safe in pregnancy. CBD is not risk-free, and no cannabis product is recommended while pregnant.
Cannabis use during breastfeeding is not considered safe. THC, the main psychoactive compound in cannabis, passes into breast milk, and health agencies including the CDC and ACOG advise avoiding cannabis while nursing because the effects on infants are not well understood.
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How does THC get into breast milk?
THC is fat soluble. It moves into breast milk and can be stored in body fat, so it may be detectable in milk for days after use, not just hours. The amount that reaches an infant depends on dose, frequency, route of use, and how the person's body processes cannabis. No safe level has been established for infants, and there is no standard waiting period that makes use risk-free.
Cannabis Use During Pregnancy: Third Trimester Guide
What risks are linked to infant exposure?
Research in humans is limited, so most guidance is cautious. Reported concerns include:
- Sedation, drowsiness, or irritability in the infant
- Poor feeding or weight gain concerns
- Possible effects on the developing brain from THC exposure, based on animal and observational data
- Exposure to smoke and secondhand cannabis smoke, which irritates infant airways
- Impaired caregiver judgment and coordination, which raises the risk of unsafe sleep or feeding practices
Health agencies note that the long-term outcomes of infant THC exposure through breast milk are not known. That uncertainty is a key reason for the recommendation to avoid use.
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Do edibles, CBD, and topicals carry the same risk?
Edibles and tinctures still contain THC unless they are labeled THC-free, and labels are not always accurate. CBD products are not tightly regulated and may contain THC. Topical creams and balms have low absorption, but they should not be applied to the nipple or breast area where the baby could ingest them. Smoking and vaping add respiratory risks for the baby and expose the household to smoke.
If you use cannabis and are breastfeeding
Clinical guidance is to stop cannabis use during lactation. If you used cannabis before you knew you were breastfeeding, or if you are struggling to stop, take these steps:
- Talk with your obstetric clinician, pediatrician, or a lactation consultant about your options.
- Do not share a bed or sofa with the baby if you feel impaired, and avoid handling the baby alone when drowsy.
- Watch the infant for sleepiness, feeding problems, or unusual behavior, and report concerns to a pediatrician.
- Avoid smoking or vaping around the baby, and change clothing after use.
- Ask about non-THC options for symptoms such as pain, anxiety, or sleep problems.
There is no evidence that pumping and dumping or a fixed waiting period removes the risk. THC can remain in milk and in the body for days.
What do health agencies recommend?
The CDC advises against using cannabis while breastfeeding. ACOG recommends that people who are lactating avoid cannabis. LactMed, a database from the National Library of Medicine, notes that THC is detectable in breast milk and recommends monitoring the infant for sedation and poor feeding if exposure occurs. These sources agree that more research is needed, and that caution is warranted.
Bottom line
Cannabis and breastfeeding risks are not fully mapped, but the known transfer of THC into milk and the lack of a safe infant dose are enough for major health organizations to advise against use. If you need help stopping or managing symptoms, talk with a clinician who can review your situation.