A survey of 187 NICUs found that 60% of those addressing THC exposure limited breast milk feeding for cannabis-positive mothers, with no consistency based on state legalization status.
NICU nurses and neonatologists, breastfeeding advocates, hospital policy makers, cannabis-using new parents
60% of NICUs with THC policies limited breast milk feeding
What the researchers found
79% of surveyed NICUs used selective toxicology screening based on risk factors or provider discretion. Among NICUs with THC-specific policies, 60% imposed at least one limitation on breast milk feeding from THC-positive mothers, ranging from total prohibition to waiting for a negative test. State cannabis legalization status had no significant association with policy strictness.
Why it matters
Inconsistent NICU policies mean that whether a cannabis-using mother can breastfeed her NICU infant depends more on which hospital she delivers at than on evidence or state law. This affects maternal bonding and infant nutrition.
The numbers in context
187 NICUs surveyed. 79% used selective screening. 60% with THC policies had at least one breast milk limitation. 33% had different policies between NICU and nursery within the same institution. No significant association between state legalization and MBM limitations.
How the study worked
Cross-sectional survey of 187 US NICUs assessing policies on toxicology screening of mother-baby dyads and breast milk feeding limitations based on THC screening status. Compared policies across different state legalization categories.
What this study cannot tell us
Survey response may not represent all US NICUs. Self-reported policies may differ from actual practice. Did not assess patient outcomes under different policies.
How to read the evidence
Moderate: nationwide survey of institutional policies, but limited by self-reporting and lack of outcome data
When this study was published
Published in 2025
The bigger picture
The disconnect between cannabis legalization and hospital policies reflects the limited evidence on THC in breast milk. National medical organizations recommend education and shared decision-making rather than blanket restrictions, but policies have not caught up.
Questions still open
- Do breast milk feeding restrictions for THC-positive mothers affect neonatal outcomes? Would standardized national guidelines reduce the policy variation?
Common questions
Does cannabis legalization affect NICU breastfeeding policies?
What do national guidelines say?
Read the original research
Toxicology Screening for Marijuana and Impact on Breast Milk Feeding Policies in Neonatal Intensive Care Units.
Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 20(8), 567-572
Citation
Bae, Sarra; Schofield, Erin M; Davis, Natalie L. (2025). Toxicology Screening for Marijuana and Impact on Breast Milk Feeding Policies in Neonatal Intensive Care Units.. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 20(8), 567-572. https://doi.org/10.1089/bfm.2025.0064
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