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Study breakdown

NICU Policies on Cannabis and Breastfeeding Vary Widely Across the US

Cross SectionalModerate evidence
The takeaway

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?
No. This survey found no significant association between state cannabis legalization status and whether NICUs restricted breast milk feeding from THC-positive mothers.
What do national guidelines say?
Current national medical organization guidelines recommend education and shared decision-making with mothers about cannabis use and breastfeeding, rather than blanket restrictions on breast milk feeding.

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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