A survey of 69 US hospital nurseries found 16% restrict breastfeeding for mothers who test positive for cannabis, with highly variable practices unrelated to state legalization status or provider knowledge.
People interested in cannabis use during pregnancy and lactation, and how hospitals handle the issue.
16% of hospitals restrict breastfeeding for THC-positive mothers
What the researchers found
For mothers with a positive cannabinoid screen at delivery, 16% of hospitals universally or selectively restrict breastfeeding. 96% of nursery directors considered marijuana use while breastfeeding somewhat (70%) or very (26%) harmful. No consistent associations were found between breastfeeding restrictions and provider knowledge, geographic region, or state legalization status.
Why it matters
Inconsistent hospital policies mean that whether a cannabis-using mother can breastfeed depends largely on which hospital she delivers at, not on evidence. This variability raises equity concerns and highlights the need for evidence-based national guidelines.
The numbers in context
69 of 110 (63%) nursery directors responded across 38 states. 16% restrict breastfeeding for THC-positive mothers. 96% consider marijuana use during breastfeeding harmful. 70% "somewhat harmful," 26% "very harmful."
How the study worked
Cross-sectional survey of 110 US hospital nursery directors in the Academic Pediatric Association BORN network. 69 (63%) responded across 38 states. The 31-question survey assessed policies, knowledge, and attitudes regarding marijuana use and breastfeeding.
What this study cannot tell us
Only BORN network hospitals surveyed, which may not represent all US hospitals. 63% response rate introduces potential selection bias. Director-reported policies may not reflect actual clinical practice. Survey did not assess outcomes for infants.
How to read the evidence
National survey of academic hospital nurseries with a 63% response rate. Provides a snapshot of current practices but cannot assess whether those practices are evidence-based or affect outcomes.
When this study was published
Published in 2024 in Pediatrics.
The bigger picture
Breastfeeding provides well-established health benefits for infants, and restricting it has consequences. Without clear evidence-based guidelines on cannabis and breastfeeding, hospitals are making policy in a vacuum, leading to inconsistent care that may disproportionately affect certain populations.
Questions still open
- What evidence would be needed to develop national breastfeeding guidelines for cannabis-using mothers? Do breastfeeding restrictions change maternal cannabis use behavior? Are infants exposed through breast milk at clinically meaningful THC levels?
Common questions
Can you breastfeed if you use cannabis?
Do doctors think cannabis during breastfeeding is harmful?
Read the original research
Marijuana Use and Breastfeeding: A Survey of Newborn Nurseries.
Pediatrics, 153(2)
Citation
Chang, Pearl W; Goyal, Neera K; Chung, Esther K. (2024). Marijuana Use and Breastfeeding: A Survey of Newborn Nurseries.. Pediatrics, 153(2). https://doi.org/10.1542/peds.2023-063682
Explore the wider topic
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