All Recreational Drugs Including Marijuana Enter Breast Milk and Can Affect Nursing Infants | Research

The takeaway

A review found that alcohol, caffeine, nicotine, and marijuana all enter breast milk to some extent and can affect both milk production and the nursing infant, recommending mothers restrict intake of all these substances.

Read this if you are breastfeeding and want to understand how cannabis and other substances affect breast milk and your baby.

All four substances enter breast milk and can affect the nursing infant

What the researchers found

This review examined the evidence on four commonly used recreational substances and their effects on breastfeeding, combining published research with reports from breastfeeding counselors.

All four substances, alcohol, caffeine, nicotine, and marijuana, enter breast milk. Each can potentially affect milk production, volume, composition, and the milk ejection reflex. Each can also directly affect the infant.

The review recommended that breastfeeding mothers restrict their intake of all four substances. However, the authors acknowledged the practical challenge: the postpartum period is stressful, and mothers may need support and practical strategies rather than simple prohibitions to limit infant exposure.

Why it matters

By reviewing marijuana alongside alcohol, caffeine, and nicotine, this paper contextualized cannabis exposure during breastfeeding within the broader picture of commonly used substances. The practical, supportive approach to harm reduction was notable for its era.

The numbers in context

Four substances reviewed: alcohol, caffeine, nicotine, marijuana. All enter breast milk. All can affect milk production and the infant.

How the study worked

Narrative review combining published literature with anecdotal reports from Nursing Mothers' Association breastfeeding counselors. Covered alcohol, caffeine, nicotine, and marijuana effects on breastfeeding.

What this study cannot tell us

Combined published evidence with anecdotal counselor reports without distinguishing between them. Did not quantify the relative risk of each substance. The marijuana-specific evidence was particularly limited. Did not address dose-response relationships.

How to read the evidence

A narrative review combining published research with anecdotal reports. Provides an overview but limited by the thinness of available evidence, particularly for marijuana.

When this study was published

Published in 1998. Research on cannabis and breastfeeding has expanded but remains limited. Current guidelines generally recommend avoiding cannabis while breastfeeding.

The bigger picture

Cannabis use during breastfeeding remains an area with limited controlled research. THC is lipophilic and accumulates in breast milk at higher concentrations than in maternal blood. Current clinical guidelines generally recommend against cannabis use while breastfeeding, though the evidence base remains thin.

Questions still open

How much THC transfers to breast milk and at what dose does it affect the infant? How do the risks of marijuana in breast milk compare to the risks of formula feeding? Would occasional versus daily cannabis use produce different outcomes?

Common questions

Does marijuana get into breast milk?

Yes. This review confirmed that marijuana enters breast milk and can potentially affect both milk production and the nursing infant.

Should breastfeeding mothers avoid cannabis?

This review recommended restricting intake of marijuana along with alcohol, caffeine, and nicotine while breastfeeding. Current clinical guidelines generally advise against cannabis use while nursing.

Read the original research

Breastfeeding and the use of recreational drugs--alcohol, caffeine, nicotine and marijuana.

Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia, 6(2), 27-30

View on PubMed ↗

Citation

Liston, J. (1998). Breastfeeding and the use of recreational drugs--alcohol, caffeine, nicotine and marijuana.. Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia, 6(2), 27-30.