Among 200,207 pregnancies, prenatal cannabis use was associated with stopping breastfeeding earlier and lower breastfeeding rates at 6 and 12 months, with stronger effects for more frequent use.
Lactation consultants, OB-GYNs, new mothers who use cannabis, and pediatricians advising on infant feeding.
What the researchers found
While breastfeeding initiation was similar across groups (90-96%), prenatal cannabis users were 12% more likely to stop breastfeeding earlier (aHR = 1.12) and had 16-19% lower breastfeeding prevalence at 6 and 12 months. Preconception-only use showed minimal differences.
Why it matters
Breastfeeding provides significant health benefits for both mother and infant. Understanding that prenatal cannabis use is associated with earlier discontinuation can help lactation consultants provide targeted support.
The numbers in context
200,207 pregnancies. 7.6% preconception cannabis only, 7.2% prenatal use. 94.6% initiated breastfeeding. Prenatal use: aHR for stopping = 1.12 (95% CI: 1.09-1.15). 6-month aPR = 0.84, 12-month aPR = 0.81.
How the study worked
Population-based retrospective cohort of 200,207 pregnancies in Northern California (2016-2022) with universal early pregnancy screening, tracking longitudinal breastfeeding outcomes at well-child visits through the first year.
What this study cannot tell us
Observational study cannot determine causation. Cannabis users may differ in other ways that affect breastfeeding. Cannot distinguish whether healthcare providers discouraged breastfeeding in cannabis users.
How to read the evidence
Very large population-based cohort with universal screening and longitudinal tracking — strong evidence for the association, though causation cannot be established.
When this study was published
Recent study from 2016-2022 providing the largest analysis to date of cannabis use and breastfeeding outcomes.
The bigger picture
The relationship between cannabis use and breastfeeding is nuanced — most users still initiate breastfeeding, but continue for shorter durations. This suggests barriers to sustained breastfeeding rather than lack of intention.
Questions still open
- Are cannabis-using mothers discontinuing by choice, due to provider advice against breastfeeding while using, or due to other factors? Should lactation support be enhanced for cannabis-using mothers?
Common questions
Should women who use cannabis breastfeed?
Does using cannabis only before pregnancy affect breastfeeding?
Read the original research
Association of Preconception and Prenatal Cannabis Use With Breastfeeding.
American journal of preventive medicine, 69(6), 107964
Citation
Young-Wolff, Kelly C; Adams, Sara R; Homsley, Kenya J; Alexeeff, Stacey E; Gunderson, Erica P; Does, Monique B; Ansley, Deborah; Castellanos, Carley; Haley, Erica; Avalos, Lyndsay A. (2025). Association of Preconception and Prenatal Cannabis Use With Breastfeeding.. American journal of preventive medicine, 69(6), 107964. https://doi.org/10.1016/j.amepre.2025.107964
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