Is CBD Oil Safe to Use While Pregnant or Breastfeeding?

When asked, somewhere between two to five out of every 100 people report using marijuana during pregnancy. The number of pregnant people using marijuana and CBD is likely much higher. Unfortunately, many people mistakenly believe CBD is safe (or safer) to use while pregnant or breastfeeding. It is easy to make this mistake – it seems like CBD is the miracle cure added to everything today. Just because it is legal to sell CBD products does not mean it is safe, especially if you are pregnant or breastfeeding. It is also not true that putting CBD on your skin in a cream or oil won’t potentially harm your baby. It turns out we know very little about CBD’s safety during pregnancy or while breastfeeding.

What is CBD?

Marijuana is a mixture of dried flowers, leaves, buds, and stems of the Cannabis sativa or Cannabis indica plants, also called hemp. Hundreds of different chemicals called cannabinoids (CBD) are found in marijuana. Manufacturers extract and refine CBD oil using ethanol. Refined CBD oil can then be added to any number of the products you have seen on a shelf near you – pills, gels, gummies, vape oils, creams, and oral tinctures, just to name a few.

How is CBD different from Tetracannabinol (THC)?

Delta-9-tetrahydrocannabinol (THC) is just one of the 80-100 cannabinoid chemicals found in marijuana. THC causes the “high” associated with marijuana and is considered a psychoactive drug. Smoking, eating, or vaping THC affects how you feel and how your brain works, changing how you see, hear, and feel things. CBD does not.

THC can only be extracted from marijuana, whereas CBD can also come from hemp and marijuana. CBD harvested from marijuana may contain more THC than CBD harvested from hemp. Manufacturers commonly choose hemp for their CBD source to avoid contaminating CBD (called cross-contamination) with unwanted THC.

Possible Uses for CBD Oil During Pregnancy and Breastfeeding

When celebrities and marketers promote CBD as the “natural cure” of the moment, it can be confusing. Unfortunately, just because CBD comes from a plant does not mean that it is safe for a developing fetus or your newborn to drink in breastmilk. Some of our most lethal or toxic substances are natural and come from plants (think tobacco or the deadly nightshade belladonna plant).

CBD and some of its brother and sister cannabinoids do show promise for treating some common pregnancy and postpartum discomforts such as:

Concerns about CBD’s Safety for Pregnant and Breastfeeding People

At this time, the U.S. Food and Drug Administration (FDA) strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding. In addition, the American College of Obstetricians and Gynecologists (ACOG), March of Dimes, and Centers for Disease Control have issued similar statements of concern.

What little safety evidence and data we have on marijuana and pregnancy do not look good.

  • THC crosses the placenta. The more a pregnant person uses marijuana, the higher the THC levels in the fetus’s bloodstream and the placenta.
  • Marijuana smoke contains many of the same toxins as tobacco smoke, and sometimes in higher concentrations, especially when vaped.
  • Breastmilk can contain THC for up to six days after use.
  • THC in breastmilk can affect newborn brain development.
  • Children exposed to marijuana during pregnancy or in breastmilk show hyperactivity, autism, poor cognitive function, impaired immune function, and other long-term consequences.

As you can see from the list above, we know much more about the harmful role of THC and marijuana than we do about CBD alone. But just because we don’t have direct evidence of CBD’s harm to a developing fetus or breastfeeding baby does not mean that it is safe.

Side effects of CBD use

Most of the buzz around CBD oil is positive, but dig a bit deeper, and you will see some people reporting some not-so-great side effects of using CBD oil. These side effects can depend on how you ingest the CBD, how much and how often you use CBD, and if it is cross-contaminated with THC or any other substances. People report that CBD can cause:

  • Changes in mood and appetite
  • Drowsiness
  • Feelings of anxiety or other mood changes
  • Nausea and dizziness
  • Diarrhea

Pregnant or postpartum people may already be experiencing these side effects without even using CBD oil. So, you might want to think twice about whether CBD oil will make things better or only worse.

Remember that the U.S. Food and Drug Administration (FDA) does not regulate products made with CBD oil. Unlike the pills or other prescriptions you take, CBD products are not checked for the dose of CBD they contain, how much THC they might have, or any other potentially harmful substances such as bacteria, chemicals, mold, or pesticides. So who knows if your CBD side effects are caused by cross-contamination from a less-than-sanitary factory or by CBD itself? In other words, there is no quality control for CBD products, so buyers beware.

Unanswered Questions About CBD’s Safety

The reality is that comprehensive research studying the effects of CBD on the developing fetus, pregnant mother, or breastfed baby does not exist.

We don’t know the impact of CBD. There are some other pretty big unanswered questions when it comes to CBD’s safety for pregnant and breastfeeding people:

  • Are there any long-term effects of CBD exposure during pregnancy on a developing fetal brain or neurological system?
  • Are there any negative pregnancy consequences of using CBD during pregnancy, such as preterm labor, low birth weight, or stillbirth (seen with THC)?
  • Is CBD absorbed and processed differently in pregnant people compared to non-pregnant people?
  • Is CBD more harmful to pregnant or breastfeeding moms depending on how it is consumed (eaten, smoked, vaped, or rubbed on in a cream or oil)?
  • Is using cross-contaminated CBD in pregnancy or while breastfeeding risky? How much THC is needed to have a harmful effect?
  • Is there a “safe” level of CBD that can be used during pregnancy or while breastfeeding?

Not Enough Known About CBD’s Safety

Even with all of these unknowns, it can be tempting to turn to a “natural” option for easing some of your pregnancy or postpartum discomforts. But, the reality remains that there are absolutely no published studies on the safety of CBD oil in human pregnancy or breastfeeding. So, until that data is available, stick with what we know best.

Your safest bet will be the time-tested, better-researched treatments. These include physical therapy, massage, mental health counseling, antidepressants, and some over-the-counter medications like Ibuprofen or Paracetamol. While some new parents dislike the idea of taking medications while pregnant or breastfeeding, prescription medications are much better studied and produced in safer factory conditions without the possibility of contamination. Also, because those medications are better studied, doctors know better what to expect in terms of side effects.

Your health care provider can help talk with you more about your pregnancy or postpartum discomforts and how to feel better. Be honest with your provider about your marijuana or CBD use so that they take the best care of you and your baby. They will be able to talk with you about any safety concerns and the latest research findings on the safety of CBD oil.

Amy Harris
Amy Harris is a certified nurse-midwife with a Master's Degree in Maternal and Child Health from Harvard Chan School of Public Health. Her passions are health literacy and women's reproductive health. A recent two-year sabbatical with her family in Spain was the impetus for becoming a freelance women's health writer. An exercise nut, she is happiest outdoors and on adventures abroad.

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