ACOG has issued new guidelines on the use of cannabis during pregnancy and breastfeeding.
The prevalence of cannabis use — medicinal or recreational — among pregnant and lactating individuals ranges from 3.9% to 16.0% according to ACOG.
Most commonly, cannabis is used in the first trimester to treat pre-existing medical conditions, as well as pregnancy-related symptoms like nausea, vomiting, stress, and weight gain. Some researchers believe that cannabis may be linked to nausea and vomiting during pregnancy.
ACOG now recommends universal screening of cannabis during pre-pregnancy, in pregnancy and after delivery. College of Physicians and Surgeons has expressed concerns that despite the fact cannabis has been linked to spontaneous preterm delivery, low birthweight, NICU admissions and neurocognitive or behavioral disorders postnatally, there is still a misconception among the public about its safety during pregnancy.
Melissa Russo MD FACOG is the co-author of these updated guidelines. She said, “We are still learning about the effect of cannabis on the placenta, the fetal development and growth, as well as the physical and mental long term health and wellbeing of the child.”
ACOG states that obstetricians should inform their patients about the medical inconsistencies of cannabis during pregnancy or postpartum. Breastfeeding:
We want to discourage the use of marijuana during breastfeeding, but continuing to use it is not contraindicated to nursing.” said Amy Valent is a DO, FACOG, and the co-author of this guidance. The guidance states that patients should be encouraged who are interested in breastfeeding because it offers many benefits to the infant.
ACOG encourages screening patients but also warns against racism, structural biases and reporting obligations.
Valent said that “institutional and state policy can differ, and we need to be familiar with these policies as well as the legal implications and possible effects of testing on our patients and families.”
ACOG’s guidelines on cannabis and breastfeeding during pregnancy can be found here.
In the past year we published an update systematic review and meta analysis of dozens or studies, which showed that using cannabis during pregnancy may have harmful outcomes for neonates.
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