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Research Letter
March 8, 2021

Persistence of Δ-9-Tetrahydrocannabinol in Human Breast Milk

Author Affiliations
  • 1Department of Pediatrics, University of Colorado School of Medicine, Aurora
  • 2Obstetrics and Gynecology, University of Utah Health, Salt Lake City
  • 3Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora
  • 4Department of Anesthesiology, University of Colorado School of Medicine, Aurora
JAMA Pediatr. 2021;175(6):632-634. doi:10.1001/jamapediatrics.2020.6098

Δ-9-Tetrahydrocannabinol (THC) crosses the placenta, is highly lipophilic, and can be detected in breast milk.1 National guidelines recommend abstinence from marijuana use during pregnancy and lactation, with limited data regarding the presence of THC in breast milk.2-4 We aimed to estimate the amount and duration of THC excretion in breast milk among women with known prenatal marijuana use.

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    1 Comment for this article
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    The Developing Child At Greatest Risk of Long Term Effects of THC.
    Pamela McColl, BA | Clear The Air Now Canada.
    A 1999 Health Canada risk assessment of THC and other cannabinoids found in foods, cosmetics and nutraceuticals concluded that the greatest risk of long term effects of THC exposure are of neuroendocrine disruption for a developing fetus, nursing infants and prepuberty/pubertal children. The March 2021 Children's Hospital Colorado study adds to the scientific literature with the 1999 findings with the duration THC remains in breastmilk. The Health Canada Risk Assessment of THC concluded that even low levels of THC and other cannabinoids posed potential health risks of neurological impairment and neuroendocrine disruption. The risk assessment further concluded that concern is warranted for THC exposure regarding the developing fetus and nursing infant through maternal use based on the knowledge that THC is rapidly transferred from the mother to the fetus, crossing both the placental and blood brain barriers within minutes of material exposure, and that THC accumulates and is transferred via human breast milk to the infant. The findings of both the 1999 risk assessment and the March 2021 study showing THC should give all mothers to be amble cause to not use THC and other Cannabinoids and for all medical professionals to impart this information with their patients. A copy of the 1999 Health Canada was brought to the attention of the Canadian Minister of Health at the time.
    More women are using marijuana during a pregnancy or while breastfeeding than ever before.
    CONFLICT OF INTEREST: None Reported
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