Transfer of Inhaled Cannabis Into Human Breast Milk
Teresa Baker ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Baker+T&cauthor_id=29630019[/url]) 1 ([url]https://pubmed.ncbi.nlm.nih.gov/29630019/#affiliation-1[/url]), Palika Datta ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Datta+P&cauthor_id=29630019[/url]), Kathleen Rewers-Felkins ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Rewers-Felkins+K&cauthor_id=29630019[/url]), Heather Thompson ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Thompson+H&cauthor_id=29630019[/url]), Raja R Kallem ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Kallem+RR&cauthor_id=29630019[/url]), Thomas W Hale ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Hale+TW&cauthor_id=29630019[/url])
Affiliations expand
- PMID: 29630019
- DOI: 10.1097/AOG.0000000000002575 ([url]https://doi.org/10.1097/aog.0000000000002575[/url])
Objective: To evaluate the transfer of delta-9-tetrahydrocannabinol and its metabolites into human breast milk after maternal inhalation of 0.1 g cannabis containing 23.18% delta-9-tetrahydrocannabinol.
Methods: In this pilot pharmacokinetic study, breast milk samples were collected from mothers who regularly consumed cannabis, were 2-5 months postpartum, and exclusively breastfeeding their infants. Women were anonymously recruited for the study. After discontinuing cannabis for at least 24 hours, they were directed to obtain a baseline breast milk sample, then smoke a preweighed, analyzed, standardized strain of cannabis from one preselected dispensary, and collect breast milk samples at specific time points: 20 minutes and 1, 2, and 4 hours. Quantification of delta-9-tetrahydrocannabinol and its metabolites in these collected breast milk samples was performed by high-performance liquid chromatography tandem mass spectrometry.
Results: A total of eight women were enrolled. Most were occasional cannabis smokers and one a chronic user. Delta-9-tetrahydrocannabinol was detected at low concentrations at all the time points beyond time zero. No metabolites were detected at any time point. Delta-9-tetrahydrocannabinol was transferred into mother's milk such that exclusively breastfeeding infants ingested an estimated mean of 2.5% of the maternal dose (the calculated relative infant dose=2.5%, range 0.4-8.7%). The estimated daily infant dose was 8 micrograms per kilogram per day.
Conclusion: This study documents inhaled delta-9-tetrahydrocannabinol transfer into the mother's breast milk. Low concentrations of delta-9-tetrahydrocannabinol were detected. The long-term neurobehavioral effect of exposure to delta-9-tetrahydrocannabinol on the developing brain is unclear. Mothers should be cautious using cannabis during pregnancy and breastfeeding.
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