Is Cannabidiol safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Cannabidiol. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Cannabidiol is a component of cannabis. Cannabidiol has not been studied in nursing women taking the pharmaceutical product (Epidiolex), but it has been detected in the breastmilk of some mothers who used cannabis products.[1-3] Because no published information is available with cannabidiol use as an antiepileptic during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
In published reports of anticonvulsant use during breastfeeding, most women were taking a combination of anticonvulsants. Some other anticonvulsants (e.g., phenytoin, carbamazepine) stimulate the metabolism of other drugs including anticonvulsants, whereas others (e.g., valproic acid) inhibit the metabolism of other drugs. Therefore, the relationship of the maternal dosage to the concentration in breastmilk can be quite variable, making calculation of the weight-adjusted percentage of maternal dosage less meaningful than for other drugs reported in LactMed.
Maternal Levels. Cannabidiol was measured in the milk of mothers who reported using cannabis and donated milk samples. Fifty mothers donated 54 samples of milk to a breastmilk repository. The median concentration of cannabidiol was 5 mcg/L (range 1.3 to 8.6 mcg/L).[2]
A physiologically based pharmacokinetic model of cannabidiol was constructed using data from 181 cannabis-using mothers who donated 200 samples of breastmilk to a breastmilk repository. Of these, 42% had cannabidiol concentration below the level of quantification. Maternal ingestion by oil or pipe tended to result in higher predicted concentrations as compared with joint, blunt or edible forms. The dose in infants was projected to result in exposure of fully breastfed infants of less than 1% of that in children 4 to 10 years old who were receiving the drug therapeutically for seizures.[3]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Cannabidiol is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Cannabidiol” (LM1442). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.