Moss Michael J, Bushlin Ittai, Kazmierczak Steven, Koop Dennis, Hendrickson Robert G, Zuckerman Katharine E, Grigsby Tamara M
Utah Poison Control Center, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
Division of Emergency Medicine, University of Utah, Salt Lake City, UT, USA.
Pediatr Res. 2021 Oct;90(4):861-868. doi: 10.1038/s41390-020-01332-2. Epub 2021 Jan 19.
Information on cannabinoids in breast milk and maternal cannabis use is limited. We quantified cannabinoids in plasma and breast milk of breastfeeding mothers and assessed cannabis use patterns.
This is a prospective study at a university hospital in a state with legal medical and recreational cannabis. Breast milk and plasma samples along with survey data were collected from volunteers using cannabis in the last 48 h at 2 weeks and 2 months postpartum.
Twenty subjects were enrolled. Median age (IQR) was 27 (24-34) years. Median (IQR) instances of cannabis use in the last 7 days were visit 1: 17 (6-29) and visit 2: 23 (15-45). Median (IQR) tetrahydrocannabinol (THC) concentrations were: plasma 3.7 ng/ml (0.8-56.8) and breast milk 27.5 ng/ml (0.8-190.5). Median (IQR) cannabidiol (CBD) concentrations were: plasma 0.6 ng/ml (0.5-6.4) and breast milk 1.2 ng/ml (0.5-17.0). Median (IQR) THC M/P: 7.0 (1.8-34.6) and CBD M/P: 2.6. Median breast milk THC concentration increased from visit 1 to visit 2 by 30.2 ng/ml (95% CI 3.05-69.3 ng/ml).
THC and CBD accumulate in breast milk. Breastfeeding mothers used cannabis frequently and increased use in the early postpartum period. Research on the effects of infant exposure to cannabinoids in breast milk is urgently needed.
Cannabis use is increasing in the general population and many nursing mothers use cannabis. THC has been previously detected in breast milk but little is known on how it concentrates relative to plasma. Data on cannabinoids other than THC, reasons for cannabis use, and patterns of use in breastfeeding women are also limited. We detected THC and CBD in breast milk. Both concentrate in breast milk relative to plasma. We showed that breastfeeding mothers increased cannabis use in the weeks after childbirth. Further research is needed to evaluate infant exposure to cannabinoids via breast milk and effects on infant health.
关于母乳中的大麻素以及母亲使用大麻的信息有限。我们对母乳喂养母亲的血浆和母乳中的大麻素进行了定量分析，并评估了大麻的使用模式。
这是一项在一个医用大麻和娱乐用大麻均合法的州的大学医院进行的前瞻性研究。在产后2周和2个月时，收集了过去48小时内使用过大麻的志愿者的母乳和血浆样本以及调查数据。
招募了20名受试者。中位年龄（四分位间距）为27（24 - 34）岁。过去7天内大麻使用的中位（四分位间距）次数为：访视1：17（6 - 29）次，访视2：23（15 - 45）次。中位（四分位间距）四氢大麻酚（THC）浓度为：血浆3.7 ng/ml（0.8 - 56.8），母乳27.5 ng/ml（0.8 - 190.5）。中位（四分位间距）大麻二酚（CBD）浓度为：血浆0.6 ng/ml（0.5 - 6.4），母乳1.2 ng/ml（0.5 - 17.0）。中位（四分位间距）THC的母乳与血浆浓度比（M/P）为7.0（1.8 - 34.6），CBD的M/P为2.6。母乳中THC的中位浓度从访视1到访视2增加了30.2 ng/ml（95%置信区间3.05 - 69.3 ng/ml）。
THC和CBD在母乳中蓄积。母乳喂养的母亲频繁使用大麻，且在产后早期使用量增加。迫切需要对婴儿接触母乳中大麻素的影响进行研究。
普通人群中大麻的使用正在增加，许多哺乳期母亲使用大麻。此前已在母乳中检测到THC，但对于其相对于血浆的浓缩情况知之甚少。关于除THC之外的大麻素、大麻使用原因以及哺乳期妇女的使用模式的数据也很有限。我们在母乳中检测到了THC和CBD。两者在母乳中的浓度均高于血浆。我们发现母乳喂养的母亲在产后几周内大麻使用量增加。需要进一步研究来评估婴儿通过母乳接触大麻素的情况及其对婴儿健康的影响。
