Cannabis, Birth Trauma, Oxytocin and Stress: Impacts on Pregnancy and Lactation

3 Featured Presentations:

1. Cannabis Use During Pregnancy and Breastfeeding:
1 L-CERP: Pharmacology and Toxicology - Cannabis

The rates of cannabis use among pregnant and breastfeeding women range from 5% to 5.7%. However, rates are significantly higher, ranging from 27% to 83% when considering other risk factors, such as unplanned pregnancy, lack of exercise, and 3 or more stressors in the past year. If women use cannabis during pregnancy, they are likely to continue using it while breastfeeding, which raises several concerns. Is breastfeeding contraindicated? If the mother is breastfeeding, how much cannabis transfers into milk and the baby? Are the parents impaired while using? Is the baby in danger? This session addresses these important questions and offers suggestions for creating a safe environment for mothers to discuss their cannabis use so we can help her plan for infant safety. If mothers cannot abstain, practitioners should focus on harm reduction, while considering “how much is too much.” Some harm-reduction strategies include addressing the underlying reasons for mothers’ cannabis use (such as trauma, depression, or anxiety) with referrals to supportive services. Can mothers use CBD products instead of cannabis? Can they use edibles instead of smoking or inhaling it? Is the infant in a safe sleep location? For heavy cannabis users, breastfeeding is contraindicated. The most important goals are ensuring infant safety, caring for the mother, supporting breastfeeding (when possible), and facilitating mother-infant attachment.

2. Does Breastfeeding Protect Maternal Mental Health? The Impact of Oxytocin and Stress:
1 L-CERP: Psychology, Sociology, and Anthropology - Maternal Mental Health

Breastfeeding and depression have a complicated relationship. On one hand, mothers who are depressed are less likely to initiate or continue breastfeeding. On the other hand, exclusively breastfeeding mothers are less likely to be depressed. To understand this apparent contradiction, it’s important to understand the underlying physiology of the stress vs. oxytocin response. Oxytocin suppresses the stress response, providing protection for the mother. Conversely, stress suppresses oxytocin, which makes both depression and breastfeeding difficulties more likely. Birth interventions also have a role in activating this system. This session describes oxytocin vs. stress and then applies this knowledge to recent studies to understand whether breastfeeding actually protects maternal mental health.

3. Birth Trauma: Causes and Consequences of Birth-Related PTSD:
1.5 L-CERPs: Psychology, Sociology, and Anthropology - Maternal Psychological/Cognitive Issues / Birth Practices

Trauma after birth is unfortunately quite common around the world. So much so that the World Health Organization has highlighted the problem of women receiving abusive or trauma-production care during labor and postpartum. In fact, recent studies have found that as many as 1 in 4 women have symptoms of posttraumatic stress disorder (PTSD) following their births. Many more experience depression or anxiety. What types of symptoms do they have and how do these symptoms impact breastfeeding and women’s emotional health? In this session, you will learn about the DSM-5 criteria for PTSD and why some types of births are more likely to cause symptoms. You will also learn how these symptoms might impact breastfeeding, and what mothers and practitioners can do to help.

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