Cannabis in the Perinatal Period with Laurel Wilson EP: 121

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Depression, anxiety and autoimmune symptoms after birth is not how it’s supposed to be. There is a much better way and I’m here to show you how to do just that. Hey, my friend, I’m Miranda Bauer, a mother to four kids and a biology student turned scientist obsessed with changing the world through postpartum care. Join us as we talk to mothers and the providers who serve them and getting evidence-based information that actually supports the mind, body and soul in the years after birth. Hello everyone, welcome to the Postpartum University podcast. Of course, miranda here with you and I have Laurel Wilson with us today. She is a TEDx and international speaker. She’s a women’s health and perinatal specialist, health coach, consultant, educator, author. Two books right the Attachment Pregnancy, the Greatest Pregnancy Ever Highly recommend. Her passion is blending today’s recent scientific findings with the mind, body, spirit, wisdom, and we’re going to highlight one of those incredibly important conversations here. First off, before we get into this, laurel welcome.

Laurel: 1:21

Thank you so much, Miranda. It’s great to be here. I’m so happy to be chatting with you and your audience. This is such an important topic.

Maranda: 1:30

Tell us a little bit about how you got into this field. What’s your story?

Laurel: 1:35

Oh gosh, I got into this field, the way a lot of mothers do. I had a very challenging birth experience with my first child and then an equally, if not more challenging, second birth. That really helped me dive fully into advocacy for families, as I started working with families, helping to provide education and support them in the doula world. Then I started to fall in love with lactation. Most specifically, I started to really develop a huge respect and interest in human milk itself. That’s really been my focus, I would say, for the last 10 years is in how human milk changes the trajectory of human beings’ health and is really what we would consider an evolutionary product. It changes our evolution. It’s just something that I’m very, very passionate about and excited to talk more about with you.

Maranda: 2:49

Yeah, we’re going to open up the conversation with lactation, but also in talking about cannabis, that’s what we’re going to hear about today. I live in a legal state. We’re seeing it more and more. It’s becoming legalized across our country. There are other countries where it’s legalized. We have quite an international group of listeners. One of the questions I hear so often by not only just mothers but also providers is cannabis safe? I want to open that question up to you.

Laurel: 3:27

That’s a big question it is. I also come from a state in the US of Colorado. We were the very first state to fully legalize cannabis, both for recreational and also for medicinal use. When that was going on, I actually had middle-aged teenagers in the home. My first thought about it really had to do with having the conversation with my children, because I really didn’t know that much about cannabis and how it interacted with the body. I didn’t know about the endocannabinoid system. I didn’t know many things at all. What started happening is I started to pull all of the data and learn about. It was that all of my students that were coming to my lactation classes and childhood classes and my breastfeeding support group started to ask the questions Well, if I have a prescription or if I’m using cannabis for ABC, is it safe for me to continue to breast or test feed my child? At the time there was so little data that caused me to do this full dive into trying to understand what we knew about cannabis and its interactions, and really what we didn’t know I think that is one of the most important questions here that we hold today is that there’s more that we don’t know about cannabis than we do. The question of. Is it safe? It depends on what that question is encompassing. Are we talking about during the prenatal period? Are we talking about during lactation? Are we talking about with a healthy term baby? Are we talking about someone who’s using CBD products, someone who’s using Delta 8 products, someone that’s inhaling, somebody that is taking edibles? It is a bigger question than Justice Cannabis Safe, because all of those different scenarios change the game and could potentially change the outcome.

Maranda: 5:32

I love this. Let’s break it down a little bit. You mentioned the endocannabinoid system. I have been in this field for a really long time and, like you said, there was not a lot of evidence. I still find that there’s not a lot of evidence for anything in particular. This whole endocannabinoid system is relatively new on the scene. I still feel like it’s not accessible information. A lot of people who are listening into that might hear that word in that system and be like well, what is that? Can you explain a little bit more about what this system is and why it’s important in this conversation?

Laurel: 6:09

Sure. So we actually discovered we not me, I was not the researcher who did it, but you know the field of research discovered the endocannabinoid system as a result of doing cannabis research and and it is relatively new on the scene it’s only been for a few decades that we’ve understood that this is a system that works within the human body and in fact, it is one of the most important systems that we have, particularly when you’re thinking about the developing fetus and the newborn. What the endocannabinoid system does is it creates homeostasis or regulation in all of our organ systems, including our immune system and structures. So our human body actually makes what we call endogenous ligands. So these are products we make within our body to communicate with our endocannabinoid system. So the two primarily. That I think most people will be most familiar with is something called anandamide. Now, if any of you are yogis, you know the term anandamide means bliss, and so it is the ligand or the endocannabinoid that we create in order to regulate those systems that create stability in our mood, so things like serotonin and dopamine and things of that nature. And then we also make something that is called 2 AG and that is primarily a ligand that is interacting with our endocannabinoid system in terms of our immune system and immune function. But just one more thing I want to bring into this conversation is that we actually have receptors throughout this endocannabinoid system that impact our nervous system, every single organ system in our body are connective tissue, our gonads, so our reproductive organs, our immune system and all the associated structures. And this is one of the reasons why this regulation system, why cannabis plays such a role because cannabis has molecules which are called cannabinoids that can interact with receptors found in our endocannabinoid system, because it’s literally found all over our body and that’s why you hear people say, you know, cannabis can work as a medicine for all of these different things. That’s because it can interact with all of these multiple receptors throughout the body. And, in fact, cannabis was one of the first prescribed medications all throughout North America by traditional physicians throughout the 1800s and into the early 1900s, and it was only through political means and, in fact, racism and financial greed that cannabis became known as a dangerous drug in a schedule one schedule one drug. So you know that has really changed the bias and the perception that we have, particularly many of us who are in the medical or healthcare field, that we have around cannabis. But even though there is this, you know, this very negative bias, it doesn’t necessarily mean that that bias can shape or should shape or change. I don’t even know how to explain that, but essentially what I mean to say is, yes, there is a tremendous bias and yet and yet we also have to recognize we don’t have a lot of evidence to direct how we should feel exclusively about cannabis in the perinatal period.

Maranda: 9:45

So, as a mouthful I’m sorry, I didn’t mean to like- no, no, this is absolutely perfect, and it sounds like a lot of that bias might be one of the reasons why we don’t have a lot of evidence.

Laurel: 9:55

It is, and because cannabis was placed into the schedule one system in the 1970s, and schedule one simply means that it is a drug that is considered too dangerous to release to the public because of its high addictive quality and because it has no medicinal purpose, neither of which is true in the case of cannabis, by the way. It means that the government cannot fund fully research for that particular drug because it is considered so dangerous At least that’s the way it’s regulated which means we have just this lack of information about its safety and the large trials that we do have. We have some that are from the 1980s. We have a couple that are from the 1990s. These are the studies with very large cohorts that people still use to this day to create policy. We’re looking at individuals who used cannabis but had a whole host of other potential drugs that were complicating the results. For example, many of them were smoking tobacco. Some of them utilized alcohol or other drugs. Some of them had other scenarios, like where it did not have exposure to healthy foods or lived in situations where there wasn’t health equity, so it was very hard to tease out. Cannabis is the result of this particular outcome in this study, and yet we still use those studies as a standard of what we consider to be safe or unsafe cannabis use in the perinatal period. They should all be just thrown out, honestly, because they’re not studies we would consider to the standards we need today to regulate perinatal health care.

Maranda: 11:50

And it sounds like it’s not even related to perinatal mental health or perinatal health and the overall scheme of perinatal health. Right, this is directly related to human health, and then putting that speculation or stipulation on it for perinatal health, you’re just even limiting it that much more, which is how we find so much in regards to healthcare today. In the first place, when it comes to women’s healthcare and perinatal healthcare, it’s so very limited. So I think that there’s a sharing of properties there, so to speak. I’m at a loss for words here, but I’m seeing the similarities between the two, and I kind of want to go back to this endocannabinoid system within the body. You’re saying that this is a biological normal system that every human being has within and that cannabinoids, which is in the cannabis, it is something that could have a feeling that benefits us. Is this something that can heal our bodies? How is it affecting our endocannabinoid system and the way we’re feeling? Why are women in the perinatal period looking for this as a solution? That’s a lot of questions, but they’re just like rolling off of my mind here.

Laurel: 13:20

Like this is. It’s such a big topic. So again, we have multiple receptors within the endocannabinoid system that respond to cannabinoids. We make our own endocannabinoids within our own human body, but there are a variety of exocannabinoids cannabinoids that you can find out in nature that can also interact with these receptors. They’re not exclusive to cannabis. You can find them in a multitude of other, like other forms of essential oils, can interact with our endocannabinoid system, and partly that’s because they have molecules that are similarly shaped to some of the molecules that we make within our own body, and we find that true for many things that can interact with the endocannabinoid system. They just they have a similar shape, they can get in, they can kind of unlock, like a skeleton key. They can get in and they can unlock and they can interact with that receptor. And that’s one of the reasons why cannabis has been used as a medicine, because it has this ability to interact in a multitude of ways with multiple systems within our body. Now can they be used as a medicine, and I’m speaking outside of the perinatal period right now. Well, there is an organization that is called the National Academy of Science, engineering and Medicine in the United States that decided a few years ago that they wanted to do a study to look and see if cannabis actually can be used as a medicine, and so what they did was they essentially looked at the entire body of research that had been done up until that point, and what Mason found was that there was conclusive and substantial evidence that it could be used for chronic pain in adults, that it was effective as an anti-imestic for people who were experiencing nausea from chemotherapy, for multiple sclerosis, spasticity, and then there was also moderate evidence that it could be used to improve short-term sleep challenges, and there was limited evidence that it could be used for Tourette syndrome, also anxiety, and also for post-traumatic stress disorder. In fact, the Veterans Association has petitioned the US government multiple times to pay for cannabis as a treatment for PTSD, because now there is a very large body of evidence that supports the fact that it is very helpful to heal the trauma that many of our soldiers have incurred in wartime conditions, and so can it be used as a medicine? Well, our National Academy of Science and Medicine says yes for certain things, but again, evidence is still very limited. That’s evidence we had at that time that was published in 2017. And you can actually download the PDF for free. It’s called the Health Effects of Cannabis and Cannabinoids. It is. It’s a chunk. We’ll provide that.

Maranda: 16:22

We’ll provide that here?

Laurel: 16:23

yes, you can get it. So, yes, it can be medicine. Is it an appropriate medicine for someone who’s pregnant or someone who’s lactating? That’s where the debate still holds. The thing that we don’t know is that we’re talking about particularly during pregnancy. We’re talking about a human organism that is in development and it is designed to respond to very specific endocannabinoids from the pregnant parent. So if you are introducing in other cannabinoids, phyto cannabinoids, exocannabinoids that are coming from outside the body, they are interacting with the trajectory of development for that child. What that means for the development, we don’t really know. We have some very small studies that suggest it changes dopamine receptors. We have some small studies that suggest it can cause babies to be born premature. We have some small studies that show it can cause some short-term challenges medical challenges for children immediately after birth. Does that cause long-term impact? We don’t know. What we know about its long-term health impact is very little, but I sometimes hear this discussion about well, if it naturally interacts with our endocannabinoid system, then it must be meant for the body, not necessarily. There are a lot of things that can interact with our systems that are not necessarily the best for a developing child. So the research is sparse, but we’re starting to see a larger body of research. One thing and I know I’m talking a lot here, but one thing that I do want to bring to the table is that there was a researcher by the name of Torres who did a meta-analysis to look at do they believe that prenatal exposure causes long-term cognitive impact. And when they did a meta-analysis they said well, they could see a very, very small percentage of short-term impact. They could not find the evidence for long-term impact for cognitive impairment. So that’s just. But that’s one aspect of development in a child.

Maranda: 18:41

Become a postpartum university professional, our evidence-based trainings, guides, downloads, tools and community membership is now open for applications. Join us as we learn, connect and implement better care practices for ourselves and for our clients we serve. You can learn more at postpartumU, the letterucom slash membership. First off, I don’t want you to stop talking. This is absolutely fascinating and there’s so much that I know that myself and others are just like oh, this is incredible information. So we have that, in terms of pregnancy, there’s a lot that we don’t understand. There’s a lot that we don’t know. We do know that there is a developing baby and a developing system and we’re interfering with that. What about breast milk and human milk? How is cannabis crossing into lactation?

Laurel: 19:46

Can I roll this back just one more moment? One thing that I also want to bring into the conversation is the fact that also cannabis has changed. In the 1970s it’s the 1980s the cannabis that most people were using was from just a naturally growing herb, and the cannabis that we see today, sold in pharmaceutical centers and recreational centers, has been bioengineered to much higher levels of THC, cbd, delta 8, cbn whatever the molecule is that they are trying to provide and so that also changes the game in terms of how it interacts with our system and, potentially, how it may interact with a developing fetus or a growing newborn child. And there are components now that are being isolated for certain products for example, delta 8, because it is a product that right now is not regulated by the federal government and has not yet been regulated by many states, and we have literally no data on this particular cannabinoid, this particular molecule. And yet it’s being sold because it can get through like legal issues, and it’s being utilized because it also provides psychotropic experiences in sort of the recreational space. It also has some potentially medicinal benefits. But these are some of the challenges that we have when we’re trying to say yes, it’s safe, no, it’s not safe because there is something called the entourage system when we’re talking about utilizing natural medicines like herbs. The entourage effect is when you have this whole host of amazing molecules and terpenes and different ingredients within natural medicine, within an herb that works synergistically to create whole body health right. When you start to isolate these individual components, it changes how they work in the body, and that is what we’re seeing in. A lot of the different forms of cannabis that are being sold today are isolates, and so there’s even less information on how they potentially impact a pregnant person, a lactating person or a developing baby or newborn.

Maranda: 22:19

And I’m so glad that you mentioned this and this conversation is right on par with everything that I teach and postpartum nutrition and nutrition as a whole, because that’s a lot of the times, that’s what we’re doing now is we’re starting to take isolates, pieces of I mean we do the same thing with supplements and minerals and those things and then we wonder why they’re not good enough, because we’re taking pieces of the whole and we really don’t have, I mean, it’s not good enough. Right? All of those pieces work together synergistically to help create the whole that’s going to help the body in the way it needs. So I am so glad that you are sharing this and this information as a whole and really helping us understand why. It’s not a straightforward answer.

Laurel: 23:08

It’s not a straightforward answer, and I know that your next question was what about lactation? Well, the thing we need to know about lactation is it is a completely different animal, in terms of exposure to the baby, than what we’re talking about with cannabis during pregnancy. With cannabis during pregnancy, the cannabinoids access the baby directly through the placenta. We do know that we find a variety of cannabinoid molecules in cord blood. How that interacts with the developing fetus again, we don’t know, but it is more like it is a more direct exposure than what will occur with lactation. What happens with lactation is that you have a variety of cannabinoids that access the blood supply, and it’s different whether someone is doing inhalation or whether they are ingesting cannabis, because when you inhale, it gets within your bloodstream very quickly and it has a very short half-life. When you ingest cannabis, it has to go through your digestive system. It interacts with your microbiome, it interacts with the amount of fat that you’ve ingested with it, and so the degree of exposure to these cannabinoids in the bloodstream occurs in a different manner, over a much longer period of time, though in a much smaller dose, than to the bloodstream. So it accesses milk in a totally different way. Now, those two scenarios are totally different scenarios when it comes to how these different cannabinoids enter into milk. The other piece we need to know is that cannabinoids are not that bioavailable in terms of oral ingestion. When a baby drinks human milk that has cannabinoids in it, it’s that we believe the research suggests from adult research not from infant research, but from adult research that bioavailability is only about five to 12%. So you’re getting a reduced amount of cannabinoids in human milk, but then what’s bioavailable is a very small amount to the baby. So if a parent is utilizing cannabis as a medicine occasionally, is that a reason to tell a parent not to breastfeed, to chestfeed, to give their baby the miracle of human milk? I would say no. I would never tell a parent to stop breast or chestfeeding. But the current recommendations are that we as professionals recommend abstaining from cannabis use during lactation, or reducing use or considering how they’re using it. For example, maybe they’re taking it because they have arthritis and they’re smoking it. Maybe instead they’re gonna use a CBD cream instead of inhaling while they’re lactating. So there are all these different things to consider. When we think about do we take an herb or a medicine when we are lactating, we often think there’s only two options you take the medicine or the herb and you don’t breastfeed, or you breast and chestfeed, or you don’t take the medicine or herb. But the reality is is there is this I call it like a whole rainbow of options that parents have a right to consider. They can abstain all day, feed their baby before their baby’s longest sleep, and that’s when they utilize their medication. They can choose a different route of administration. They can choose a lower dose, they can micro dose. There’s all these different options that parents who are using certain medications can have a discussion with their healthcare provider about what might be their best option, as opposed to I’m not gonna use it, or I’m gonna use it, or I’m not gonna feed my baby. Provide my baby this amazing milk, right? There’s just so many other options out there.

Maranda: 27:10

I am so, so grateful for your time and attention to this. Is there any other questions that you wanted me to ask that I haven’t?

Laurel: 27:19

Oh, let’s see, I’m I’m not sure. I mean, I would suggest that people definitely check out my website. I have a whole reference page that has a lot of the studies that have been done on human milk and lactation. It’s a great study by Dr Baker and Dr Hale that was looking at how cannabis accesses human milk and from what we know is that it tends to peak for smoking Tends to peak at about four hours. I mean tends to peak at about one hour after use and by about four hours it has started to significantly diminish from human milk. And then we also have another pretty decent sized study that was published in the in pediatrics that looked at a little over 50 parents who donated their milk who were regular users of cannabis and they found, very similarly, that it’s very small amounts of access to human milk and you know we saw significant diminishment pretty quickly. However, what made it into all of the news journals was that for one parent there was like a two nanograms of THC that was found in milk at six days after potential use. So that’s what made that’s what made the news, instead of the fact that it’s we’re talking very, very small amounts accessing human milk, even in regular users. So I think the conversation is just bigger than what we make it out to be, and there are just a lot of questions that we, we don’t know.

Maranda: 29:08

And a lot of bias, obviously still living in a world that is sharing this bias. So when you’re hearing something, especially on the news or whatever the case may be, really doing your diligence and checking the sources and learning that there probably is a lot more to the story, obviously to you know this entire conversation really, and then beyond I mean perinatal mental health, perinatal health, postpartum health all of that is in the same predicament, in the same exact place. Please do your research, because what you’re hearing in the news, what you’re hearing in the mainstream, is likely not the case. So yeah, laurel, thank you so much for your time. Where can people find you? Obviously, we’re going to include all of those links so that our viewers can click on those. I highly recommend it, but can you share a little bit about where you are and where to find your information?

Laurel: 30:03

Sure, well, they can find me on my website at MotherJourneycom, or they can find me on social media at MotherJourney Laurel Wilson. So you can find me on Facebook, instagram and threads there.

Maranda: 30:16

Gorgeous, gorgeous. Thank you so much for your time. I’m so glad to have this conversation, thank you. I am so grateful you turned into the Postpartum University podcast. We’ve hoped you enjoyed this episode enough to leave us a quick review and, more importantly, I hope more than ever that you take what you’ve learned here, applied it to your own life and consider joining us in the Postpartum University membership. It’s a private space where mothers and providers learn the real truth and the real tools needed to heal in the years Postpartum. You can learn more at wwwpostpartumu. That’s the letter youcom. We’ll see you next week.