One great joy of my job as a family medicine physician is taking care of pregnant women from the moment their pregnancy test is positive through infancy and beyond. In pursuing good health for mother and baby, we sometimes enter difficult territory.

Pregnancy can feel restricting to mothers, including rules on avoiding smoking, alcohol and illicit drug use. After giving birth, mothers are often tempted to resume old habits. But illicit substances, such as marijuana and other illegal drugs, should be avoided in pregnancy and while breastfeeding. Many prescription medications are safe while breastfeeding, but it is best to discuss them with your primary care provider.

Marijuana, one of the most common illegal drugs, is the most common source of the chemical compound THC (tetrahydrocannabinol), which is typically smoked or added to food. Some women even carry a medical marijuana card to use marijuana for a medical condition and a few states have legalized the recreational use of marijuana. Montana still recognizes the drug as an illicit substance, largely due to its hallucinogenic properties that render a user high.

THC is stored in fat cells, which means it can be stored in the body for several weeks. Fat storage also means that it enters breast milk and is ingested by a breastfeeding infant. The potential for harm makes it challenging to study drug use in pregnancy and breastfeeding. So we do not have ideal evidence on the potential risks. Given the lack of acceptable data, both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend avoiding marijuana use while breastfeeding.

Although we have not studied the effects of marijuana use in breastfeeding enough to be certain of its effects, there are plenty of potential risks. Many are supported in small studies and anecdotally. These include:

These potential risks apply to other illegal drugs as well. While breast milk offers the best nutrition for babies, formula may be a better option for women who want to continue using marijuana. Extreme cases of drug abuse during or after pregnancy may trigger the involvement of Child Protective Services in deciding the safest place for the baby.

Here is the bottom line: Marijuana and other illicit drugs pose dangerous risks for your babys health and may compromise good parenting. Using them is simply not worth those risks. Future research may shed light on how babies are affected by a mothers marijuana use during breastfeeding. Until then, I advocate protecting young ones the best way we know how. Enjoy your pregnancy and breastfeeding phase to the fullest while you abstain from illegal drug use.

Dr. J. Abi Ashcraft, a resident physician with the Montana Family Medicine Residency at RiverStone Health, may be reached at 247-3306.

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Drug use can harm pregnancy, baby care - Billings Gazette