Maternal Cannabis Use during Lactation and Potential Effects on Human Milk Composition and Production: A Narrative Review

IF 8 1区 医学 Q1 NUTRITION & DIETETICS Advances in Nutrition Pub Date : 2024-03-01 DOI:10.1016/j.advnut.2024.100196
Irma Castro-Navarro , Mark A McGuire , Janet E Williams , Elizabeth A Holdsworth , Courtney L Meehan , Michelle K McGuire
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Abstract

Cannabis use has increased sharply in the last 20 y among adults, including reproductive-aged women. Its recent widespread legalization is associated with a decrease in risk perception of cannabis use during breastfeeding. However, the effect of cannabis use (if any) on milk production and milk composition is not known. This narrative review summarizes current knowledge related to maternal cannabis use during breastfeeding and provides an overview of possible pathways whereby cannabis might affect milk composition and production. Several studies have demonstrated that cannabinoids and their metabolites are detectable in human milk produced by mothers who use cannabis. Due to their physicochemical properties, cannabinoids are stored in adipose tissue, can easily reach the mammary gland, and can be secreted in milk. Moreover, cannabinoid receptors are present in adipocytes and mammary epithelial cells. The activation of these receptors directly modulates fatty acid metabolism, potentially causing changes in milk fatty acid profiles. Additionally, the endocannabinoid system is intimately connected to the endocrine system. As such, it is probable that interactions of exogenous cannabinoids with the endocannabinoid system might modify release of critical hormones (e.g., prolactin and dopamine) that regulate milk production and secretion. Nonetheless, few studies have investigated effects of cannabis use (including on milk production and composition) in lactating women. Additional research utilizing robust methodologies are needed to elucidate whether and how cannabis use affects human milk production and composition.

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哺乳期母亲吸食大麻及其对母乳成分和产量的潜在影响:叙述性综述。
在过去 20 年中,包括育龄妇女在内的成年人吸食大麻的人数急剧增加。最近大麻的广泛合法化与母乳喂养期间使用大麻的风险意识下降有关。然而,吸食大麻(如果有的话)对乳汁分泌和乳汁成分的影响尚不清楚。本叙述性综述总结了目前与母乳喂养期间母亲使用大麻有关的知识,并概述了大麻可能影响乳汁成分和乳汁分泌的途径。多项研究表明,在吸食大麻的母亲分泌的母乳中可以检测到大麻素及其代谢物。由于其理化特性,大麻素储存在脂肪组织中,很容易到达乳腺,并能分泌到乳汁中。此外,脂肪细胞和乳腺上皮细胞中都存在大麻素受体。激活这些受体可直接调节脂肪酸代谢,从而可能导致乳汁中脂肪酸含量的变化。此外,内源性大麻素系统(ECS)与内分泌系统密切相关。因此,外源性大麻素与 ECS 的相互作用可能会改变调节乳汁生产和分泌的关键激素(如催乳素和多巴胺)的释放。然而,很少有研究调查了使用大麻对哺乳期妇女的影响(包括对乳汁分泌和成分的影响)。需要利用可靠的方法开展更多研究,以阐明吸食大麻是否以及如何影响人类乳汁的分泌和成分。意义说明:据我们所知,目前还没有一篇综述侧重于研究母体吸食大麻对母乳成分和产量的潜在影响。本文提供的证据证明,大麻素有可能通过几种有据可查的途径改变乳腺的脂质代谢以及乳汁的生成和分泌。考虑到最近育龄妇女吸食大麻的人数有所增加,本综述强调有必要开展设计周密、重点突出的研究来解决这一问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Advances in Nutrition
Advances in Nutrition 医学-营养学
CiteScore
17.40
自引率
2.20%
发文量
117
审稿时长
56 days
期刊介绍: Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.
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