Cannabis Across Life: Infancy

The most important first steps of our lives actually happen well before we learn to walk or talk. Our first metaphorical steps are the processes we instinctively use to propel ourselves from a seed into a sapling. Basic functions like breathing, suckling, crying, reflexes, evacuating, and more are essential for survival in our earliest, most vulnerable stages. 

The newborn phase, infancy, and childhood are critical periods for laying down the foundation for a healthy life. These populations each require personalized guidance, care, and patience. Babies and children need a lot of nutritional, emotional, medical, developmental, and hygienic maintenance from parents and caregivers. 

During these times, there’s a natural inclination to be attentive to all the possible foods, liquids, and substances going into their developing brain and body. With this in mind, let’s begin our journey.

Infancy and Cannabinoids

This is where the distinction between endocannabinoids and plant-based cannabinoids is key. Endocannabinoids are naturally present and safe from birth. However, cannabis and impairing cannabinoids like THC carry negative short and long-term health and legal consequences if introduced during this stage. 

By contrast, nonintoxicating prescription CBD can be a literal lifesaver for some infants and children over age 1 who are affected by certain rare pediatric epilepsies. This is because our endocannabinoid system (ECS) comes built-in and activated right from the start.

As a CB1 activator, THC is impairing and can hijack the developing endocannabinoid system and cause lasting issues. Meanwhile, CBD doesn’t activate CB1 receptors, so it doesn’t cause a high, but it can increase endocannabinoid levels, slow enzymes, and activate important, non-cannabinoid receptors. 

The ECS During Infancy

Endocannabinoids are believed to play a critical role in early development and newborn physiology. Animals like cows and humans naturally have endocannabinoids in their milk, but the reasons aren’t clear. Since virtually all animals have an endocannabinoid system, there’s room for influence at any age.

We know that endocannabinoids gently stimulate CB receptors and the ECS to a lesser degree and differently than plant-based ones. In fact, an intact ECS is needed for healthy development.

The exact role of endocannabinoids during this time is still being understood. However, based on early research, some of the emerging findings on the ECS and development are that:

• Animal models show CB1 activation is critical for:
  • Infant feeding behavior
  • Initiating suckling
  • Growth 
  • Development
• Human breast milk has endocannabinoids like:
  • Trace amounts of anandamide (AEA)
  • 1,000 times more 2-AG than AEA
• 2-AG levels in breast milk are high during the day and drop at night
  • Like hormones, endocannabinoids fluctuate with our circadian rhythm

So what do these mean, and how do they affect our parenting choices?

Breastfeeding

When discussing infancy, breastfeeding is generally recommended for the first 6–12 months, but not all pregnant parents are able to, plan to, or choose to nurse or breastfeed their newborn – and that’s okay. Everyone’s family and stories are different, but if breastfeeding is part of your postpartum plans, it’s essential to know how cannabis factors in.

Breast milk is a nutritionally rich and densely fatty substance, lending it well to form endocannabinoids and absorb cannabinoids, as well as hormones, medications, and substances. Endocannabinoids like 2-AG and anandamide are naturally present in breast milk, in levels that rise and fall with day and night rhythms (diurnal pattern).

This diurnal fluctuation in endocannabinoids may help the infant develop a better sense of day and night. This may help infants tune their own circadian rhythm – without consciously interpreting environmental information like the moon and sun. The effects of endocannabinoids on infancy and breastfeeding are a promising area of ongoing research.

Cannabis and Breast Milk

Unfortunately, plant-based cannabinoids like THC can also easily make their way into breast milk within an hour, and quickly pass on to the infant. Once ingested by the milk donor, THC can linger in breast milk for anywhere from 6 days to 6 weeks. 

THC is moderately strong at activating CB1, the receptor we mentioned before as significant for development. But THC acts differently than our endocannabinoids and isn’t good for infants and children. More importantly, cannabis use during pregnancy and breastfeeding can result in lasting cognitive, social, and motor deficits. 

Cannabis use doesn’t appear to negatively affect how long lactation lasts, but it can compromise the safety of breastfeeding due to several biological, consumption, and legal factors:

• Introducing impairing cannabinoids like THC to the infant causes adverse short and long-term neurodevelopmental and social effects
• Positive urine drug screens in newborns trigger CPS involvement and subsequent legal implications
• Any pesticides, chemicals, unknown compounds, or solvent residues on low-quality, street cannabis, or dubious unregulated products can bring harm
• Smoking cannabis, or anything else, creates second-hand smoke that must be avoided by the infant to prevent sudden infant death syndrome

Interestingly, this doesn’t mean that every single cannabinoid is off the table for infants and children. In fact, for some, it’s a lifesaving medication. Enter the world of prescription CBD. 

Rare Childhood Epilepsies

Certain pediatric patients as young as one are eligible for prescription CBD in the form of pharmaceutical Epidiolex®. This first-of-its-kind prescription is a natural CBD isolate purified from hemp extract. 

Epidiolex is FDA-approved for treatment-resistant seizures caused by these rare childhood syndromes:

• Lennox-Gastaut syndrome 
• Dravet syndrome
• Tuberous sclerosis complex

Keep in mind that over-the-counter CBD products are made differently and don’t necessarily translate into the same benefits or safety profile. The dosing for treating pediatric seizures is much higher than for over-the-counter products. Attaining Epidiolex is an expensive, lengthy, and difficult process involving specialists. 

In Europe, CBDV is an approved orphan drug for seizures in Rett and Fragile X syndromes. 

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is linked to ECS alterations. CBD-dominant therapy may help relieve many of the core and behavioral symptoms through its antianxiety and antipsychotic properties. Clinical data are limited but overall promising and safe, along with significant reductions in other medications. Like CBD, CBDV is also promising for ASD and research is ongoing. 

Autism interventions are most effective when diagnosed and treated as early as possible. We’ve put together a detailed guide on this complex topic here. 

Final Thoughts 

To wrap up, the early stages of life, from infancy to childhood, are essential for laying the groundwork for lifelong health and development. The endocannabinoid system is naturally active from birth and plays a vital role in this process, influencing feeding behavior, growth, and circadian rhythm.

While endocannabinoids are essential and safe, plant-based cannabinoids like THC can negatively affect neurodevelopment and are associated with health risks during infancy. On the other hand, prescription CBD has shown promise for certain pediatric conditions like epilepsy and autism.

Always consult a pediatrician before considering any cannabinoid treatment for infants.

References

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