Wait until you’ve weaned your baby is the most common advice for inquiring mothers on discussion boards about psychedelics—and it’s a reasonable recommendation. We have very little knowledge on the volume of psychedelic compounds that reach breastmilk, and what, if any, effects these compounds might have on developing brains and bodies. And while some animal studies have found adverse effects of using psychedelics during pregnancy, none have examined these compounds’ effects during the breastfeeding period alone. All in all, our scientific knowledge on this subject is extremely minimal, says breastfeeding advocate and registered nurse, Marissa Fratoni: “When it comes to psychedelics and entheogenic plant-based medicine in regards to women’s health, the unmet needs for research are astounding.”
But a breastfeeding or chest-feeding journey can last two or more years per child—even up to three or five years per child for those who practice extended breastfeeding—and mothers of multiple children may find themselves pregnant and/or lactating for a decade or more. The benefits of breastfeeding are numerous (including boosting a baby’s immunity and gut flora while promoting the mother-baby bond) and most pediatricians encourage the practice for at least six months, or as long as it’s feasible for a nursing pair. Is refusing psychedelic assistance for the entire lactation period really the only choice for mothers?
This question comes at a time when increasing attention is focused on both maternal mental health and on the potential benefits of psychedelic-assisted therapy. If we know that at least one in seven women who give birth experience postpartum depression, and that maternal mental health affects babies and children—and we also know that psychedelics are of great benefit for some people with depression, anxiety, PTSD, and more—then perhaps the subject deserves a closer look.
Indigenous Women, Breastfeeding, and Psychedelics
The use of both peyote and ayahuasca by indigenous mothers while breastfeeding is documented. A myth associated with the Native American Church says that Peyote Woman was wandering in the desert, alone, hungry, and pregnant. After consuming peyote, she easily birthed her baby and found her hunger abated and her milk plentiful. Wixárika women, native to present-day southwestern U.S. and Mexico, have reported to anthropologist Stacy Shaefer, Ph.D., that peyote boosts their breast milk production, and preliminary research seems to back that up: A 1979 study found a four-fold boost in the breastfeeding-associated hormone prolactin with oral intake of mescaline (the psychoactive compound in peyote). In the study, prolactin levels peaked 90-120 minutes after ingestion.
According to anthropologist and executive director of the Chacruna Institute, Bia Labate, Ph.D.—who has done extensive fieldwork among indigenous groups that utilize ayahuasca—some members of the União do Vegetal and Santo Daime communities are known to participate in ceremonies while pregnant and breastfeeding, and even to give their babies extremely small amounts of ayahuasca. The mothers themselves appear to take less than a usual adult dose during these periods, and there are no published scientific reports of toxicity resulting from these practices.
What the Science Says
Clinical research on this topic is extremely limited, as is research on many drugs, herbs, and supplements in the case of pregnant or lactating women. Because it’s unethical to recruit mothers to consume any substance with an unknown effect on fetuses and babies, researchers either rely on observational studies (in which they examine the effects of varied—sometimes unspecified—doses in “natural” or uncontrolled environments), or animal research (which has its own ethical issues and practical limitations). In the case of psychedelics and breastfeeding in humans, we have little to go on.
We know that most drugs ingested by breastfeeding mothers—including pharmaceuticals—do show up to one degree or another in breast milk, but that substances with a shorter half-life will also exit the system more quickly. We also know that the concentration of a drug in the mother’s blood plasma is related to the volume of the drug in the milk, and that the amount of a drug that enters breastmilk is related to the mother’s dose. To complicate matters further, milk composition usually varies within a single feeding; foremilk, which appears earlier in a feeding, has a higher lactose content and hindmilk, near the end of a feeding, contains more fat. Therefore, fat-soluble drugs may appear in greater concentrations in the latter part of a feeding.
Dr. James Abbey of Infant Risk, an organization that informs lactating mothers on matters around pharmaceutical drugs and breastfeeding, has written that four half-lives is “usually enough to render all but the most toxic drugs safe for breastfeeding.” Some sources recommend refraining from breastfeeding for five half-lives of the drug to reach an even greater level of safety. To maintain milk levels, breast-or-chest-feeding people can pump and dispose of breastmilk during the waiting period (a practice known as “pump and dump”).
Estimated Half-lives of Common Psychedelics
- Psilocybin – approximately 50 minutes; A 2002 study found that, based on a dose of .21 mg/kg, the majority of psilocybin and psilocin is entirely excreted from the body within 24 hours of intake
- LSD – approximately 1.5 to 3 hours; according to an article on Erowid, only a small amount of LSD is detectable in the system by the end of a trip and it’s almost entirely excreted within 24 hours
- Ayahuasca – DMT, the primary psychoactive ingredient in ayahuasca, has a short half-life of approximately 15 minutes, however ayahuasca preparations typically include a plant-based MAO-inhibitor that lengthens the duration of the psychedelic experience and the drug’s half-life by hours; since ayahuasca preparations vary in their MAO-inhibitor composition, we don’t have exact data on ayahuasca’s half-life
- Ketamine – approximately 45 minutes to 2.5 hours; in an evidence-based discussion of esketamine—a pharmaceutical variation of ketamine in use for treatment-resistant depression—it’s written that refraining from breastfeeding for 8 hours after treatment is likely to “reduce infant exposure to the drug significantly.” The article also notes that, because ketamine is processed by the liver, babies with conditions affecting the liver may experience greater impact
- MDMA – approximately 8 hours (though possibly up to 31 hours, depending on the acidity of the mother’s urine); MDMA has the longest and most unpredictable half-life of these common psychedelics
Remember, waiting for a period of four to five half-lives of a drug before breastfeeding will reduce its occurrence in breastmilk and is considered a safer practice, not a risk-free one.
Mothers’ Experiences with Psychedelics While Breastfeeding
Bianca, mother to a five-year-old living in Michigan, relates that a few months after her traumatic birth experience, she felt the need to re-center with a guided ayahuasca ceremony. There, she experienced another kind of birthing that helped her come to terms with her changed identity and role. “It was like giving birth to a new me in empowered motherhood,” she tells DoubleBlind.
Bianca discussed breastfeeding with the shaman who advised her to spend plenty of time after the ceremony with her baby resting, cuddling, and feeding. Her baby, according to the shaman, would not receive enough ayahuasca from breastmilk to have psychedelic effects, but the medicine could help promote closeness and bonding.
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Erika, a mother of two living in Petaluma, California, had a difficult time breastfeeding her first daughter, who was born with an initially undiagnosed tongue tie. “It took me a good three to four months to be breastfeeding her full-time. We couldn’t figure out why she wouldn’t latch, and why I wasn’t producing enough milk,” she tells DoubleBlind. On top of that, breastfeeding was painful for Erika. “I was screaming into a pillow,” she says—all in all, a rocky start.
San Pedro ceremonies were already integrated into Erika’s life, and she continued taking part in them after the birth of her first baby. The plant medicine, she says, helped her come to terms with her challenges and to accept how things were unfolding. “I could see that it’s all perfect. I was able to forgive myself and let go of how I thought it should be. There was peace with the medicine to understand that I’m on my particular journey—that there’s nothing wrong with me.”
San Pedro, she says, helped her accept donor milk as an alternative to formula when her own milk was in short supply. “I wouldn’t have done it without the medicine in my life… it felt wonderful to me to have my daughter exposed to such a variety of antibodies and nutrition, and it made so much sense to me after being in ceremony and seeing how interconnected we are.”
Toward a Better Understanding of Breastfeeding and Psychedelics
Any discussion of breastfeeding and psychedelics in this context must acknowledge the dramatic differences in worldview between a Western medicalized model on one hand, and a non-Western approach on the other, to pregnancy, breastfeeding, and childrearing. In some indigenous cultures where psychedelics are well-integrated and traditional wisdom has guided people’s actions for generations, exposing babies and children to smaller amounts of the same psychedelic substances utilized by adults in the community is fairly common and acceptable. In indigenous contexts, says Schaefer, “shamans, roadmen, and women have access to information and ways of ensuring the health and safety of everyone involved.”
Likewise, says Bia Labate of Chacruna, “What happens in indigenous settings can’t necessarily be transferred to non-indigenous ones, as these are cultural practices backed up by collective practices and beliefs.”
Most Western medical professionals have neither the worldview nor the knowledge to guide mothers through the process of safer breastfeeding alongside psychedelics use. On top of that, women can be criminalized and have their children removed from their care if they test positive for illegal drugs while breastfeeding.
With better research and training for Western medical professionals around safer psychedelics consumption, the picture could look quite different. But, in a capitalist and patriarchal system, maternal and child health are not, in fact, prioritized.
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In the words of nurse Marissa Fratoni:
“If the patriarchy really cared about the neurodevelopment of children, perhaps food-like substances wouldn’t be more affordable than real produce, perhaps we’d stop medicating kids from early ages because they don’t fit in socio-normative boxes, perhaps we’d take a serious look at the negative outcomes that constant stress promotes in our society… If the paternalistic system that reigns really cared about the children, particularly their neurodevelopment, we’d get our priorities straight and stop demonizing substances as if doing so is the thing that will result in a healthier generation of humans.”
While acknowledging the rights of lactating mothers belonging to religious minorities or indigenous groups for whom ritual psychedelic use is a longstanding practice, the safest choice—according to conventional medicine and the Western child welfare and criminal justice system—is to abstain from psychedelics while breastfeeding. Knowing this, if a lactating person chooses to consume, risks can be reduced, not eliminated, by:
- ·Asking a non-consuming adult to care for your child while you are consuming
- Utilizing drug checking when applicable
- Seeking guidance from a psychedelics-knowledgeable practitioner
- Ingesting smaller and less frequent doses while lactating
- Waiting four-to-five half-lives of the psychedelic before breastfeeding
- Pumping and disposing of milk in the waiting period