August represents National Breastfeeding Month. There are celebratory weeks, like National WIC Breastfeeding Week, Indigenous Milk Medicine Week, and Black Breastfeeding Week throughout August as well.

This post is going to highlight tobacco and pregnancy/parenthood. We’ll share some breastfeeding and other general pregnancy/motherhood/parenthood resources at the end of it. This post will be longer, so please feel free to come back as you have time for it.

Tips from a Former Smoker, Amanda (Amanda B.’s Story | Real Stories | Tips From Former Smokers | CDC)

Did you know that 24.5% of Alaskans fully breastfed in 2021. Another 21.9% partially breastfed. Alaska was #8 in the country for the percentage of women who breastfed to some level.

Tobacco Use and Pregnancy in Alaska

• Cigarette use before, during, and after pregnancy has declined since 2011. (Before and after were 3 months prior pregnancy or after birth).
• In 2020, 20% of Alaskan mothers used cigarettes pre-pregnancy.
• About 10% of Alaskan mothers used cigarettes during pregnancy in 2020.
• Post-pregnancy: 13% of Alaskan mothers used cigarettes in 2020.
• About 4% of Alaskan mothers used smokeless tobacco during pregnancy in 2020. Differences exist, with about 16% of Alaskan Native mothers reporting smokeless tobacco use during pregnancy.
• 5% of Alaskan mothers used e-cigarettes pre-pregnancy in 2020. This remained unchanged since 2016.
• During pregnancy, 6% used e-cigarettes during pregnancy in 2020. This has decreased from 9% in 2016.
• Regional differences exist as well:
  • In Northwest AK, 35% of moms smoked and 10% used smokeless tobacco during pregnancy between 2018-2020.
  • In the Y-K Delta, 20% of moms smoked and 52% used smokeless tobacco during pregnancy between 2018-2020.
  • In Southwest AK, 17% of moms smoked and 6% used smokeless tobacco during pregnancy between 2018-2020.
  • The remaining regions, between 5% and 11% of moms smoked during pregnancy. Between 0% and 2% used smokeless tobacco during 2018-2020.

Tobacco Use Impacts Related to Pregnancy

• Cigarette smoking and secondhand smoke can:
  • Make it harder to become pregnant. Smoking impacts both female and male fertility.
  • Increase the chance of never becoming pregnant.
  • Cause tissue damage to the unborn baby, particularly the lung and brain.
  • Increase the chance of miscarriage.
  • Lead to preterm delivery. Preterm birth is a leading cause of death, disability, and disease among newborns.
  • Increase the chance of low birth weight.
  • Increase the likelihood of Sudden Infant Death Syndrome.
• Smokeless tobacco increases the chances of stillbirth and early delivery during if used during pregnancy
• Nicotine, which is found in smokeless tobacco, cigarettes, and nearly all e-cigarettes can:
  • Affect how the baby’s brain develops before birth.
  • Be passed to the baby through breastmilk. Babies and children can be poisoned if too much is consumed.
• Smoking can lower how much breastmilk is produced. Researchers suspect that nicotine plays a role.
• An early study on vaping suggest that doing so while pregnant may lead to reduced lung function and lung disease in the baby when they enter adulthood.
• Research is still needed on all the impacts that e-cigarettes can have the pregnant person and baby.

Source: Healthcare Triage (Is Marijuana Safe During Pregnancy? – YouTube)

Marijuana Use and Pregnancy in Alaska

• During the year prior to pregnancy, marijuana use declined from 2009 to 2014. However, since legalization, use increased to 19.5% in 2017. 2017 was the highest reported levels. (There isn’t data after 2017.)
• Prenatal and postpartum use were similar and remained steady from 2009 to 2014. After legalization, use during post periods increased to their highest levels. Postpartum use was at 11.8% in 2017. Prenatal use was at 8.6% in 2017.
  • There were about 900 births contributed to women who reported marijuana use during pregnancy.
• Differences in marijuana use during pregnancy include:
  • Those under 25 were 2x more likely to use it than those over 25.
  • Alaska Natives were 3x more likely to use it than white people and 4x more likely than other race.
  • Those with Prenatal Medicaid coverage were 4x more likely to use it than those not on Medicaid.
  • Rural residents were 1.6x more likely to use it than urban residents.
• There was a reduction in use while pregnant. However, 8% still reported daily use, 25% said they used it weekly, and 23% said they used it 1-3 days a month or less.
• About 23% of pregnant women chose to consume marijuana via eating it. Meaning: most used it in a way that emitted secondhand byproduct.
• Breastfeeding and non-breastfeeding mothers used marijuana at similar rates in 2017.

Marijuana Impacts Related to Pregnancy

Marijuana and its impacts are still being studied. This is what the data currently suggests. Information can change and/or new information may be added as time goes on.

Impacts on Baby

• Fetal growth restriction – the baby doesn’t gain the appropriate amount weight before birth
• Greater chance of stillbirth
• Preterm birth
• Low birth weight
• Long-term brain development issues: these affect memory, learning, and behavior. The effects may not be noticeable immediately upon birth.
• THC and other chemicals can be passed to the baby through breast milk. This exposure can increase the chance for problems with brain development.

Pregnancy

We don’t know how marijuana can impact on things like fertility or the impacts on pregnant women specifically. So what is known is based on studies on non-pregnant people, which can potentially impact people who are pregnant. They include:

• Permanent lung injury
• Dizziness – can lead to falls
• Impaired judgement – can lead to injury
• Lower levels of oxygen in the body, which can lead to breathing problems
• Increase blood pressure and make heart beat faster
• Lead to increased risk of stroke, heart disease, and other vascular disease
• Lead to poisoning

Source: USDA, WIC Breastfeeding Support (Social Media | WIC Breastfeeding Support (usda.gov))

Reminder: wherever you are in your, you are doing great! Below are some resources for when you’re ready for them.

I Want to Quit Tobacco or Marijuana

• Did you know that the Alaska State Quitline provides extra support for pregnant people? If you’re ready to quit tobacco, give them a call! You’ll get more sessions if you’re pregnant, including some after you give birth. The number is 1-800-QUIT-NOW if you haven’t heard of it.
• Freedom From Smoking: from the American Lung Association. You can participate online, in groups, or on your own with a self-help guide.
• Home | Smokefree: takes you to the Smokefree Women page. You can get more info if you aren’t quite ready to quit tobacco.
• Find Help and Treatment | SAMHSA: you can find ways to find help for things like finding help for substances disorders, help during a crisis (call 988!), or you just want support.

Breastfeeding

• Alaska Breastfeeding Coalition: provides information and resources on breastfeeding.
• National Breastfeeding Month (usbreastfeeding.org): highlights the national month and offers resources, such as lactation support and breastfeeding coalition directories.
• National WIC Breastfeeding Week: provides social media, support, and information around breastfeeding. It does have a WIC focus. This is the first week of August.
• Indigenous Milk Medicine Week: second week of August. Promotes breastfeeding in the Indigenous communities.
• Asian American, Native Hawaiian, and Pacific Islander Breastfeeding Week: third week of August. Promotes breastfeeding for our AA/NH/PI friends.
• Black Breastfeeding Week: last week of August. Promotes breastfeeding to the Black community.
• New! Semana de La Lactancia Latina: 5-11. Promotes breastfeeding in the Spanish speaking community.

References

1. Alaska Tobacco Facts 2022
2. Marijuana Use and Public Health in Alaska 2020
3. Smokeless Tobacco: Health Effects | CDC
4. Tobacco and E-Cigarettes | Breastfeeding | CDC
5. Smoking During Pregnancy | Smoking and Tobacco Use | CDC
6. Smoking, Pregnancy, and Babies | Overviews of Diseases/Conditions | Tips From Former Smokers | CDC
7. Vaping during pregnancy causes long-term pulmonary effects in mouse offspring | Ohio State Medical Center (osu.edu)
8. Marijuana During Pregnancy – Know the Risks | SAMHSA
9. Marijuana and Pregnancy | ACOG