The common medical practice is to avoid psychoactive substances while breastfeeding. However, the safety of psychedelics during lactation remains less clear due to limited evidence and conflicting perspectives between indigenous traditions and Western biomedicine.

Despite these uncertainties, psychedelic-assisted therapy has recently been proposed as a novel treatment for postpartum depression, highlighting the potential for innovative approaches to maternal mental health while emphasizing the need for careful research and guidance in breastfeeding populations.

Psychoactive substances, including compounds like THC (the active ingredient in cannabis), can be found in breast milk and may potentially affect infant brain development. For example, research indicates that babies breastfed by mothers who use cannabis may show reduced motor skills by their first birthday.

Classical psychedelics, such as DMT, LSD, and psilocybin, may also transfer into breast milk due to their molecular properties. These compounds are small and lipid-soluble, allowing them to move from the bloodstream into fatty tissues, including those in breast milk. However, no studies have directly confirmed this transfer.

Moreover, other molecular characteristics may reduce the likelihood of transfer. Psychedelics tend to bind strongly to human serum albumin (HSA), a protein in the blood. This binding can keep the compounds in the bloodstream, preventing them from reaching the mammary glands and entering breast milk.

Experts have suggested that even if psychedelics were to transfer breast milk, it’s likely they wouldn’t linger for long. A review paper from Imperial College London estimated that psilocin, the active compound from psilocybin, would likely be almost eliminated from someone’s system after 48 hours, with only about 0.0016% remaining.

LSD and mescaline may remain in someone’s system for longer. Pharmacological studies show LSD can be identified in someone’s urine for up to three days after ingestion, and mescaline for up to four days.

Based on their time-to-clear, Benjamin Malcolm, known as the Spirit Pharmacist, advises mothers who use ayahuasca, psilocybin, or LSD to wait 24-48 hours before breastfeeding. However, he notes that the intensity of a psychedelic experience and it’s psychological effects may be more impactful than the length of time in someone’s system.

“I hypothesize that the way a psychedelic is used has large repercussions as to the ultimate risks that are being taken. I would think that more intense experiences from higher doses or routes of administration with shorter latency to onset carry higher risks,” he writes.

Experts have suggested that even if psychedelics were to transfer breast milk, it’s likely they wouldn’t linger for long. A review paper from Imperial College London estimated that psilocin, the active compound from psilocybin, would likely be almost eliminated from someone’s system after 48 hours, with only about 0.0016% remaining.

LSD and mescaline may remain in someone’s system for longer. Pharmacological studies show LSD can be identified in someone’s urine for up to three days after ingestion, and mescaline for up to four days.

Based on their time-to-clear, Benjamin Malcolm, known as the Spirit Pharmacist, advises mothers who use ayahuasca, psilocybin, or LSD to wait 24-48 hours before breastfeeding. However, he notes that the intensity of a psychedelic experience and it’s psychological effects may be more impactful than the length of time in someone’s system.

“I hypothesize that the way a psychedelic is used has large repercussions as to the ultimate risks that are being taken. I would think that more intense experiences from higher doses or routes of administration with shorter latency to onset carry higher risks,” he writes.

If psychedelics were to pass into breast milk, could this pose a risk to infants? While no direct studies have examined how psychedelics affect the developing brains of newborns and toddlers, some researchers suggest these substances could potentially interfere with early brain development.

During infancy, the brain undergoes a “critical period” in which neural circuits are highly malleable and easily shaped. This phase is crucial for learning fundamental skills such as language acquisition and understanding how the world works. Rochelle Hines, a researcher at the University of Nevada, Las Vegas, explains that psychedelics could impact this critical period.

“We need critical periods to help our experiences shape and prepare the brain for the world around us,” Hines said in an interview with Business Insider. “And since some research suggests that psychedelics reopen critical periods, these drugs could potentially interfere with natural developmental changes in the brain.”

However, the precise impact of such interference remains unclear. One study investigating early exposure to ayahuasca found no differences in cognitive development between those exposed and unexposed. Interestingly, participants who had early exposure reported lower rates of alcohol and substance use and reduced levels of anxiety later in life.

This research focused on members of the Santo Daime and União do Vegetal (UDV) religious traditions in Brazil, which use ayahuasca for spiritual growth and healing. In these communities, mothers may consume ayahuasca during pregnancy, potentially exposing the developing fetus, and young children may receive small doses during baptism ceremonies.

Microdosing and Breast Feeding?

When considering the risks of psychedelics, dosing and frequency are important. Members of the UVD report that babies are given but a drop of ayahuasca, and those between one and three years are given “just the dregs from the bottom of the glass.”

Microdosing could be a safer means of ingesting psychedelics when breastfeeding, with only negligible amounts of active compounds passed onto infants. Some reports suggest that mothers are turning to microdosing to help manage the stress of parenting. However, while the accumulative effect of psychedelics breastmilk remains unknown, even if in trace amounts, it can’t be said for certain whether or not this would pose a risk.

A research project from Mama de la Myco and Psychedelic Research, Dr James Fadiman has collected over 300 stories from people around the world who have microdosed while pregnant and breastfeeding. The results are yet to be shared.

Considering the Role of Bonding

As well as potential physical risks, there are likely to be psychological implications of mothers using psychedelics during breastfeeding stages. Breastfeeding goes beyond providing nutrition; it establishes a vital physical and emotional bond between mother and child, contributing to the child’s social and cognitive development.

Psychedelic journeys could disrupt this bonding process. The introspective experiences often triggered by these substances might cause a mother to become overly focused on her inner journey. This inward focus could be detrimental during a period when her child is forming a sense of self and self-worth, potentially leading to attachment issues as the child grows.

On the other hand, psychedelics have been found to enhance empathy and emotional openness, which might strengthen the parent-child relationship. One study found that LSD increases levels of oxytocin, the hormone released during breastfeeding that plays a crucial role in bonding. In a Double Blind article, one mother described a shaman who recommended that ayahuasca could “promote closeness and bonding.”

Given these properties and their therapeutic efficacy in treating depression, researchers have proposed that psychedelic-assisted therapy could be a valuable tool for the treatment of postpartum depression.

In a review about this potential, scientists from Kings College write, “Psychedelic-assisted therapy may be beneficial in treating one of the core features of PPD – a maternal loss of connection with herself and her infant – and can engender a sense of acceptance, which can promote enduring positive changes for the mother-infant dyad.”

Could Psychedelics Affect Breast Milk Production?

On a practical level, psychedelics could also affect the quality and production of breastmilk, which supports brain growth, nervous system development and the immune function of infants.

Some evidence shows psychedelics may increase the amount of breast milk being produced through increasing levels of prolactin, the hormone responsible for its production. In line with these findings, women from the Wixárika, an Indigenous group from Mexico, claim to eat mescaline-containing peyote when nursing to increase the amount of breast milk they have for their children.

On the other hand, dietas–a common practice before psychedelic ceremonies–could negatively affect breast milk. This practice involves avoiding certain foods that could impact a mother’s nutritional intake and potentially affect the quality and quantity of breast milk. Nutritional deficiencies or imbalances during this period could influence both the mother’s health and the baby’s development.

New Mothers Interested in Psychedelics or Psychedelic Therapy

When it comes to psychedelics and breastfeeding, the risks remain uncertain due to a lack of concrete research. Traditional wisdom from some Indigenous cultures suggests that certain psychedelics can be used safely during breastfeeding, while Western medicine tends to advise caution.

For now, the general recommendation is to avoid psychoactive substances, including psychedelics, while breastfeeding. However, the increasing recognition of psychedelic therapy means studies investigating this risk may be on the cards, especially given the potential for this therapy to treat depression.

Please note that this article covers only classical psychedelics. MDMA, ketamine, and other non-classical substances (such as the 2C family) will have a different risk portfolio and are generally considered more dangerous.