Weeding Out Breastfeeding? Evidence from the Expansion of Marijuana Dispensaries and Marijuana Laws

• In Event: Substance Use, Maternal Behavior, and Racial Inequities in Perinatal Health

Abstract

The rapid expansion of marijuana legalization and dispensary openings across the United States has raised significant public health concerns, particularly regarding maternal cannabis use during breastfeeding. Breastfeeding provides critical health benefits, including enhanced infant immune function, cognitive development, and reduced risk of chronic disease. However, marijuana use while breastfeeding exposes infants to tetrahydrocannabinol (THC), potentially compromising neurodevelopmental outcomes. This study uses state-level panel data from 2010 to 2023 to examine the effects of marijuana legalization laws (medical and recreational) and dispensary availability on breastfeeding initiation, duration, exclusivity, and formula supplementation. Our findings show that dispensary access - especially recreational dispensaries - is significantly associated with lower breastfeeding initiation rates (−2.95 percentage points, p<0.01). Medical dispensaries are also linked to declines in initiation (−2.22 pp, p<0.05) and exclusive breastfeeding at three months postpartum (−1.66 pp, p<0.05). In contrast, marijuana laws alone exhibit weaker and less consistent effects, underscoring the role of dispensary access rather than legal status per se as a key behavioral driver. Importantly, these declines in breastfeeding are not offset by increased formula use, raising concerns about potential nutritional gaps for infants. The findings carry implications for public health policy, including the need for targeted education campaigns, updated clinical guidance for healthcare providers, and careful regulation of dispensary locations. Future research should explore maternal decision-making and long-term infant health outcomes linked to postnatal cannabis exposure. As cannabis policy continues to evolve, balancing access with protections for maternal and child health remains a critical priority.

Author

• Arjun Teotia, Henry Ford Health System
  Presenting Author