Substance use during pregnancy or breastfeeding

Being substance-free during and after your pregnancy protects you and your baby's health. It is also important to discuss prescription and over-the-counter medications with your health care provider.

Where to Get Help for Substance Use Guide to a Healthy Pregnancy

Alcohol and pregnancy

Alcohol and pregnancy don't mix! Drinking alcohol during pregnancy can lead to a permanent disability called Fetal Alcohol Spectrum Disorder (FASD).

Experts recommend that women planning a pregnancy or are already pregnant avoid drinking all types of alcohol throughout their pregnancy. Drinking alcohol during pregnancy can cause permanent birth defects and brain damage to your baby. To help your baby be as healthy as possible, stop drinking alcohol when you are trying to get pregnant, or as soon as you suspect you are pregnant.

What is Fetal Alcohol Spectrum Disorder (FASD)?

FASD is the term used to describe all of the physical and learning disabilities that are caused by alcohol use in pregnancy. Drinking alcohol in pregnancy can cause:

Brain damage
Vision and hearing difficulties
Bones, limbs and fingers not properly formed
Heart, kidney, liver and other organ damage
Growth deficiencies

Alcohol use in pregnancy affects the developing brain and can cause brain damage. This creates problems with:

Learning and remembering
Thinking things through and understanding consequences
Getting along with others
Learning from past mistakes and solving problems
Making good decisions

FASD is a permanent, lifelong disorder. Teens and adults with FASD may have:

Depression
Trouble with the law
Drug or alcohol problems
Difficulty living on their own
Trouble keeping a job
Difficulty understanding how their behaviour affects others

How can you help your pregnant partner?

The best way to help a pregnant woman to remain alcohol free is to be supportive and encouraging and to ask her how you can help. Supporting your partner by joining her with alcohol-free mocktails and socializing without alcohol are great ways to provide support without nagging. Some studies have found that partners who pressure a woman to stop drinking in pregnancy may cause some women to drink more.

For more information, check the What partners can do to help resource.

How can health care providers help?

Don't wait to talk about your alcohol use until pregnancy. If your health care provider has not talked to you about alcohol, ask to discuss it long before you plan to get pregnant.

It is recommended that all healthcare providers talk to women who are able to get pregnant about their alcohol and birth control use and the risks of using alcohol in pregnancy. If women are using alcohol at all, reliable birth control is recommended to prevent pregnancy. The alcohol screening tool, T-ACE, is a screening tool that can be used in pregnancy.

Alcohol and breastfeeding

At present, there is limited research on the effects of alcohol during breastfeeding. What is known is:

Alcohol passes into a woman's breast milk
The baby's nervous system is developing rapidly at this stage, and
The baby has an underdeveloped ability to metabolize alcohol

If you decide to have an occasional alcoholic drink, it is best to avoid breastfeeding for three hours after consuming one standard alcoholic beverage.

For more information, visit Canada’s Guidance on Alcohol and Health.

Cannabis use while pregnant and breastfeeding

Cannabis use in any form while pregnant and breastfeeding may have negative effects on both you and your baby. Do not use cannabis if you are trying to get pregnant, are pregnant, breastfeeding or parenting your child. If you have further questions, contact your health care provider.

Preconception

Cannabis can affect you and your partner when you are trying to become pregnant by:

changing your menstrual cycle
lowering sperm count
reducing sperm quality

Pregnancy

Cannabis crosses the placenta and your baby absorbs the chemicals that are in cannabis. Do not use cannabis while you are pregnant. If you are using cannabis for nausea, talk to your doctor about safe alternatives that are less risky to your baby’s growth and development.

Some immediate effects of cannabis use during pregnancy include:

low birth weight
pre-term birth
lower IQ scores
impulsivity and hyperactivity
brain development slows

Some effects of cannabis use during pregnancy that affect your child later in life include:

decreased ability to self soothe
sleep disturbances
poor memory
attention difficulties
hyperactivity and impulsivity
difficulty learning
depression and anxiety
reduced school performance
more likely to start using substances

Breastfeeding

Do not to use cannabis while you are breastfeeding. Cannabis passes into the breast milk and is taken into the baby’s fat cells and their brain.

Cannabis can affect your breastfed baby by:

slowing baby’s movements and responses
slowing baby’s brain development
baby becoming sedated

Cannabis can affect breastfeeding by:

lowering mother’s breast milk supply
baby having poor suck
baby becoming drowsy

Resources

Smoking, tobacco products and pregnancy

Avoid smoking and second hand smoke. Smoking can reduce fertility in all individuals. If you smoke, increase your chances of becoming pregnant by quitting now. Talk to your health care provider about nicotine replacement therapy.

Create a smoke-free home environment and seek support from your partner, family and friends.

If you are thinking of having a baby or are already pregnant and you smoke or use other tobacco products, get resources and support:

Pregnets — Resources and support for pregnant and postpartum women who use tobacco products
Health811 — 24/7 support for smoking/vaping cessation
Prenatal and Postnatal Smoking Issues

Other drugs, pregnancy and breastfeeding

Drug use of any kind, unless recommended by your health care provider, is not recommended in pregnancy or while breastfeeding.

It is safest not to use recreational or street drugs, especially if you are planning a pregnancy or already pregnant. Use of recreational or street drugs may affect your ability to become a parent and the health of your baby. If you use drugs, talk to your health care provider about services available to help you stop safely.