GOLD Learning Speakers

Increased cannabis liberalization has resulted in a more active conversation about perinatal cannabis use, but globally, research and policy perspectives vary dramatically. This presentation will provide a summary of the endocannabinoid system, international rates of perinatal cannabis use, and varying beliefs about the use of cannabis as medicine across the globe. We will explore the published research on the potential health effects of perinatal cannabis use, highlighting physiologic harm reduction strategies. Beyond the health implications, we will discuss the relationship between professional organizational recommendations and the care pregnant and lactating families receive when healthcare policies reflect an abstinence-only approach. Any risk/benefit analysis about perinatal cannabis use should include the potential for significant legal and governmental intervention, which has its own set of outcomes and implications. Finally, the emerging science of high CBD/low THC products will be presented with an eye towards understanding the potential implications of perinatal CBD use.

Feeding a human infant human milk is physiologic and mammalian, but it is far from simple. Indeed, feeding human babies is a complex interplay between biology, culture, policy, practice, and access. This session will discuss the current understanding of the biologic complexity of breast/chestfeeding for parents and babies and the varying ways biology affects outcomes and satisfaction. We will explore the ways in which societal and familial culture add to the complexity of the nursing dyad and how dominant culture drives varying approaches to breastfeeding support around the globe and creates institutional forces (such as racism). This talk will investigate how access to support, supplies, milk substitutes, and definitions/measures of success play a significant role in lactation experiences. Importantly, policy often informs access, so we will examine the impact of the intersection of sociodemographics, policy, and practice on lactation experiences/outcomes. We will specifically explore times in which access and autonomy may be limited by legal or child welfare forces and the right to breastfeed becomes the central issue. Finally, the science of complex adaptive systems will be discussed and applied to specific clinical examples. This fresh, nuanced view of breast/chestfeeding complexity broadens the support provided by perinatal practitioners.