Volatile Organic Compound Metabolites Are Found in the Urine of Breastfed Infants Whose Mothers Use Cannabis: the Lactation and Cannabis (LAC) Study.

Cannabis use among breastfeeding women is increasing. While studies have shown that cannabinoids transfer into human milk, whether breastfed infants of mothers who use cannabis are exposed to volatile organic compounds (VOCs) is not known. Here, we characterized VOC metabolite concentrations in urine produced by exclusively breastfed infants whose mothers used cannabis. Relationships between infant urinary VOC metabolite concentrations and milk delta-9-tetrahydrocannabinol (∆9-THC) concentrations and cannabis use modality (smoking/vaping) were documented. Twenty mother-infant dyads (<6 months postpartum) living in Washington and Oregon were enrolled in the Lactation and Cannabis (LAC) Study, and nineteen were included in the current study. Mothers collected baseline infant urine and milk samples (following ≥12 h of cannabis abstention) and three infant urine and five milk samples over 8-12 h following cannabis use. Sixty-five urine samples were analyzed for VOC metabolite concentrations, and 111 milk samples were previously analyzed for ∆9-THC. Results indicate detectable levels of 24 VOC metabolites in infant urine. Non-baseline infant urine had greater concentrations of 15 VOC metabolites than matched baseline samples (p < 0.05). Urinary 2CyEMA (acrylonitrile metabolite) and 2CaEMA (acrylamide metabolite) concentrations were positively correlated with ∆9-THC concentrations in milk. Urinary 2CyEMA concentrations were higher in infants whose mothers primarily smoked (including those who smoked and vaped) compared to those who exclusively vaped (B = -0.637, SE = 0.317, p = 0.044). 2CaEMA concentrations were also greater in the urine produced by infants whose mothers reported any cannabis smoking versus only vaping on the study day (B = -4.06, SE = 1.42, p = 0.004). Results indicate that infants whose mothers use cannabis have measurable VOC exposure. Further research is needed to assess the potential health implications, if any.