This sheet is about fever and hyperthermia in pregnancy and while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is fever and hyperthermia?

A person’s typical body temperature is around 98.6oF (37oC). Fever refers to a temporary rise in body temperature over 101oF (38.3oC).  Infection is one of the most common causes of fever. Autoimmune conditions, some cancers, and allergic reactions can also cause fever.  

Hyperthermia, or overheating, is a rise in body temperature that happens when the body absorbs more heat than it releases. The most common causes of hyperthermia are heat stroke and severe reactions to medications (malignant hyperthermia). Long exposure to hot temperatures on hot days can also cause hyperthermia. Hot days are often described as being 86oF (30oC) or higher. Extreme exercise or use of hot tubs or saunas might also cause hyperthermia.   

A raise in body temperature due to fever or hyperthermia can be of concern in early pregnancy, especially if it lasts for a long period of time. Talk with your healthcare providers to learn if a fever from an infection or illness needs to be treated with fever-reducing medications. Your healthcare provider can decide if the illness causing your fever needs to be treated as well. In some cases, hyperthermia may require immediate medical attention.  

I have fever or hyperthermia. Can it make it harder for me to get pregnant?

It is not known if having a fever or hyperthermia could make it harder to get pregnant. 

Does having a fever or hyperthermia increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies suggest there might be an increased chance for miscarriage with increase in body temperature in pregnancy. Other studies have not suggested an increased chance of miscarriage. As there can be many causes of miscarriage, it is hard to know if a fever, hyperthermia, underlying illness causing a fever, or other factors are the cause of a miscarriage. 

Does having a fever or hyperthermia increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like fever / hyperthermia, might increase the chance of birth defects in a pregnancy. 

Several studies have reported a small chance for birth defects called neural tube defects (NTDs) in babies of people who had fevers or hyperthermia before the 6th week of pregnancy. Neural tube defects occur when the spinal cord or brain does not form properly. High body temperatures that happen after the 6th week of pregnancy are not expected to increase the chance for NTDs.   

A few studies have reported a small increased chance for other birth defects when fever or hyperthermia occurs in early pregnancy (before week 12), especially if the fever is untreated. These include heart defects, abdominal wall defects (an opening in the abdomen through which organs such as intestines or stomach can stick out), or oral clefts (an opening in the upper lip [cleft lip] and/or the roof of the mouth [cleft palate]). However, there are also studies that have not found these results. As there can be many causes of birth defects, it is hard to know if a fever, hyperthermia, the illness that is causing a fever, or other factors are the cause of birth defects. 

Does having a fever or hyperthermia increase the chance of other pregnancy-related problems? 

It is not known if having a fever or hyperthermia can cause other pregnancy complications. Some underlying illnesses or health conditions that may cause fever could increase the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

Does having a fever or hyperthermia in pregnancy affect future behavior or learning for the child? 

A few studies have reported a small increased chance for problems such as attention deficit disorder (ADHD) and autism when a person had a fever in pregnancy, especially if the fever was untreated. As there can be many things that affect future behavior and learning for a child, it is hard to know if a fever, underlying infection, underlying medical condition, or other factors were the cause of these problems.  

Does taking medication for fever during pregnancy cause birth defects or other pregnancy complications? 

The most common medications used to treat a fever are acetaminophen/paracetamol (Tylenol®) or ibuprofen (Motrin®, Advil®, and Nuprin®).  

Most healthcare providers consider acetaminophen to be the fever-reducer of choice during pregnancy. It has been suggested to use only as needed and at the lowest effective dose, unless your healthcare provider has instructed you to use differently. For more information, please see the MotherToBaby fact sheet on acetaminophen at https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.  

Ibuprofen is in a class of medications called non-steroidal anti-inflammatory drugs (NSAIDs). It has been recommended to avoid the use of NSAIDs, like ibuprofen, after week 20 of pregnancy, unless your healthcare provider feels it is necessary. For more information, please see the MotherToBaby fact sheet on ibuprofen at https://mothertobaby.org/fact-sheets/ibuprofen-pregnancy/.  

Talk to your healthcare provider about the best way to treat your fever. You can contact MotherToBaby with your questions about specific medication.  

How do I prevent fever or hyperthermia during pregnancy?

Fever is usually a sign of another underlying illness or infection, including cold and flu. Limiting exposure to infections, washing hands often, and staying up to date on vaccinations are some of the best ways to prevent illness and possible fever. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/. Hot tub or sauna use during pregnancy should be limited. If you live in or are visiting a hot climate, be sure you take precautions and limit the amount of time you spend in the heat.  

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects, such as neural tube defects or congenital heart defects. A blood test looking for a chemical called alpha fetoprotein (AFP) is also available to screen for certain types of neural tube defects. Talk with your healthcare provider about prenatal screenings or testing that are available to you.  

Breastfeeding while I have a fever or hyperthermia:

Having a fever or hyperthermia does not seem to affect the ability to breastfeed. If your fever is due to an illness, there are likely antibodies in the breast milk to help lower the chance that the baby will get sick. Be sure to wash your hands often and wear a mask or try not to breathe directly on the baby’s face while nursing. For more information about the use of specific medications during breastfeeding, contact a MotherToBaby expert. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man has a fever or hyperthermia, could it affect his fertility or increase the chance of birth defects?

Heat can affect the process of making sperm (spermatogenesis). Studies looking at high temperature to the testes have found lower sperm production, which might make it harder to get a woman pregnant. Fever in males at the time of conception or in early pregnancy, or a male’s use of fever-reducing medication, has not been associated with an increased chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.

This sheet is about exposure to citalopram or escitalopram in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What are citalopram and escitalopram?

Citalopram is a medication that has been used to treat depression. It belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). A common brand name for citalopram is Celexa®.   

Escitalopram contains the same active medication as citalopram and acts in a similar way in the body. It has been used to treat depression and generalized anxiety disorder. Escitalopram also belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). A common brand name is Lexapro®.   

MotherToBaby has facts sheet on depression https://mothertobaby.org/fact-sheets/depression-pregnancy/ and anxiety https://mothertobaby.org/fact-sheets/anxiety-fact/.  

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. Some people might have a return of their symptoms (relapse) if they stop this medication during pregnancy. Stopping this medication suddenly can cause some people to have withdrawal symptoms. If you plan to stop this medication, your healthcare provider might suggest that you slowly lower the dose instead of stopping all at once.  

I take citalopram or escitalopram. Can it make it harder for me to get pregnant? 

It is not known if citalopram or escitalopram can make it harder to get pregnant. Studies in animals suggest that citalopram might lower fertility (ability to get pregnant).  

Does taking citalopram or escitalopram increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. A study on citalopram and escitalopram did not find an increased chance of miscarriage in people taking these medications.   

Does taking citalopram or escitalopram increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like citalopram or escitalopram, might increase the chance of birth defects in a pregnancy.  

There is published information about more than 15,000 pregnancies exposed to citalopram or escitalopram. Most studies have not found that these medications increase the chance of birth defects. While some studies have suggested a higher chance of heart defects or other birth defects with use of citalopram or escitalopram, most of these studies have flaws that make it hard to know if the birth defects were due to the medication or to other factors.  

Does taking citalopram or escitalopram in pregnancy increase the chance of other pregnancy-related problems?

Some studies suggest that taking citalopram or escitalopram throughout pregnancy might increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, research has also shown that depression could increase the chance of pregnancy complications. This makes it hard to know if the medication, the underlying depression, or other factors are the cause of these problems.  

​A study looked at a worldwide database of reports of problems that happened after using medications. The study suggested that citalopram might increase the chance of stillbirth (pregnancy loss after week 20). However, this suggestion was based on only a small number of cases of stillbirth after use of citalopram in pregnancy (7 in total), and the overall increased risk appeared to be low. Also, the reports of stillbirth did not include information about other possible causes, such as the health or past medical history of the person who was pregnant, use of other medications, or other factors during the pregnancy. This makes it hard to know if the medication or other factors were the cause of these stillbirths.  

Some, but not all, studies have suggested that when people take SSRIs such as citalopram or escitalopram during the second half of pregnancy, their babies might have a higher chance of a serious lung condition called persistent pulmonary hypertension (PPH). In the general population, PPH happens in 1 or 2 out of every 1,000 births. Some studies suggest that the overall chance of PPH when an SSRI is used in pregnancy is less than 1 out of every 100 births (less than 1%). 

I need to take citalopram or escitalopram throughout my entire pregnancy. Will it cause symptoms in my baby after birth? 

The use of citalopram or escitalopram during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms can include irritability, jitteriness, tremors (shivering), constant crying, or changes in sleep patterns. Problems with eating, controlling body temperature, or breathing can also happen. In most cases, these symptoms are mild and go away within a couple weeks with no treatment. Some babies might need to stay in the nursery or NICU until the symptoms go away. Not all babies exposed to citalopram or escitalopram will have symptoms. It is important that your healthcare providers know you are taking citalopram or escitalopram so that if symptoms occur your baby can get the care that is best for them. 

Does taking citalopram or escitalopram in pregnancy affect future behavior or learning for the child?  

One study followed 11 babies exposed to citalopram during pregnancy. At one year of age, there was no difference in their development compared to children who were not exposed to citalopram. Studies on the use of SSRIs in pregnancy and the chance of attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) in children have had mixed results. However, most studies do not find an increased chance of ADHD or ASD in children exposed to SSRIs during pregnancy after considering the possible role of other factors, such as family history of these conditions.  

Breastfeeding while taking citalopram or escitalopram:

Citalopram and escitalopram get into breast milk in small amounts. There have been a few case reports of sleepiness and weight loss in infants. Most studies have not reported harmful effects, or differences in intellectual development, in babies exposed to citalopram or escitalopram through breast milk. If you suspect the baby has any symptoms, such as being very sleepy (hard to wake for feeding), poor feeding, or poor weight gain, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes citalopram or escitalopram, could it affect fertility or increase the chance of birth defects?

Citalopram, escitalopram, and other SSRIs have been reported to cause some sexual side effects in men, such as lower sexual desire or problems with ejaculation. There are several case reports of effects on sperm quality after long-term use of citalopram or escitalopram. These effects could lower men’s fertility (ability to get a partner pregnant). Sperm quality improved when the medication was stopped. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.

National Pregnancy Registry for Psychiatric Medications:

There is a pregnancy registry for women who take psychiatric medications, such as citalopram and escitalopram. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.

This sheet is about exposure to fentanyl in pregnancy and while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is fentanyl? 

Fentanyl is an opioid medication. Opioids are sometimes called narcotics. Fentanyl is used to treat pain and is often given during and after surgery. Brand names of fentanyl include Abstral®, Actiq®, Duragesic®, Fentora®, Ionsys®, Lazanda®, Sublimaze®, and Subsys®. 

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

If you have been taking fentanyl regularly or have a dependency or opioid use disorder, talk with your healthcare provider before you stop taking this medication. Stopping an opioid medication suddenly could cause you to go into withdrawal. It is not known if or how withdrawal might affect a pregnancy. It is suggested that any reduction in fentanyl be done slowly, and under the direction of your healthcare provider. 

I take fentanyl. Can it make it harder for me to get pregnant?  

Studies have not been done to see if taking fentanyl can make it harder to get pregnant. 

Does taking fentanyl increase the chance for miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if fentanyl increases the chance for miscarriage. As there can be many causes of miscarriage, including surgery, it is hard to know if a medication, the medical condition, or other factors (such as a surgical procedure) are the cause of a miscarriage.  

Does taking fentanyl increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like fentanyl, might increase the chance of birth defects in a pregnancy. The majority of studies have not found that fentanyl would significantly increase the chance of birth defects above the background risk.  

There is one small case series on 10 infants born to people who had fentanyl use disorder (using fentanyl without a prescription) who were born with similar birth defects, such as: small head size (microcephaly), smaller body size than expected, similar facial features (short nose, small chin, thin upper lip, drooping of upper eyelid (ptosis), cleft palate (an opening in the roof of the mouth), feet abnormalities (foot turns inward (club foot) or rounded bottom of foot (rocker bottom feet), toes fused together (syndactyly)), and short, broad thumbs. These features are similar to those seen in another medical condition called Smith-Lemli-Opitz syndrome. Smith-Lemli-Opitz syndrome is caused by a gene change that lowers cholesterol in the body. Cholesterol is very important for a fetus to grow and develop in pregnancy. This case review suggested that fentanyl misuse might affect levels of cholesterol and might explain the similar features noted. This case series has limitations, which does not allow a firm connection to be linked to fentanyl misuse and the findings in these 10 infants. For example, the authors did not report how much fentanyl was used, the timing of exposure in pregnancy, or if the fentanyl was contaminated or laced with other ingredients. In addition, fentanyl was not the only drug exposure reported for these infants. This means it is not known if fentanyl, other exposures, or a combination of factors were the reason for the physical features discussed in the case series.  

Some studies that look at exposure to any opioid (not just fentanyl) suggest that opioids in general might be associated with birth defects. Based on these studies, if there is an increased chance for birth defects with opioid use, it is likely to be small. 

Does taking fentanyl in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if fentanyl can cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).  

Studies involving women who often use some opioids during their pregnancy have found an increased chance for pregnancy-related problems, including poor growth of the baby, low levels of amniotic fluid (fluid that surrounds baby in uterus), stillbirth, preterm delivery, and C-section. This is more commonly reported in those who are taking heroin or who are using prescribed opioid medication in greater amounts or for longer than recommended by their healthcare provider. Use of an opioid close to the time of delivery can result in withdrawal symptoms in the baby (see the section of this fact sheet on neonatal opioid withdrawal syndrome). 

Will my baby have neonatal opioid withdrawal syndrome if I continue to take fentanyl? 

Neonatal opioid withdrawal syndrome (NOWS) is the term used to describe withdrawal symptoms in newborns from exposure to opioid medication(s) during pregnancy. NOWS symptoms can include irritability, crying, sneezing, stuffy nose, poor sleep, extreme drowsiness (very tired), yawning, poor feeding, sweating, tremors, seizures, vomiting, and diarrhea. Most often, symptoms of NOWS appear 2 days after birth and may last more than 2 weeks. The chance that NOWS will occur depends on the length of time and/or the dose of opioid taken during pregnancy, if other medications were also taken, if baby was born preterm, and/or size of the baby at birth. If opioids were taken in pregnancy, it is important to let your baby’s healthcare providers know so that they can check for symptoms of NOWS and provide the best care for your newborn. 

Temporary problems with breathing or heart rate have been reported in some newborns following the use of fentanyl for pain at delivery. Longer exposure to fentanyl during pregnancy might result in NOWS. 

Does taking fentanyl in pregnancy affect future behavior or learning for the child? 

Short-term use of fentanyl during surgery or for pain after surgery during pregnancy is not expected to cause learning or behavior problems for the child. It is not known if longer use of fentanyl in pregnancy increases the chance for behavior or learning issues. Some studies on opioids as a general group have found more problems with learning and behavior in children exposed to opioids for a long period of time during pregnancy. It is hard to tell if this is due to the medication exposure or other factors that can increase the chances of these problems.  

What if I have an opioid use disorder?  

Talk with your healthcare provider about your use of opioids. Studies find that women who are pregnant and take opioids in higher doses or for longer than recommended by their healthcare providers have an increased chance for pregnancy problems. These include poor growth of the baby, stillbirth, preterm delivery, and the need for C-section.  

What screenings or tests are available to see if my pregnancy has birth defects or other issues? 

Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning. 

Fentanyl and breastfeeding:  

Speak to your healthcare provider about your pain and medications that may be used while you are breastfeeding. Fentanyl can pass into breast milk. Babies might have problems with the amounts of fentanyl in the breast milk. Talk with your healthcare provider or a MotherToBaby specialist about your specific situation, as information on breastfeeding might change based on the age of your baby, the medication dosage, and/or other factors.  

The use of some opioids in breastfeeding might cause babies to be very sleepy and have trouble latching on. Some opioids can cause trouble with breathing. If you are using any opioid, talk to your healthcare provider about how to use the least amount for the shortest time and how to monitor (watch) your baby for any signs of concern. Contact the baby’s healthcare provider immediately if your baby has any problems such as increased sleepiness (more than usual), trouble feeding, trouble breathing, or limpness.  

Product labels for fentanyl might recommend women who are breastfeeding not use this medication. But the benefit of treating your condition and breastfeeding may outweigh possible risks of taking fentanyl. Your healthcare providers can talk with you about using fentanyl and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes fentanyl, could it affect fertility or increase the chance of birth defects? 

Studies have not been done to see if fentanyl could affect a man’s fertility (ability to get partner a woman pregnant) or increase the chance of birth defects above the background risk. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

This sheet is about exposure to marijuana in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.

What is marijuana?

Marijuana is a mix of dried leaves, seeds, stems, and flowers from the Cannabis sativa or Cannabis indica plant. Some other names for marijuana are pot, weed, and cannabis. The main active chemical in marijuana is delta-9-tetrahydrocannabinol (THC), which is what gives a “high” feeling. Some of the ways people use marijuana or THC include smoking or vaping (inhalation), eating or drinking products (ingestion) that contain marijuana or THC (edibles), and applying products that contain marijuana or THC to the skin (topical use).

In addition to THC, another active chemical in marijuana is cannabidiol (CBD). CBD is sold in many kinds of products, such as coffees, chocolates, supplements, tinctures, cosmetics, lotions, suppositories, and bath salts. CBD products labeled as “THC free” might still contain a measurable amount of THC.

The American Academy of Pediatrics (AAP) recommends that women who are pregnant or breastfeeding avoid using marijuana. The American College of Obstetricians and Gynecologists (ACOG) advises that women who are planning pregnancy, currently pregnant, or breastfeeding avoid using marijuana. The U.S. Food and Drug Administration (FDA) advises against using CBD, THC, and marijuana in any form during pregnancy or while breastfeeding.

I use marijuana, but I would like to stop before getting pregnant. How long does the drug stay in my body?

The time it takes the body to metabolize (to process) drugs is not the same for everyone. In healthy non-pregnant adults, it takes up to 14 days, on average, for most of the THC to be gone from the body. However, the way marijuana is used (inhaled, ingested, used topically), how often it is used, and how much is used can affect how long the THC and other active chemicals in marijuana stay in the body.

I use marijuana. Can it make it harder for me to get pregnant?

It is not known if marijuana can make it harder to get pregnant. Some studies suggest that regular use of marijuana might affect the menstrual cycle (a woman’s period or ovulation (release of an egg from the ovaries)), which could make it harder to get pregnant.

Does using marijuana increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if using marijuana can increase the chance of miscarriage. One study found a higher chance of miscarriage among women who used marijuana. Other studies have not found a higher chance of miscarriage.

Does using marijuana increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like marijuana, might increase the chance of birth defects in a pregnancy.

Some studies have suggested that using marijuana during pregnancy increases the chance of birth defects, including heart defects, genital defects, defects of the central nervous system (CNS) (brain and spinal cord), and intestinal defects such as gastroschisis (a hole in the belly wall where the intestines can poke out through the skin). Other studies have not found a higher chance of birth defects in pregnancies exposed to marijuana. It is difficult for researchers to confirm how much and how often a person uses marijuana in pregnancy, and how much THC or other chemicals they are exposed to in the products they use, or if they are also using other substances. These limitations make it hard to know if marijuana can increase the chance of birth defects.

Does using marijuana in pregnancy increase the chance of other pregnancy-related problems?

Some studies have suggested a higher chance of pregnancy-related problems such as preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), small length, small head size, and stillbirth among women who smoke marijuana regularly. Some of these studies suggest that the more a woman uses marijuana during pregnancy, the higher the chance of these complications. The difficulties with studying marijuana use during pregnancy make it hard to know if these complications are caused by the marijuana use, the use of other substances that can increase these risks (such as cigarettes), or other factors.

Some studies have suggested that prenatal use of marijuana increases the chance of health problems for the woman during pregnancy such as high blood pressure, problems with the placenta, and effects on pregnancy weight gain. The studies were not able to look at some other important factors that could have increased the chances of these outcomes, such as problems in previous pregnancies, other underlying health conditions, and the use of some other substances. This makes it hard to know if the marijuana, other factors, or a combination of factors might be the cause of these pregnancy problems.

If I use marijuana throughout my entire pregnancy, will it cause withdrawal symptoms in my baby after birth?

There are reports of temporary symptoms, such as jitteriness and irritability, in newborns who were exposed to marijuana during pregnancy. There are also reports of babies who did not have these symptoms. It is important that your healthcare providers know if you are using marijuana so that if symptoms occur your baby can get the care that is best for them.

Does using marijuana in pregnancy affect future behavior or learning for the child? 

Studies have shown that prenatal exposure to marijuana can change how the brain develops, but it is not clear if or how these changes affect learning or behavior later in life. Some studies of children and/or adolescents who were exposed to marijuana during pregnancy report more problems with executive function (such as the ability to plan, focus, remember, and multi-task) and problems doing well in school. In some studies, exposed children and/or adolescents are reported to have more impulsive, hyperactive, aggressive, or disruptive behavior and/or to be more likely to experience depression, anxiety, and substance use. Some of these issues have been reported more often in children of “heavy” marijuana users (users who reported smoking one or more marijuana cigarettes per day) than in children of less frequent marijuana users. The difficulties with studying marijuana use during pregnancy make it hard to know if these issues in children and adolescents are caused by the marijuana use, other factors, or a combination of factors. Other studies have not found increased behavior or learning issues in children or adolescents with prenatal exposure to marijuana.

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects, such as defects of the heart, genitals, CNS, and intestines. Ultrasound can also be used to watch the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.

Breastfeeding while using marijuana:

THC passes into breastmilk. The amount of time THC stays in the milk can range from 6 days to 6 weeks. Some studies on the use of marijuana in breastfeeding suggest a delay in motor development (learning to crawl and walk on time) in the child. Other studies have not proven clear health concerns for a child exposed to marijuana through breast milk.

Use of marijuana might affect levels of prolactin (a hormone that helps the body make milk). Low prolactin levels could reduce the amount of milk produced. Using marijuana might also change the quality of breast milk, including the amounts of nutrients such as fat and protein.

Professional organizations including AAP, ACOG, and FDA advise that women who are breastfeeding avoid using marijuana. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man uses marijuana, could it affect fertility or increase the chance of birth defects?

Marijuana use can affect the number, size, shape, and movement of sperm. These changes in the sperm might affect a man’s fertility (ability to get a woman pregnant). In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about having a COVID-19 infection in pregnancy and while breastfeeding. This information is based on available published research studies. It should not take the place of medical care and advice from your healthcare provider.

What is COVID-19?

COVID-19 (Coronavirus Disease 2019) is an illness caused by a virus called SARS-CoV-2. The virus spreads mostly by close person-to-person contact. When an infected person breathes, talks, coughs, or sneezes, the virus can spread to others who are nearby.

The most common symptoms of COVID-19 include fever, cough, and shortness of breath. Other symptoms might include chills, muscle or body aches, headache, sore throat, new loss of taste or smell, runny nose, nausea or vomiting, and diarrhea. Some people have only mild symptoms or no symptoms at all (are asymptomatic), but they could still spread the virus to other people.

Women who are pregnant or were recently pregnant have a higher chance of getting very sick if they get COVID-19. Studies have shown higher chances of hospitalization, admission to the intensive care unit (ICU), and death from COVID-19 during pregnancy.

How can I help prevent getting COVID-19?

Staying up to date with recommended COVID-19 vaccines is the best way to protect yourself and others from COVID-19. MotherToBaby has fact sheets about COVID-19 vaccines at https://mothertobaby.org/fact-sheets/covid-19-mrna/ and https://mothertobaby.org/fact-sheets/covid-19-protein-subunit-vaccine/.

Other ways to help protect yourself and others include wearing a mask in public, avoiding large indoor gatherings, avoiding contact with people who might have COVID-19, and washing your hands often. The Centers for Disease Control and Prevention (CDC) has information about prevention at https://www.cdc.gov/covid/prevention/index.html.

What should I do if I get sick with COVID-19 while I am pregnant?

If you are pregnant and have symptoms of COVID-19 or test positive for COVID-19, be sure to tell your healthcare team. Your healthcare provider might recommend an antiviral medication to help lower the chance of getting very sick. Antiviral medications work best if taken early in the course of the illness. MotherToBaby has a fact sheet about one kind of antiviral medication used for COVID-19 at https://mothertobaby.org/fact-sheets/nirmatrelvir-ritonavir-paxlovid/. You can also talk to your healthcare provider about the best way to treat symptoms such as fever (see the section of this fact sheet about birth defects and fever for more information). While you are sick, stay home and avoid close contact with others to help prevent passing the virus to other people.

I have COVID-19. Can it make it harder for me to get pregnant?

It is not known if having COVID-19 can make it harder to get pregnant.

Does having COVID-19 increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies on COVID-19 infections in pregnancy have not suggested a higher chance of miscarriage compared to the general population.

Does having COVID-19 increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like COVID-19, might increase the chance of birth defects in a pregnancy. Some studies have observed higher rates of some kinds of birth defects in infants born to women with a COVID-19 infection in pregnancy. Other studies have not found a higher chance of birth defects. Overall, the research does not find a clear link between COVID-19 and any specific birth defect or pattern of birth defects.

Fever is a possible symptom of COVID-19. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been recommended to reduce fever in pregnancy. If you get sick with COVID-19 or any other illness and develop a fever, talk with your healthcare provider to confirm if taking acetaminophen is okay for you. For more information about fever and pregnancy, see the MotherToBaby fact sheet about hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.

Does having COVID-19 increase the chance of other pregnancy related problems?

Studies have shown that women who are pregnant or recently pregnant and get COVID-19 have higher chances of becoming very sick, being admitted to intensive care, and needing to be put on a ventilator (machine that helps you breathe). Some studies have also reported a higher chance of death. The chance of these outcomes can be higher among women who also have other underlying health conditions, such as obesity, pre-pregnancy diabetes, and/or chronic hypertension. Just as in the general population, pregnant women who are up to date on COVID-19 vaccines are less likely to get infected, and less likely to get severely ill, be hospitalized, or die from a COVID-19 infection.

Studies have reported higher chances of pregnancy-related problems following COVID-19 infection in pregnancy, including preterm delivery (birth before 37 weeks of pregnancy), stillbirth, preeclampsia (dangerously high blood pressure), blood clots, and the need for an emergency c-section. Some studies suggest the virus can infect the placenta (a condition called placentitis) or cause changes to the placenta, which can lead to problems with how well the placenta works to support the pregnancy and fetal growth and development. Having COVID-19 might also make it harder to manage other health conditions that are common in pregnancy, such as other infections or high blood pressure. Women who are up to date with COVID-19 vaccines in pregnancy are less likely to experience pregnancy complications from a COVID-19 infection than women who are not up to date.

Can the virus that causes COVID-19 pass to the fetus during pregnancy or at the time of delivery?

The virus can pass from a woman who is pregnant to the fetus during pregnancy, but this appears to be rare. The chance of the baby getting the virus during or soon after birth might be higher if the pregnant woman has an active infection at the time of delivery. Most infants who test positive soon after delivery have only mild or no symptoms and fully recover from the virus. Severe illness might be more likely in infants who are born preterm or have other health problems.

Does having COVID-19 in pregnancy affect future learning or behavior for the child?

Studies have looked at the development of children born to women who had COVID-19 in pregnancy. A few studies have reported a higher chance of issues related to motor (movement) skills and speech and language in children up to 2 ½ years of age. Other studies have found no differences in development, learning, or behavior up to 2 years of age. Since many factors can affect children’s development (such as their home and school environment and other possible exposures in pregnancy), it is not clear if having COVID-19 in pregnancy affects long-term development in children.

Breastfeeding while having COVID-19:

The virus that causes COVID-19 has not been found to pass into breast milk. There have not been any reported cases of infants getting COVID-19 through breast milk. Women are often encouraged to continue breastfeeding or providing breast milk even when they are sick with a virus, such as the flu.

Women who are breastfeeding while sick with COVID-19 can help prevent passing the virus to their babies by washing their hands frequently and wearing a mask while nursing. They can also consider pumping milk for someone else to feed their baby while they recover. CDC has information on COVID-19 and breastfeeding at https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/covid-19.html. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man has COVID-19, could it affect fertility or increase the chance of birth defects?

A COVID-19 infection can cause a temporary decrease in the number and motility (movement) of sperm in some men. These changes in sperm could affect fertility (ability to get a woman pregnant). In most cases, the sperm are expected to return to normal after full recovery from the infection. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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