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Kratom During Pregnancy and Breastfeeding: Need-to-Know Facts

Kratom can be purchased as a capsule or as a powder.

More and more, opium withdrawal is treated by using Kratom. And that’s especially concerning if the user is pregnant or lactating. Pregnant women may think that if it’s legal, it’s safe, and providers may not have even heard of it. Whether you are a parent or a provider, here are the facts you need to know about using kratom during pregnancy and breastfeeding.  

Using kratom during pregnancy isn’t as safe as it sounds

Native to southeast Asia, kratom is an herbal substance, derived from the leaves of a tree in the coffee plant family. Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak. Of course, kratom is all-natural, and in most US states, it’s legal. Hence it can be purchased fairly easily as a capsule, or as a powder which can be made into a tea. But it’s not harmless.

The Food & Drug Administration (FDA) does not regulate herbal products. Therefore, like any other herbal product that’s for sale, the exact contents (or the amounts of the contents) in the package may not be what’s on the label. So this means that you cannot assume the amount of active ingredient, and in some cases, the contents could be lethal. Also, remember, too, that the possibility of contamination poses yet another threat.

Reports of kratom contamination exist

Kratom products were linked to a recent Salmonella outbreak. According to the Centers for Disease Control (CDC), 199 kratom-users were infected with the outbreak strains of Salmonella. Infections were reported in 41 states as a result of consuming kratom products; 38% percent of ill people were hospitalized, and no deaths were reported.

I can almost hear you saying, “Oh! So they’ll do some recalls and we’ll all be okay right?” Not so fast.

The CDC warns that “[c]ontaminated products may still be available for purchase because the investigation was not able to identify a single, common source of contaminated kratom. Illnesses could continue to occur if people consume contaminated kratom.”

Kratom has a strong allure

In the medical literature, more and more reports are surfacing about pregnant mothers who have used kratom. No wonder!

Kratom acts at opioid receptors, so it helps a person who is trying to withdraw from an opioid product. Like morphine or any other opioid, kratom creates euphoria and analgesia in the user. It is different from morphine, however. It does not seem to depress respirations.

There’s another motivator for using kratom during pregnancy and breastfeeding. Mothers may not want healthcare professionals to know they’ve been using it. Unlike true opioids, routine drug tests do not detect kratom. (It can, however, be confirmed with specialized urine testing with long turn-around times for results.)

Kratom has toxic effects on adults

In adults, kratom toxicity manifests as palpitations, tachycardia, hypertension, seizures, altered mental status, nausea, abdominal pain, syncope, and liver toxicity. 

Kratom has deleterious effects on unborn and newborn babies

Because this is an opioid-like substance, infants born to mothers who use kratom during pregnancy exhibit withdrawal symptoms that mimic opioid withdrawal.

In my recent interview with Dr. Whitney Eldridge, she cautioned, “We cannot predict which babies will experience withdrawal, and it is independent of the maternal dose.”

Dr. Eldridge’s recent article described a case of neonatal abstinence syndrome (NAS) due to maternal use of kratom. There’s little in the existing literature to guide medical management of the infants exposed to kratom in utero. Eldridge and her colleagues relied primarily on reports from McKay and colleagues in Canada, and Cumpston and colleagues in Thailand to manage the infant’s withdrawal symptoms.

Unanswered questions are worrisome

From the few existing reports, we can assume that using kratom during pregnancy and breastfeeding is risky. Further, we know a little information about the short-term effects of kratom exposure on the newborn. Dr. Eldridge acknowledges several unanswered questions:

  • What are short and long-term effects of kratom exposure on newborns?
  • Is kratom withdrawal among newborns underreported as it is not detected on routine drug screens and is it likely to increase?
  • Is kratom secreted in the mother’s milk?
  • What is the optimal management of a newborn who experiences withdrawal from kratom?

That may take a while, but in the meantime, healthcare providers need to conduct respectful but thorough interviews with clients about possible usage of kratom during pregnancy and breastfeeding.  And, that interview will be much more effective by using specialized listening techniques, often best learned through a course.  

Have you heard of kratom? What are your thoughts on using kratom during pregnancy and breastfeeding? Share in the comments below!

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8 Comments

  1. L. Svor

    I have witnessed first hand the effects of kratom exposure through pregnancy and breastfeeding of my grandchildren whose mother is a high- dosage kratom abuser of 7 years. The children were exposed during pregnancy and through breastfeeding, and have become addicted to kratom. The 4 1/2 year old, continuously exposed her entire life to kratom, has had significant weight loss and eating problems. She has had difficulty eating, with sore throat and stomach problems. When removed for a week from kratom infused breastfeeding, she exhibited side effects of spasms and heartbreaking cravings for the drug with uncontrollable whimpering and crying for long periods of time. The 2 year old has exhibited similar symptoms, and also diarrhea and vomiting when removed from breastfeeding on his kratom addicted mother. It is unconscionable that this is allowed to continue and ignored by child services, the courts and medical professionals, as is their mother’s continuance of marketing and advising pregnant and breastfeeding mothers to buy and use this drug through her ‘tom mamas / kratom mamas’ fb page.

    • Marie Biancuzzo

      Ohhhh……I hardly know what to say! Thank you for sharing this story. We really don’t have much science to go on, but your story makes very real the warnings I was trying to give as I wrote the article. What a sad story for these children. And, not only for these children, but for the fact that their mother is selling the kratom to other breastfeeding (or pregnant) mothers. I’m stunned. Again, thank you for adding a valuable insight.

  2. Serina

    This article addresses the effects of kratom used for opiate withdrawal, which will always be large amounts, only. Opiate withdrawal and pain relief are not the only reasons for kratom use. Many people use it in extremely small amounts as a coffee substitute. In small amounts it has a stimulating effect but without the jitteryness of coffee. Whereas someone using it for major pain relief or opiate withdrawal might consume multiple grams a day, up to 28 grams a day in the most addicted individuals, many use less than one half of a gram a day and never go above that, which is not enough to cause withdrawal in any way. While there is not much research about it, I think it is safe to assume that in small amounts it has similar effects on mother and baby as coffee and may in fact be even less toxic than coffee or even sugar. I understand that some women avoid even small amounts of coffee or sugar in pregnancy and would also wish to avoid kratom as well, but if youre okay with coffee or sugar, then youre most likely okay with kratom too.

    As far as contamination, even heavily regulated products are often contaminated and the fda misses things. Lots of coffee is full of pesticide residue, for example, which is arguably more harmful than the coffee itself. Just like we might pay extra attention to where we source any product we consume, we can pay attention to where we source our kratom to reduce chances of contamination.

    One last note, on use as an opiate withdrawal aide or opiate substitute, while it is not ideal to be using that much while pregnant for sure, I would have to argue that it is far better than using or abusing opiates while pregnant, if those are the only two choices available.

    Thank you for listening and providing the space to comment our thoughts.

    • Marie Biancuzzo

      Although you did not cite any type of studies in your comments, you did point out some issues that we all need to acknowledge. (1) The dose of the substance (kratom or just about any other substance) is a factor to pay attention to; we often forget that. (2) There is good evidence and plenty of anecdotal evidence to show that the problem of contamination for multiple substances is absolutely a problem. (3) Consuming an opiate withdrawal aid is arguably better consuming the opiate “if those are the only two choices available.” And that last part is important to remember.

  3. Heather Fixico

    I have been drinking kratom for a few years .Like anything in large quantities is not good .Its heart breaking that people put false information on kratom and definitely not the whole situation. I drink to help with yard work or cleaning fun stuff .Cant have caffeine so this is a way better alternative. Takes the aches and pains away .My husband has chronic back pain .This helps alot takes way less Tylonal. Please do your research!Big Pharm is trying to put bad information out in the media for there own selfish reasons. Be safe and well thank you for letting me put in my own 2 cents !

    • Marie Biancuzzo

      Heather, thanks, everyone is always welcome to put their 2 cents in! I’d just like to clarify that my post was specifically about the mother-baby situation. There is almost no actual research on that. I use the word “research” in the classical way to mean formal, structured studies conducted in a way that reflect rigorous scientific inquiry.

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