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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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18 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.

  4. Shelley Clark

    My daughter just had a baby yesterday and today I was told he’s having trouble breathing. She has been using Kratom for a few years now. Not sure how many, but at least 4 that I know of. Women should NOT be putting any type of drug, alcohol or tobacco products into their system for ANY reason. To hell with the excuse of I needed it for withdrawal purposes”. It’s called cold turkey and anyone can do it. I quit smoking cigarettes and marijuana and alcohol the very moment I found out I was pregnant. It’s not fair to the unborn child to decide for them that they come into this world and addict. No mother has the right to make that choice!!! That is child abuse and is clearly wrong. I agree with the 1st woman’s comment. The rest of you guys are obviously addicts and that’s all there is to it. Your comments are a reflection of someone who will defend this drug, no matter what. It seems that there still isn’t enough research done on Kratom to know just how damaging it is.

    • Marie Biancuzzo

      Shelley, thank you for your thoughts. Let me be quick to say that quitting any addictive drug isn’t easy. But as you point out, we can’t make excuses for choices we make that might hurt our own children.

  5. Tammy

    As a grandmother I’m stuck between all of these comments. I watched my daughter go through hell for years with drugs. She’s been clean except for kratom for about three years and I finally feel like I have my daughter back. My granddaughter is about 8 months old so of course when she was pregnant I looked up all the research on kratom and pregnancy I could find. I cautiously approached my daughter (anyone who’s had a drug addicted child knows what I mean) with what I’d found only to have her defend kratom with the same things those here defending it have said. I know she loves her daughter so much she would never intentionally hurt her, in fact other than the kratom she’s overprotective of my granddaughter especially since the drugs kept her from having these experiences with her older daughter who’s now 7. When my granddaughter gets a slight fever she starts having febrile seizures, not sure if kratom is the link. Her sleep pattern is still not that of most infants. She is the happiest little girl most of the time, she eats good. I understand the users saying it’s better than opiates because it definitively is, but I can’t get my daughter to even consider giving up the kratom because every user says how it’s only like caffeine and even she won’t tell her doctors she’s taking it so as you’ve stated there’s no good research out there. I went to one appointment with her and when the nurse stepped out I said honey are you going to tell her about the kratom (because she hadn’t mentioned it) and she got so defensive (almost like the drug addicted daughter version of her). She was furious and said she already asked a dr and they said it’s like caffeine so don’t bring it up! I don’t know if I’m more excited or scared that I heard they are about to ban it. Just wanted to share my experience of the seizures and restless sleeping in babies with kratom in their breast milk.

    • Marie Biancuzzo

      I see you trying to create safety for your granddaughter and show acceptance for your daughter. That’s a tall order to fill, but it seems like you’re indeed doing it! As for the medical community, try to keep some historical perspective. Physicians who were educated in the 1950s smoked. (Including an anesthesiologist, whom I knew fairly well; he didn’t quit until about the 1980s!) Everyone, including physicians, thought that smoking wasn’t a big deal. Now, as you can see, that has changed. So while we may not “believe” the threat from substances today, tomorrow may be another story.

      Let me be quick to say that all we can do is give information. People usually aren’t very receptive to unsolicited advice. All of us will want to follow your example. You’re doing a remarkable job for your family.

    • Katrina

      Praying for your family! It is definitely an addiction and is going to be so hard for them to get clean from.
      Also I hate this stuff and it’s hold on my fiance and everyone’s nonchalance about it….it’s not like caffeine….withdrawal is terrible to watch your family feel. I can’t even imagine it for little ones. 😔

  6. Ray

    I’m about ready to find out my experience but this whole process. But I have known at least eight different mothers who have used kratom their entire pregnancy. Never mentioned it because you know what happens if you do. Not one of their babies had any issues whatsoever nor do they to this day. Just like 20 years ago doctors would tell women go ahead smoke a little marijuana If you’re nauseated and losing weight while pregnant (I personally can’t stand the stuff). I knew women that smoked marijuana their entire pregnancy before the days of drug testing and every prenatal appointment. None of these women had babies born addicted to marijuana none of these babies have learning disabilities or any other issues. I have worked in labor and delivery and I have seen them lie and say these babies are born addicted to marijuana when they clearly had no symptoms whatsoever. Along with the accusations that say smoking causes low birth weight. I was never a smoker while pregnant all of my children were about 5 lb. Never used any drugs caffeine yet some of my children have ADHD and learning disabilities. Well one of my best friends smoked about a pack a day for four pregnancies. Her babies were 8-9 lb. Every single one of them sharp as a tac. Now that I’m pushing 40 I can definitely say I have head prescriptions in my life for narcotics and I can definitely say kratom seems like how much better alternative they just can’t make any money off of it. I also believe there’s lots of sexist arguments in the science about women and pregnancies. Everyone wants to put a woman up on her left side but really the studies prove that’s not even necessary and that it does absolutely nothing. The studies with alcohol and caffeine now I’m not promoting drinking alcohol while pregnant. Alcohol fetal syndrome and them women must be drinking a heck of a lot because it’s proven that smoke quantities of alcohol do not affect the baby. Same with caffeine. A mother has a liver and a mother has a compare kidneys that should filter most toxins before it reaches the baby. Now we know that some things the placenta barrier. More and more studies are showing that when things cross the placenta barrier it’s more often than not a defect in the placenta. The defect is not caused by anything the mother has done but it is caused by the DNA of the fetus itself. And in some circumstances if babies DNA is almost exact replica of moms the body does not distinguish the difference between mom and baby thus allowing things to cross the barrier. Like a viruses they’re the smallest thing known to man and we know some of those across the barrier in which cases there’s abnormalities in the placenta.

    • Marie Biancuzzo

      Your post gives anyone food for thought! You caught my attention on that “left side” baloney. As a very seasoned labor/delivery nurse, I never thought the “left side” made much, if any difference to the labor process or the birth outcome. Similarly, the kicker here is that anecdotal evidence doesn’t “count” for that issue or the kratom or anything else, really. We need some controlled research. But also as you point out, we can go decades before we get such research, and in the meanwhile, we’re often leaping to conclusions about what is or isn’t safe, effective, or whatever. It reminds me that my husband often says that medicine is only a “soft science.” So true!

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