Don’t judge me. Psilocybin and breastfeeding: What do you know?
—Anonymous
I would never!
This is a great question. Psilocybin, the active ingredient in “magic mushrooms,” has had a resurgence in recent years. In addition to increases in recreational use, there is ongoing and promising research into using this compound to treat depression. One natural question — asked by this review paper — is whether it might be helpful in postpartum depression in particular.
Addressing this question (which I will not today) also means asking whether psilocybin usage is compatible with breastfeeding.
Unfortunately, I am sorry to report that neither the authors of that paper nor I were able to find any studies, in people or in animals, that looked directly at the safety of psilocybin in breastfeeding. The authors in the paper make an indirect case. They note that in general — for other drugs — concentration in blood is similar to concentration in breast milk. Psilocybin breaks down into psilocin, which is largely eliminated from the bloodstream within 48 hours, or possibly much faster. If the concentration in breast milk was indeed similar to blood and urine, then it is possible that it could be largely or completely eliminated after a couple of days.
This is speculative, though, and in the case of cannabis, the concentrations in milk are higher than in the bloodstream in some studies. Other characteristics of psilocin suggest it is likely it would transfer to the milk in some concentration (some drugs with heavier molecules transfer less well).
Overall: it is likely that these drugs would make their way into milk, in concentrations that are unknown, and probably but not definitely decline quickly. This is a pretty flimsy evidence base on which to make decisions. From a research point of view, I think waiting until there is at least some animal evidence seems like a good idea.
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