Cannabis use during pregnancy has continued to rise, particularly in developed countries, as a result of the trend towards legalization and lack of consistent, evidence-based knowledge on the matter. While there is conflicting data regarding whether cannabis use during pregnancy leads to adverse outcomes such as stillbirth, preterm birth, low birthweight, or increased admission to neonatal intensive care units, investigations into long-term effects on the offspring’s health are limited. Historically, studies have focused on the neurobehavioral effects of prenatal cannabis exposure on the offspring. The effects of cannabis on other physiological aspects of the developing fetus have received less attention. Importantly, our knowledge about cannabinoid signaling in the placenta is also limited. The endocannabinoid system (ECS) is present at early stages of development and represents a potential target for exogenous cannabinoids in utero. The ECS is expressed in a broad range of tissues and influences a spectrum of cellular functions. The aim of this review is to explore the current evidence surrounding the effects of prenatal exposure to cannabinoids and the role of the ECS in the placenta and the developing fetus.

Objectives This study aimed to identify recommendations given to breastfeeding individuals by Canadian cannabis dispensary employees, since the legalization of recreational cannabis in 2018. Methods This was a nationwide cross-sectional study conducted from November 2020 to January 2021. A mystery caller approach was used to identify recommendations given to breastfeeding individuals seeking a product for “relaxation.” This study was modelled on similar studies which assessed recommendations given to pregnant women looking for cannabis products to manage nausea and vomiting (Vastis V, Shea AK, Vincent S, Metz TD. 275: Are canadian cannabis dispensaries counselling pregnant women appropriately? Am. J. Obstet. Gynecol. 2020;222: S187.(Abst). Lusero I, Paltrow LM, Rosenbloom N. Recommendations from cannabis dispensaries about first-trimester cannabis use Obstet Gynecol 2018;132:781–2.). The primary outcome was the recommendation of a cannabis product. Secondary outcomes included stated benefits of cannabis, recommended discussion with health care provider, length of call, rationale for recommendation, and reported source of information on which the recommendation was based. Results The majority (79.4%) of employees of the 714 Canadian dispensaries contacted recommended against a cannabis product for “relaxation” while breastfeeding. The recommendations from dispensary employees were often (80%) provided without a specific reason, whereas a minority referenced published research (2%) and opinion (17.6%). Cannabis products were rarely (3.3%) classified as safe in breastfeeding. Approximately 76.6% of dispensary employees recommended contacting a health care provider, while 2.4% recommended against. Conclusions Although a high proportion of dispensary employees recommended against using a cannabis product during lactation, there were still 20.6% that did recommend use, which contrasts the current public health guidelines and is not supported by the paediatric and obstetric societies. These findings highlight the need for further education about the safety of cannabis products while breastfeeding.

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Program is an early intervention, family focused, transition preparation program for families with young adolescents with chronic illness or childhood onset disability. The multidisciplinary approach in this program includes youth engagement and leadership, parent education, goal setting and action plan development. Implemented in a camp setting, this program is designed to help families initiate the discussions and actions that will prepare them to navigate the transition from pediatric to adult health care. Results: Both youth (n ¼ 12) and parent (n ¼ 14) participants showed changes in their scores after participating in the program. Youth participants had statistically significant improvements in the behavioral domain items (p ¼ .009) while parent participants had statistically significant improvements in the knowledge domain items (p ¼ .001). Both groups had improvements in the other domains although these changes were not statistically significant. These results indicated a shift from the preparation to action phase of the readiness continuum. Conclusions: The early findings from the first year of the You're in Charge program indicate that participants shift in their perceived readiness for behavioral change in preparation for the transition from pediatric to adult health care. It is not known if these behavioral changes are maintained after participation in the program. The need for additional exposures to the intervention is not known. It is also not known if participation in the program affects the actual transition experience later in the adolescents' lives. Qualitative feedback from participants collected in the four-week period following program participation indicates that the goal setting and action planning are particularly effective elements of the intervention. Further investigation of the long-term effects and determination of the potency of program elements is needed to refine the intervention. Sources of Support: The You're in Charge program is funded in whole by the Nova Scotia Department of Health and Wellness.