GLP-1s and Breastfeeding
GLP-1s are medications that help to lower blood sugar levels, control diabetes, and promote weight loss. Common versions include tirzapetide (Mounjaro/Zepbound), semaglutide (Ozempic/Wegovy/Rybelsus) and are available orally or subcutaneously (injections).
These drugs have recently become more common and there is a lot we do not know about how they impact breastfeeding. However, early research, as well as our understanding of how other medications get into milk, are promising that some of these medications may be compatible with lactation. One study was unable to detect injectable semaglutide in breast milk and infants showed no adverse effects (Diab et. al 2024). At this time, oral GLP-1s (ex. Rybelsus) are not recommended due to additives like salcaprozate sodium which may enter milk.
Beyond medication transfer into breast milk, it is important to consider the nutritional demands of lactation and if a GLP-1 is an appropriate medication to use during this time. Breastfeeding parents need an average of at least 500 additional calories daily, and GLP-1s can significantly decrease appetite and compromise energy and nutrition. There is an unhealthy focus in our society on postpartum weight loss and “bouncing back”, but in reality an immediate return to a pre-pregnancy body is not realistic and a preoccupation with weight loss can be a red flag for mental health concerns like an eating disorder.
Rapid weight loss is not recommended and should not exceed more than 1 lb a week while breastfeeding. While there may not be an immediate impact in milk production as the body will use up any available nutritional stores, over time production will decrease.
If you are breastfeeding and you and your healthcare provider decide that GLP-1s are right for you:
✅ Start at a low dose and increase slowly as needed
✅ Prioritize regular meals and snacks, even if not experiencing normal hunger cues, prioritizing fats and protein
✅ Avoid weight loss that exceeds 1 lb/week
✅ Monitor infant growth
✅ Check in regularly with IBCLC and healthcare provider
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Sources:
Diab H, Fuquay T, Datta P, Bickel U, Thompson J, Krutsch K. Subcutaneous Semaglutide during Breastfeeding: Infant Safety Regarding Drug Transfer into Human Milk. Nutrients. 2024 Aug 28;16(17):2886. doi: 10.3390/nu16172886. PMID: 39275201; PMCID: PMC11397063.