Can you take semaglutide while breastfeeding?

Key Points

• Research into the effect of semaglutide on breastfeeding is still emerging, but initial studies suggest minimal risk to breastfed babies
• Oral semaglutide (Rybelsus), however, is specifically not recommended during breastfeeding
• While early evidence is reassuring, long-term effects on infants remain unknown
• Healthcare providers still recommend caution and individualized decision-making

You've heard about semaglutide's impressive weight loss results. Maybe you're struggling with postpartum weight retention, or you have diabetes and wonder if you can continue your medication while breastfeeding.

It's a tough spot to be in. You want what's best for your baby, but you also need to take care of your own health. While the research into the safety of using semaglutide while breastfeeding is still emerging, we now have more information than we did even a year ago.

Let's dive into what the latest research says about semaglutide and breastfeeding – and what it means for you and your baby.

Why new mothers consider semaglutide

Semaglutide is the active ingredient in several popular medications you might know by brand names like Ozempic, Wegovy, and Rybelsus. It's a GLP-1 receptor agonist that works by mimicking a hormone your body naturally makes to control blood sugar and appetite.

Here's why it's on many new moms' radar:

For weight management: About 40% of normal-weight women and 60% of overweight women gain more than the recommended amount during pregnancy, and postpartum weight retention is incredibly common. With semaglutide helping people lose 10-15% of their body weight over a year, it can be a good fit for new mothers trying to shed baby weight.

For diabetes control: Some women develop gestational diabetes or have type 2 diabetes that needs ongoing management after birth.

Ozempic, which has a lower dose of 0.5-2 semaglutide, is FDA-approved for diabetes control, while higher-dose semaglutide, Wegovy, is approved for weight loss.

Is semaglutide safe while breastfeeding?

There hasn’t been much direct research on breastfeeding while taking semaglutide. As of writing, only one very small study (and one systematic review) has been conducted on the topic. So, while the initial results are encouraging, it’s important to remember that a lot more research is needed before reaching any formal conclusions.

Bear this in mind as we discuss the latest findings on semaglutide and breastfeeding.

Recent breakthrough findings

A 2024 study is our primary insight into the effect of semaglutide on breastfeeding. Researchers looked at breast milk from eight women taking weekly semaglutide injections and found no detectable semaglutide in any of the milk samples.

This is very encouraging news for new mothers eager to try (or get back on) semaglutide.

How much semaglutide reaches your baby

Even when researchers used worst-case scenario calculations – assuming there might be tiny, undetectable amounts – they estimated that a breastfed baby would receive at most 1.2% of the mother's dose.

To put this in perspective, medical experts generally consider medications safe during breastfeeding if the baby receives less than 10% of the mother's dose. At 1.2%, semaglutide falls well below this threshold.

The eight infants in the study, ranging from four to 23 months old, showed normal growth and development with no reported health problems during the observation period.

But here's another important caveat: This study only looked at short-term effects. We still don't know about long-term developmental impacts – and the researchers themselves called for more studies on this topic.

What about your milk supply?

This is where things get a bit more complex. Semaglutide itself doesn't directly interfere with the hormones that control milk production, so the concern is more indirect.

Because semaglutide reduces appetite, there's a theoretical worry that mothers might not eat enough calories to maintain good milk production. Research shows that rapid weight loss or very low calorie intake can reduce milk supply.

The key is making sure you're still eating enough nutritious food to support both your health and breastfeeding, even if you're not feeling as hungry as usual.

Injectable vs. oral semaglutide for breastfeeding: Is there a difference?

Not all semaglutide medications are the same when it comes to breastfeeding safety.

Injectable forms (Ozempic, Wegovy): These are the semaglutide medications that were tested in the existing research and show no drug transfer to breast milk. They contain only semaglutide without any other ingredients.

Oral semaglutide (Rybelsus): This form contains an absorption enhancer called SNAC to help the medication work. The drug manufacturer specifically advises against using Rybelsus while breastfeeding because your baby could potentially absorb this enhancer.

So if you're considering semaglutide while breastfeeding, the injectable forms appear to be safer options based on current evidence.

Current medical recommendations for semaglutide & breastfeeding

As mentioned, the research into the risks of taking semaglutide while breastfeeding is ongoing. Some providers are updating their approach from "absolutely avoid" to discussing the risks and benefits on a case-by-case basis.

“My recommendation would be to monitor the infant's growth as indicated by the pediatrician to ensure the baby is thriving,” says Rebecca Blake, RD. “I would also advise paying attention to any abnormalities in feeding or digestion.”

It's worth noting that most medications are actually compatible with breastfeeding. The American Academy of Pediatrics emphasizes that very few drugs are absolute contraindications, and each situation should be evaluated individually.

The FDA's official stance

The FDA label for semaglutide states that it's unknown whether the drug appears in human milk. It recommends weighing "the benefits of breastfeeding for the child and the benefits of treatment for the mother" along with any potential risks.

Essentially, it's neither a green light nor a red light – it's a yellow light that says "proceed with medical guidance and caution."

Ultimately, the decision is up to you and your healthcare provider. Be sure to discuss all risks and share your concerns before deciding whether to proceed with semaglutide while breastfeeding.

Common myths vs. reality

Let's clear up some misconceptions that are floating around online.

"You must stop breastfeeding to take semaglutide"

Reality: The research into the risks of taking semaglutide while breastfeeding is ongoing, but a very small initial study shows encouraging findings that none of the medication transfers to the breastfeeding baby. Some healthcare providers are now cautiously supporting continued breastfeeding for mothers who need semaglutide, particularly those with significant diabetes or weight-related health issues.

However, this decision should always be made with your doctor's guidance in consideration of your specific situation.

"Semaglutide will definitely harm your baby"

Reality: There's currently no evidence of harm to breastfed infants from maternal semaglutide use. The babies in the research study developed normally with no reported problems.

That said, we're still learning about long-term effects, so continued monitoring is still encouraged.

"It will completely dry up your milk supply"

Reality: There's no evidence that semaglutide directly affects milk production. The concern is that if you're not eating enough due to reduced appetite, your milk supply could decrease.

Safer semaglutide alternatives for nursing mothers

Not wanting to try semaglutide while breastfeeding? There are plenty of alternatives. The best option depends on your goals, whether it’s for diabetes control or weight loss.

Proven safe diabetes medications

For blood sugar control, insulin and metformin have proven track records during breastfeeding. Insulin doesn't pass into breast milk in meaningful amounts, and metformin appears at very low levels with no adverse effects on babies.

Natural approaches to postpartum weight management

Focusing on balanced nutrition, gentle exercise, and adequate sleep can support both your health goals and milk production. There are some Ozempic alternatives you can explore, but be sure to check the research and proven efficacy of these options before committing to them.

Remember that breastfeeding itself burns extra calories and can help with weight loss. Research shows a longer breastfeeding duration is associated with reduced maternal rates of type 2 diabetes and less postpartum weight retention.

Making the right decision for you

Here's the bottom line: the decision about semaglutide during breastfeeding isn't black and white. The emerging evidence is more reassuring than we had before, but it’s not conclusive.

Consider these factors with your healthcare provider:

• How much do you need semaglutide? If you have significant diabetes or weight-related health issues, the benefits to your health might outweigh the small theoretical risks.
• Your baby's age: Older infants (over 6 months) can get nutrition from solid foods too, which might influence the risk-benefit calculation.
• Your comfort level: Some mothers prefer to wait until after weaning to start any new medications, while others feel comfortable with the current evidence.
• Monitoring plan: If you do take semaglutide while breastfeeding, regular check-ins with both your doctor and your baby's pediatrician make sense.

Final Thoughts

The landscape around semaglutide and breastfeeding has changed dramatically with new research showing virtually no drug transfer to breast milk and no short-term harm to infants. While long-term data is still needed, the immediate safety picture is much more encouraging than previously thought.

This doesn't mean semaglutide is automatically right for every breastfeeding mother, but it does mean the conversation with your healthcare provider can be more nuanced than "absolutely not."

Your health matters too. Taking care of yourself – whether that includes medication for diabetes, weight management, or other health issues – ultimately benefits your whole family.

Every mother's situation is unique, and decisions about medication during breastfeeding should always be made with professional guidance. A registered dietitian can help you develop a nutrition plan that supports both your health goals and successful breastfeeding.

Find a registered dietitian who accepts your insurance and can provide personalized advice for your situation.

Frequently Asked Questions (FAQs)

What's the difference between Ozempic, Wegovy, and Rybelsus for breastfeeding?

Ozempic and Wegovy are injectable forms that showed no detectable levels in breast milk in recent studies. Rybelsus (oral semaglutide) contains an absorption enhancer and is specifically not recommended during breastfeeding.

Will semaglutide affect my milk production?

Semaglutide doesn't directly affect milk production hormones. The main concern is that reduced appetite could lead to inadequate calorie intake, which might affect milk supply. Monitoring your nutrition is important.

When can I start semaglutide after stopping breastfeeding?

There's no official waiting period after weaning. Many doctors suggest starting once milk production has fully ceased, but discuss timing with your healthcare provider based on your individual situation.

Are there safer alternatives to semaglutide while breastfeeding?

For diabetes management, insulin and metformin have established safety records during breastfeeding. For weight management, focusing on balanced nutrition and gradual weight loss through lifestyle changes is typically recommended.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.