Can you take semaglutide while breastfeeding?

More and more people have been using GLP-1s for weight loss — including postpartum individuals. Semaglutide medications like Ozempic and Wegovy can help people lose about 5%–15% of their body weight over roughly a year to a year and a half. But is it safe to take semaglutide while breastfeeding? 

So far, there’s very little research on the safety of semaglutide while breastfeeding. Below, we review the existing research so you can weigh the pros and cons with your healthcare provider. 

The short answer: We don’t know.

Animal studies suggest that semaglutide does pass into breast milk in lactating rats. But we don’t know for sure if it also passes into human breast milk. After all, we have different physiologies, including when it comes to breastfeeding.

And there’s no official policy recommendation from the American Academy of Pediatrics (at least not yet).

Currently, only one study has been conducted on the safety of semaglutide in breastfeeding. It involved eight breastfeeding women who were taking injectable semaglutide and had children between 7 and 23 months of age. The researchers analyzed their breast milk samples immediately after semaglutide administration as well as 12 and 24 hours later. At each analysis, they detected no semaglutide in the breast milk. 

And after at least three weeks of exposure to semaglutide, all the mothers reported that their child met or exceeded developmental milestones. 

One mother did say she noticed some  gastrointestinal side effects (which are common with semaglutide) in her child. She was initially concerned that the side effects were affecting her child's growth. But this was temporary and more likely due to the fact that her child had just started walking.

While these results are promising, they’re not quite enough to definitively say that semaglutide is safe while breastfeeding. The study was very small, and focused only on short-term effects. More research is needed, both with larger samples and on the possible long-term effects. 

Bottom line: Given the current lack of research, it’s typically best to play it safe and avoid taking semaglutide while breastfeeding. It’s possible that adding semaglutide back to your routine may be comparably safer once your child is also getting food from other sources besides breast milk, around 6–9 months of age. However, this is speculative. 

It’s best to discuss the risks and benefits with your healthcare provider.

See if you qualify

Yes, there does appear to be a difference between injectable and oral semaglutide when it comes to breastfeeding. When taking oral semaglutide, it is strictly advised not to breastfeed. Breastfeeding may be safer when using injectable forms.

Recommendation for injectable semaglutide (Ozempic, Wegovy): Discuss the safety of breastfeeding with your healthcare provider. 

• It’s unknown if injectable semaglutide passes into breast milk. One small study suggests it may not, but further research is needed before being able to make recommendations based on the information.

• The prescribing labels for Ozempic and Wegovy recommend discussing the risks and benefits closely with your healthcare provider. 

Recommendation for oral semaglutide (Wegovy pill, Rybelsus): Avoid breastfeeding. 

• The prescribing labels for both forms of oral semaglutide specifically recommend against breastfeeding. 

• That’s because Rybelsus, which treats diabetes, and the Wegovy pill, which is used for weight loss, both contain salcaprozate sodium (SNAC), an ingredient that helps the medication be absorbed. SNAC does pass into breast milk. It’s unknown how it could affect infant development, though animal studies have shown potentially negative effects at high doses. 

There isn’t enough research to definitively say whether or not all forms of semaglutide go into human breast milk. Here’s what we know:

• In animal studies, injectable semaglutide passed into the breast milk of rats, but these results do not necessarily translate to humans.  

• Both the Wegovy pill and Rybelsus contain an absorption enhancer called SNAC that does pass into breast milk. It’s unknown what effect this could have on infant growth and development. So, the drug labels specifically recommend against breastfeeding while taking oral semaglutide.

• A small study of injectable semaglutide found no detectable semaglutide in milk samples of eight breastfeeding women. In a worst-case scenario of this study, the researchers estimated that at most, a breastfeeding baby would receive 1.26% of their mother’s dose of semaglutide. This falls well below the 10% safety threshold recommended for medications taken while breastfeeding, but again, results are only specific to that study. 

In summary, it’s specifically recommended to avoid breastfeeding when taking oral semaglutide. Unfortunately, there is very little research on whether the injectable form of semaglutide goes into human breast milk. 

Before taking semaglutide while breastfeeding, discuss the risks and benefits with your healthcare provider.

It’s unknown whether semaglutide directly affects breast milk supply. However, rapid weight loss and a reduced caloric intake — both of which can happen when you’re taking a medication like semaglutide — can reduce breast milk supply. 

It’s also worth considering whether semaglutide aligns with your goals while breastfeeding. For many people, breastfeeding is a time when maintaining nutrition, energy, and milk supply takes priority. 

It’s important to eat enough while breastfeeding to avoid reducing your supply. Research indicates that breastfeeding women require 300–500 more calories daily.

Here are four ways you can manage your weight while breastfeeding — without semaglutide.

Make some changes to your diet

You’ve got enough going on without having to worry about what you’re eating. Having said that, if you are interested in changing your diet for weight loss, here are some recommendations to do so safely while breastfeeding.

• Aim for a modest caloric deficit. Your healthcare provider can help you choose a target, but a common starting point is cutting about 500 calories per day. Don’t forget to account for the fact that breastfeeding mothers need 300–500 more calories daily. If you’re looking for calories to cut, limit foods that pack in lots of fat, sugar, and salt. Keep in mind that overly aggressive calorie restriction can affect milk supply.

• Eat more protein and fiber. Both of these macros boost satiety, so eating more will help you feel full longer between meals. This can make it easier to eat the right amount and achieve your caloric deficit. Focus on whole foods, such as fresh fruits and vegetables, lean proteins, nuts, grains, and seeds.

• Stay hydrated. Drinking more water can help you support weight loss, especially when you drink before a meal or swap out caloric beverages (e.g. soda, juice) for water. Plus, breastfeeding can be dehydrating, making it all that much more important to get enough fluids throughout the day. 

Exercise when you can

Exercise generally isn’t recommended for the first 4–6 weeks after delivery and even longer — up to 8 weeks — for C-sections. Once you have been cleared for movement, consider these tips for incorporating some movement safely and gradually:

• Choose low-impact activities at first. Think: Walking, postpartum-friendly yoga, and other provider-approved exercises that can start to slowly strengthen your core, pelvic floor, and glutes. Be careful not to overdo it. If you experience any pain or discomfort, stop immediately and take rest. 

• Increase intensity gradually. Check in with your healthcare provider, but the typical recommendation is to work your way up to 150 minutes per week of moderate-intensity aerobic exercises (up to 30 minutes per day,  five days a week) and up to three sets of muscle exercises two days per week. Each person is different, and it may take some people longer to be able to work up to this degree of exercise comfortably than others. Remember not to push yourself more than what feels right for your body.

• Look for small opportunities to move. Easier said than done when breastfeeding. But if you find yourself feeling restless, remember short walks, stretching, or light movement throughout the day can add up. 

Ask your healthcare provider about medication

No weight loss medications are specifically approved by the US Food and Drug Administration (FDA) for postpartum use. 

• If you are not breastfeeding, you can speak with your healthcare provider about whether weight loss medications are appropriate after recovering from delivery.  

• If you are breastfeeding, the recommendations are different. It’s generally recommended to avoid semaglutide while breastfeeding, along with any other GLP-1 medications. 

If you have diabetes, you may be able to safely resume your metformin postpartum even while breastfeeding.Metformin is sometimes prescribed off-label for weight loss, so some people may notice modest weight loss when restarting it. 

That said, the cornerstone of postpartum weight management (especially while breastfeeding) is lifestyle changes. Using medications specifically for weight loss while breastfeeding comes with potential risks as well as benefits, and should be discussed closely with your healthcare provider. 

Let go of any pressure you’re feeling

Despite all the myths (and they are myths) you’ll read about “bouncing back” after giving birth, it’s actually recommended that you don’t rush into weight loss postpartum. The official recommendation from the American College of Obstetricians and Gynecologists is to reach your pre-pregnancy weight about 6–12 months postpartum.

There’s already way too much pressure on new parents. Don’t add more stress to your life if you don’t have to. Set some realistic weight loss goals, and make a plan to meet them over time — with plenty of wiggle room for setbacks. 

Remember: The act of breastfeeding burns calories and, thus, may even help with postpartum weight loss, especially when paired with a balanced diet. 

See if you qualify

There is growing interest in using GLP-1 medications for postpartum weight loss. But there isn’t enough research to definitively say if semaglutide is safe to take while breastfeeding — at least not yet. Because of these unknowns, some providers may recommend playing it safe and avoiding these medications until more data is available. 

• There is very little research regarding whether semaglutide passes into human breast milk or how it affects infant development.

• A small study of eight women taking injectable semaglutide (Ozempic, Wegovy)  found no detectable drug in their breast milk, though this sample size is too small to draw broad conclusions.

• Breastfeeding while taking oral forms of semaglutide (Rybelsus, Wegovy pill) is strictly not recommended because these oral medications contain an ingredient called SNAC that is known to pass into breast milk.

• Safer alternatives for weight management while breastfeeding include diet and exercise changes once approved by your healthcare provider.

• Talk to your healthcare provider to discuss your medical history and the potential risks before deciding whether to take semaglutide while breastfeeding.