As a former midwife, I’ve thought a lot about the GLP-1s (semaglutide [Wegovy/Ozempic/etc.], dulaglutide [Trulicity], and tirzepatide [Mounjaro]) and their effects on pregnancy and breastfeeding.
In Mounjaro: Pregnancy Worries, I talked about my expectations for a subspecialty of Bariatric Obstetrics, Neonatology, Perinatology, etc. There doesn’t seem to be any information yet (made public) regarding women getting pregnant on the medications and what it might do to the fetus. Beyond the baby, I believe there will be repercussions when a pregnant woman stops the GLP-1s in pregnancy. From early Gestational Diabetes to knee-jerk Gestational Hypertension that might domino into Pre-Eclampsia and Eclampsia.
And Then There is Breast Feeding
As I did with GLP-1 and pregnancy, I went on a search for GLP-1s with breast feeding.
I found, in the Drugs and Lactation Database (LactMed®), this tiny bit of information regarding semaglutide and breast milk:
Summary of Use during Lactation
No information is available on the clinical use of semaglutide during breastfeeding. Because semaglutide is a peptide molecule with a molecular weight of 4113 Da and is over 99% protein bound, the amount in milk is likely to be very low. Furthermore, semaglutide is only 0.4% to 1% orally absorbed, so it is unlikely to adversely affect the breastfed infant.
When it came to questions about maternal and infant drug levels, the medication’s effects on infants, or the medication’s effects on breast milk, the responses were all the same:
Relevant published information was not found as of the revision date.
The last revision date was September 15, 2023.
Below is the summary for tirzepatide and breast feeding/breast milk from the same journal.
Summary of Use during Lactation
No information is available on the clinical use of tirzepatide during breastfeeding. Because tirzepatide is a large peptide molecule with a molecular weight of 4814 daltons, the amount in milk is likely to be low and absorption is unlikely because it is probably partially destroyed in the infant’s gastrointestinal tract. Until more data become available, tirzepatide should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.
Their responses were the basically the same, except their last revision date was June 20, 2022. They need an update!
My Response to the Summaries
I’m quite relieved to see the professional’s knowledge on the chemical makeup of the semaglutide. It’s encouraging how they suspect very little of the GLP-1 will enter the baby through nursing. They also say they don’t expect a great affect on the baby, either. Of course there are years of research ahead, but if this is so, that is great news for the mom who wants or needs to go back on a GLP-1 after the baby is born.
As I write this, I know how, in just five years, these words will seem archaic and ridiculous because there will be so much more information. Perhaps there will be an injection once every six months instead of every thirty days. I still stand by there being a vaccination for obesity one day in the distant future. I wonder what kind of conspiracy theory that might create.
For the health of the mother’s who need the GLP-1s postpartum, let’s hope the effects on the babies are few.