From the Guidelines
GLP-1 receptor agonist injectables are not recommended for someone who is breastfeeding due to limited safety data and potential risks to the nursing infant. The most recent and highest quality study, published in 2023 1, lists pregnancy and breastfeeding as contraindications for semaglutide, a GLP-1 analog. Additionally, the 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes 1 also advises against the use of GLP-1RAs in pregnant or breastfeeding women due to lack of safety data.
Some key points to consider when making this decision include:
- Limited safety data in lactating women
- Unknown effects on the nursing infant
- Contraindications listed by manufacturers and recent studies
- Alternative medications with better established safety profiles during lactation, such as insulin for diabetes management
- Importance of consulting with a healthcare provider to weigh potential risks and benefits
It's essential to prioritize the health and well-being of both the mother and the infant, and to consider alternative treatment options that have a more established safety profile during breastfeeding.
From the Research
GLP-1 Injectables and Breastfeeding
- The use of GLP-1 injectables during breastfeeding is a topic of concern due to the limited data available on their safety in this context 2, 3.
- A study published in 2023 found that GLP-1 agonists were excreted in breast milk in animal studies, but human data on excretion were not available 2.
- Another study published in 2025 recommended that patients use contraception to prevent unintended pregnancy while taking GLP-1 receptor agonists, but did not specifically address breastfeeding 3.
- There is no clear evidence to suggest that GLP-1 injectables are safe or not recommended for someone who is breastfeeding, highlighting the need for further research in this area 2, 3, 4.
Safety of GLP-1 Receptor Agonists
- A study published in 2024 found that the use of GLP-1 receptor agonists during early pregnancy was not associated with a large increased risk of major congenital malformations, but the estimates were imprecise and confirmation from other studies is needed 4.
- Another study published in 2017 discussed the potential benefits of using GLP-1 receptor agonists as a first-line therapy for type 2 diabetes, but did not address their safety during breastfeeding or pregnancy 5.
- A review of head-to-head clinical studies published in 2021 found that all GLP-1 receptor agonist agents were effective therapeutic options for reducing A1C, but did not address their safety during breastfeeding or pregnancy 6.
Recommendations
- Due to the limited data available, it is recommended that healthcare providers exercise caution when prescribing GLP-1 injectables to breastfeeding women, and consider alternative treatment options if possible 2, 3.
- Further research is needed to fully understand the safety and efficacy of GLP-1 injectables during breastfeeding, and to provide clear guidance for healthcare providers and patients 2, 3, 4.