From the Guidelines
GLP-1 agonists should be avoided during breastfeeding due to the lack of extensive safety data and potential risks to the nursing infant. The use of these medications, such as exenatide (Byetta) and liraglutide (Victoza), in lactating women has not been thoroughly studied, leaving uncertainty about the amount that may pass into breast milk and the potential effects on the infant 1. Although the large molecular weight of these peptide-based medications suggests limited transfer into breast milk, some passage cannot be entirely ruled out.
Key considerations for managing diabetes in breastfeeding women include:
- The benefits of breastfeeding for both the mother and the baby, as highlighted in the standards of medical care in diabetes-2020 1
- The potential for lactation to increase the risk of overnight hypoglycemia and the need for insulin dose adjustments 1
- The preference for insulin as a treatment option during breastfeeding due to its long safety record in lactation
- Metformin as a possible alternative with more available safety data regarding breastfeeding than GLP-1 agonists
Women who require GLP-1 agonists should consult their healthcare provider to weigh the potential benefits of these medications against the unknown risks of exposure to the infant, considering their individual circumstances. The decision to use GLP-1 agonists during breastfeeding should be made with caution, prioritizing the safety and well-being of both the mother and the baby.
From the FDA Drug Label
It is not known if liraglutide injection passes into your breast milk. You should talk with your healthcare provider about the best way to feed your baby while using liraglutide injection.
The FDA drug label does not answer the question.
From the Research
GLP-1 Agonists and Breastfeeding
- There is limited information available on whether GLP-1 agonists, such as exenatide and liraglutide, pass into breast milk during breastfeeding 2, 3, 4, 5, 6.
- None of the studies provided directly address the issue of GLP-1 agonists passing into breast milk.
- However, it is known that GLP-1 agonists are large peptides that are unlikely to pass into breast milk in significant amounts.
- More research is needed to determine the safety of using GLP-1 agonists during breastfeeding.
Mechanism of Action of GLP-1 Agonists
- GLP-1 agonists work by mimicking the action of the natural hormone glucagon-like peptide-1 (GLP-1) in the body 2, 4, 6.
- They stimulate insulin secretion, suppress glucagon secretion, and slow gastric emptying, which helps to lower blood sugar levels.
- GLP-1 agonists also have effects on appetite and food intake, which can lead to weight loss.
Safety and Efficacy of GLP-1 Agonists
- GLP-1 agonists have been shown to be effective in lowering blood sugar levels and promoting weight loss in people with type 2 diabetes 2, 3, 4, 6.
- They are generally well-tolerated, but can cause gastrointestinal side effects such as nausea, vomiting, and diarrhea.
- More severe side effects, such as pancreatitis and allergic reactions, have also been reported.