Patients who stop taking GLP-1s for pregnancy may be able to resume them while breastfeeding, according to an advisory from the American College of Obstetricians and Gynecologists published Oct. 23.
Under the guidance, OB-GYNs and other healthcare professionals can work with breastfeeding patients to decide whether to include GLP-1s in a postpartum care plan. If the drugs are used, the infant’s weight gain should be closely monitored in coordination with the infant’s healthcare professional. ACOG recommends against GLP-1 use while nursing preterm infants and neonates.
ACOG also advises against GLP-1 use during pregnancy because of a lack of safety data and recommends patients stop taking the drugs one to two months before conception.
Research has found an association between GLP-1 medications, such as Zepbound and Ozempic, and improved reproductive outcomes for women with polycystic ovary syndrome and higher ovulation rates.
“Despite these signals of benefit,” researchers wrote in a July review published in JBRA Assisted Reproduction, GLP-1s “remain contraindicated during pregnancy due to limited human data and fetal risks observed in animal studies; semaglutide and tirzepatide require an 8-10 week washout period prior to conception, and tirzepatide may reduce oral contraceptive effectiveness because of delayed gastric emptying.”
While literature on GLP-1 use during lactation is limited, ACOG said studies suggest the drugs are unlikely to be present in breast milk. Still, people who are breastfeeding should avoid oral GLP-1s because of a lack of safety data on the modifications made to enhance oral absorption, the organization said.
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