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What the evidence supports: Injectable semaglutide was undetectable in breast milk from eight nursing mothers at doses up to 1 mg weekly Injectable tirzepatide was undetectable in approximately 96 percent of milk samples from 11 nursing mothers at 5 mg doses Both medications have molecular weights (4,114 and 4,813 Daltons) that make significant milk transfer biologically unlikely Any trace amounts in milk would have negligible oral bioavailability in the infant No adverse infant effects were observed in any of the lactation studies LactMed states tirzepatide is not a reason to discontinue breastfeeding What the evidence does not support: Use of oral semaglutide (Rybelsus) during breastfeeding due to the absorption enhancer SNAC Use of any GLP-1 agonist without physician supervision during lactation Aggressive weight loss goals (more than 1 to 1.5 pounds per week) while breastfeeding Assumption that compounded formulations carry the same safety profile as pharmaceutical-grade products without specific data What remains unknown: Safety at higher therapeutic doses (semaglutide above 1 mg, tirzepatide above 5 mg) Long-term infant outcomes from maternal GLP-1 exposure during breastfeeding Effects on breast milk composition and nutritional quality Safety of newer GLP-1 agonists like retatrutide The decision is ultimately yours and your physician's
Diabetes Care, 19 (8), 843-848.
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The semaglutide speed of action guide and tirzepatide speed of action guide set realistic expectations
These effects may lead to temporary or permanent infertility, impaired spermatogenesis or oogenesis, and increased risk of congenital anomalies in the event of conception during treatment
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