Is Semaglutide Safe While Breastfeeding? Risks and Considerations

Semaglutide (the active ingredient in Ozempic®) has gained popularity as a weight loss medication. Many breastfeeding mothers are concerned about its safety and potential effects on their infants. It's important to carefully consider the available information and consult a healthcare provider before using semaglutide during this critical time. 

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This question has raised worries among doctors and breastfeeding mothers as they try to balance their desire to manage their weight while keeping their babies healthy. To make smart choices during this time in motherhood, it's important to understand how semaglutide might affect breast milk and the health of infants. This article looks into how safe semaglutide is during breastfeeding, how it affects breast milk production, and what's in it. 

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Key Takeaways

• The safety of semaglutide during pregnancy and breastfeeding is not fully established, as there are limited studies in humans. Mothers considering this medication should consult with their healthcare providers to weigh the potential risks and benefits.

• Animal studies have shown potential risks, but these may not directly translate to humans ^{[1] [2]}.

• It takes about six weeks for semaglutide to leave the body in healthy adults ^[1].

• Healthcare providers recommend stopping semaglutide two months before planning a pregnancy ^[1].

• Potential side effects for breastfed infants could include hypoglycemia and gastrointestinal issues ^[2].

• Semaglutide might affect milk production, but human data is lacking ^[2].

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Is Semaglutide Safe While Breastfeeding?

The safety of semaglutide for breastfeeding mothers is an important concern, especially for those considering its use for weight management or diabetes control. Currently, there is no clinical data on the effects of semaglutide during breastfeeding, making it essential to consult a healthcare provider before use. Right now, there isn’t any clinical data on how semaglutide affects breastfeeding [3]. This gap in human studies makes things challenging for both doctors and breastfeeding moms.

Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, influences blood sugar regulation and appetite control [2]. This drug boosts insulin secretion, reduces glucagon release, and makes you feel full. These effects help with weight loss and diabetes management, but they also raise concerns about possible risks to babies who are breastfed.

Animal studies have shown that semaglutide can be present in the milk of nursing rats at higher levels than in their blood. It's important to note that animal studies do not always predict outcomes in humans, and more research is needed to understand the potential effects on breastfed infants. The drug reached its highest concentration in milk 8 hours after the rats received their dose [2]. Again, keep in mind that what happens in animals doesn't always coincide with what happens in humans.

The molecular structure of semaglutide suggests that it may not pass easily into breast milk due to its high molecular weight and protein-binding properties. This does not eliminate the potential risks, and human studies are needed to confirm its safety during breastfeeding. Its high molecular weight of 4113 Da and protein binding over 99% mean the amount in milk could be low [3]. Also, semaglutide has poor oral bioavailability (0.4% to 1%), which means it could make it less likely to affect breastfed babies [3]. 

Even with some of these positive signs, we can't rule out risks to infants. Some possible concerns include:

1. Hypoglycemia: Semaglutide lowers blood sugar, which might have an impact on babies [2].

2. Stomach problems: Breast milk could pass on side effects like feeling sick and having loose stools [2].

3. Changes in milk supply: Semaglutide changes how hungry you feel and how fast your stomach empties, which could change milk production [2].

Because of these unknowns, it’s questioned if a breastfeeding mother should take semaglutide. The label on Rybelsus®, which is semaglutide in pill form, says not to use semaglutide while breastfeeding. This is because of worries that babies might get some of the drug passed on to them through the breastmilk [1].

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Semaglutide And Breastmilk

If breastfeeding moms use semaglutide, they should follow the guidance of a qualified healthcare provider and look out for signs in their babies, such as less hunger, bloated belly, acid reflux, hard stool, or runny stool [4]. Also, keeping an eye on how much weight the baby gains and how often they urinate can help spot any problems with getting enough milk [2].

A clinical trial that’s underway aims to analyze semaglutide levels in breastmilk after oral administration to healthy women who are breastfeeding [2]. This study's findings will shed more light on how semaglutide might pass through breastmilk.

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Possible Pros Of Taking Semaglutide While Breastfeeding

Possible Weight Control Advantages

Semaglutide influences appetite control and blood sugar regulation, which can help nursing mothers manage their weight [2]. This benefit is helpful for women who find it hard to lose weight after giving birth.

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Diabetes Management

Semaglutide helps mothers with type 2 diabetes control their blood sugar [2]. 

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Poor Oral Bioavailability

Semaglutide has an oral bioavailability of 0.4% to 1%, which means the body absorbs very little of it. 

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Ongoing Research

A clinical trial is investigating how much semaglutide ends up in breastmilk after healthy breastfeeding women take it by mouth [2]. This study will help us understand whether semaglutide can pass through breast milk, which will guide future advice.

Remember that these potential benefits exist, but we don't know how safe semaglutide is during breastfeeding because of limited human studies [2]. Doctors can give personalized advice on using semaglutide while breastfeeding, considering individual situations and possible risks [2]. You should also consider other treatments and ways to manage weight or blood sugar while breastfeeding [2].

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Cons Of Taking Semaglutide While Breastfeeding

Potential Infant Hypoglycemia

Potential Infant Hypoglycemia: Semaglutide can lower blood sugar levels, which may increase the risk of hypoglycemia in breastfed infants. Mothers should pay attention to signs of low blood sugar in their infants and consult their healthcare provider if they have concerns. Mothers should also watch their infants for signs like irritability, tremors, sweating, and lethargy. If these symptoms show up, it's a good idea to check blood glucose levels. Extra feedings may help prevent low blood sugar in the baby.

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Gastrointestinal Issues

The common side effects of semaglutide - nausea, vomiting, and diarrhea - might pass through breast milk [2]. Babies could feel stomach pain, have trouble eating, or experience digestive issues. Babies born too early face higher risks from stomach problems, so using semaglutide while nursing a preemie isn't a good idea because their digestive and immune systems aren't developed yet.

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Potential Impact on Milk Supply

Semaglutide might have an indirect effect on milk supply. It slows down stomach emptying and cuts hunger [2]. The release of prolactin and oxytocin, key for making milk, connects to how fast the stomach and gut empty. Less appetite could also mean less nutrition, which matters for milk production. Dehydration, another possible side effect, can affect breastfeeding. To fight low milk supply, moms may need to drink plenty of water and consider using milk boosters.

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Lack of Human Studies

At present, we don't have specific data about how semaglutide affects human milk production [2]. This gap in knowledge makes it hard to know if it's safe to use while breastfeeding. Studies on animals hint that small amounts of semaglutide might get into breast milk, but we need human data to make solid recommendations [1].

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Possible Issues with Tablet Form

The product label for Rybelsus®, the tablet form of semaglutide, advises against its use during breastfeeding [1]. This advice comes from theoretical worries that the tablet form might cause higher levels in a nursing baby compared to injectable forms. Doctors should talk about the good and bad points of different semaglutide forms with breastfeeding moms to choose the best treatment plan.

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Where To Buy Semaglutide

Semaglutide, which works as the main ingredient in drugs like Wegovy®, Ozempic®, Rybelsus®, and SubMagna™ (an oral form of semaglutide), is known for its ability to help people lose weight and control diabetes. But it's vital to know that in the US, Novo Nordisk is the only company that can sell FDA-approved medicines with semaglutide [7]. 

To buy semaglutide, you need a doctor's prescription. You can find semaglutide in many pharmacies, both online and in stores [9]. Online pharmacies let you order medicines from home and get them delivered to you. 

When purchasing semaglutide, it is crucial to obtain it from a licensed pharmacy and avoid versions from unverified sources. Compounded medications do not undergo the rigorous FDA approval process, which can raise concerns about their safety and effectiveness. Things to consider when buying semaglutide:

1. Talk to a doctor and get a proper prescription based on your individual needs.

2. Check if an online pharmacy is licensed using the National Association of Boards of Pharmacy's search tool. This ensures that they follow state pharmacy standards [7].

3. Use the FDA's state-by-state links to verify the pharmacy has a license in your state [7].

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Semaglutide: A Quick Wrap-Up

Mild stomach issues are the most common side

effects. But some rare and serious reactions have been seen, including:

·  Low blood sugar

·  Pain in joints and back

·  Swelling of the pancreas

·  Sudden kidney problems

·  Eye problems in people with diabetes

·  Allergic responses

·  Sudden gallbladder issues

·  Faster heart rate

·  Thyroid cancer

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Still, like with any drug, you should talk to a doctor to check your own risks and benefits.

Semaglutide comes in pill form, as a sublingual suspension, and as an injection. Each type has its pros and cons, and there are several factors to consider when deciding between semaglutide tablets vs injections:

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Oral forms (tablets and sublingual suspension):

·  No needles needed

·  You take them every day

·  Can make you feel sick, throw up, or have stomach pain

·  You should take them in the morning before eating and wait 30 minutes before having food

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Shots:

·  You need to use needles

·  You take them once a week

·  Might cause reactions where you inject

·  You can take them whether you've eaten or not

As with any other weight loss medication, there are pros and cons of semaglutide for weight loss.

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Pros:

·  Clinical trials show it works

·   It makes your overall health better

·   It cuts down on hunger

·   It helps control blood sugar

·   It gives you a way to manage weight without surgery

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Cons:

·   It can cause problems with your stomach and gut

·   It costs a lot even more if you don't have insurance

·   You need to take semaglutide for a long time to keep seeing results

·   You might gain weight back if you stop taking it

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In order to get approved for semaglutide, you should meet some minimum requirements:

1. To lose weight (Wegovy^®): A BMI of 30 or above,

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or a BMI of 27 or above with at least one health problem related to weight

2. To manage

diabetes (Ozempic^®, SubMagna™, and Rybelsus^®): A diagnosis of type 2

diabetes

You’ll need to talk to a doctor to find out if you can take semaglutide and if it's right for you.

The semaglutide costs can add up quickly if your insurance doesn't cover it. Prices can change based on your insurance plan, where you buy the semaglutide, and other factors. Research shows patients might pay up to 68% of the cost themselves for weight loss drugs.

You can get semaglutide prescriptions online through telehealth services, making it possible for you to get semaglutide online. Getting semaglutide from reputable sources like Eden ensures connections with qualified healthcare providers to get a prescription for semaglutide if your provider considers you an eligible person for the treatment.

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If you don't have insurance coverage, you have a few options when it comes to how to get semaglutide without insurance:

1.          Novo Nordisk, which makes semaglutide products, has programs to help eligible people.

2.          You can get discounts at different pharmacies using services like Optum Perks.

3.          Some pharmacies also make their own version of semaglutide that costs less.

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Without insurance, semaglutide can be expensive. Prices can change based on the pharmacy and where you live, but the cost of semaglutide without insurance can still be expensive. Some online coupons or discount programs can help cut the cost of semaglutide treatments.

Many people have lost weight using this drug when combined with diet and exercise. Always talk to your doctor to figure out the best way to treat your condition.

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Final Thoughts

The decision to use semaglutide during breastfeeding should be made in close consultation with a healthcare provider. While semaglutide offers benefits for weight management and diabetes control, the potential risks to breastfeeding infants are not fully understood due to the lack of human studies. Until more research is available, it is important to carefully consider alternative treatments and closely monitor both mother and baby if semaglutide is used.

Nursing mothers should talk to their doctors and consider other treatments to make smart choices. If they need to take semaglutide, it's crucial to keep a close eye on both mom and baby. As scientists do more research, including new studies, we'll learn more about how semaglutide affects breastfeeding. This will help guide future advice and keep moms and their babies healthy.

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Disclaimers:

• General Disclaimer: The information provided in this article is for educational purposes only and should not be considered medical advice. Always consult a healthcare provider before starting any new medication, especially during pregnancy or breastfeeding.
• Animal Studies Disclaimer: While animal studies provide initial insights, they do not always predict human outcomes. More research is needed to determine the safety of semaglutide during breastfeeding.

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FAQ

1. What are the risks of using semaglutide during pregnancy?

Ozempic^®, which contains semaglutide, is used primarily for managing Type 2 diabetes but has very limited data regarding its safety in human pregnancy. In animal studies, the use of Ozempic^® has been associated with pregnancy loss and birth defects. Therefore, it is usually recommended to avoid this medication during pregnancy.

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2. Are medications from the GLP-1 category safe to use while breastfeeding?

Current advice suggests discontinuing the use of GLP-1 agonists and SGLT2 inhibitors during both pregnancy and lactation. This recommendation is due to the limited data available, which primarily comes from animal studies. It is also recommended to continue documenting pregnancy outcomes related to these drugs in pharmacological databases.

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References

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1. OTIS Mother to Baby. Semaglutide. PubMed. Published March 2023. Accessed August 7, 2024. https://www.ncbi.nlm.nih.gov/books/NBK600385/

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2. Dr. V Medical and Aesthetics. Semaglutide While Breastfeeding. Dr. V Medical Aesthetics. Published September 25, 2023. Accessed August 7, 2024. https://www.drvaesthetics.com/semaglutide-while-breastfeeding/

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3. Drugs.com. Semaglutide use while Breastfeeding. Drugs.com. Published May 6, 2024. Accessed August 7, 2024. https://www.drugs.com/breastfeeding/semaglutide.html

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4. Jones W. Semaglutide and Breastfeeding – Breastfeeding and Medication. Breastfeeding-and-medication.co.uk. Published July 16, 2024. Accessed August 7, 2024. https://breastfeeding-and-medication.co.uk/fact-sheet/semaglutide-and-breastfeeding

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5. LactMed. Semaglutide. PubMed. Published September 15, 2023. Accessed August 7, 2024. https://www.ncbi.nlm.nih.gov/books/NBK500980/

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6. Lang L. I Got Pregnant Unexpectedly While Taking Ozempic. GoodRx Health. Published June 14, 2024. Accessed August 7, 2024. https://www.goodrx.com/ozempic/getting-pregnant-on-ozempic

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7. Lupkin S. Thinking of buying Wegovy online. Here’s what to know about compounding pharmacies. NPR. Published June 7, 2024. Accessed August 7, 2024. https://www.npr.org/sections/shots-health-news/2024/06/07/g-s1-3331/wegovy-online-compound-semaglutide-compounding-pharmacies

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8. Novo Nordisk. Semaglutide Medications | novoMEDLINK^TM. novoMEDLINK. Published 2024. Accessed August 7, 2024. https://www.novomedlink.com/semaglutide/medicines.html

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9. St. Mary's County Health Department. Breast Cancer and Your Risk - St. Mary’s County Health Department. St. Mary’s County Health Department. Published October 2018. Accessed August 7, 2024. https://smchd.org/2018/10/breast-cancer-and-your-risk

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10. Novo Nordisk. Supply update. Novo Nordisk. Published 2024. Accessed August 7, 2024. https://www.novonordisk-us.com/supply-update.html

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‌Disclaimer: The FDA does not approve compounded medications for safety, quality, or manufacturing. Prescriptions and a medical evaluation are required for certain products. The information provided on this blog is for general informational purposes only. It is not intended as a substitute for professional advice from a qualified healthcare professional and should not be relied upon as personal health advice. The information contained in this blog is not meant to diagnose, treat, cure, or prevent any disease. Readers are advised to consult with a qualified healthcare professional for any medical concerns, including side effects. Use of this blog's information is at your own risk. The blog owner is not responsible for any adverse effects or consequences resulting from the use of any suggestions or information provided in this blog.

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