Fighting Misinformation on Weight Loss Drugs and the Affect on Breastfeeding Moms

The idea of weight loss drugs can be attractive to postpartum moms.

With a new baby, it is hard to find the time for self-care. Unlike the gym, taking a medication to lose weight doesn’t require childcare. Weight loss medication doesn’t require meal planning or carb counting. It is easy to see why medications like Wegovy, Ozempic, and Mounjaro are trending for new moms. But when they are breastfeeding, is this maternal medication safe for their baby? Healthcare providers know maternal medications can pass into breastmilk, and often aren’t prepared to help breastfeeding moms in need of treatment.

Healthcare providers say that a lack of conclusive drug data in breastfeeding is a barrier to sound decision making. It isn’t surprising as the most commonly used resources for drug information are the poorest sources of information on breastfeeding pharmacovigilance.

Medication product information states,

“The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for MOUNJARO or WEGOVY and any potential adverse effects on the breastfed infant from MOUNJARO or WEGOVY or from the underlying maternal condition.”

But for what risks, and what benefits?  How is a busy provider able to devote the necessary time to make that decision? When providers are unsure, they have trouble communicating the evaluation to the mother. Hale’s Medications and Mothers’ Milk™ can help with these decisions.

There is no data available on the transfer of Wegovy, Ozempic, and Mounjaro into breastmilk, or of infant outcomes. (The InfantRisk Center is collecting milk samples for these now--if you would like to participate in this research, contact us!) A legitimate fear exists that if these drugs get into breastmilk, the baby could lose weight or slow their growth. However, these fears may be overestimated. These drugs are large molecules, which should limit the amount of drug that can get into the milk compartment. It also makes the oral bioavailability low…even if the drug does get into breastmilk, an infant would only absorb 1% of the drug present. This is the reason Wegovy, Ozempic, and Mounjaro are all injectable medications: they have trouble being absorbed in the GI system.

We suspect that these drugs will not pass into breastmilk, not be absorbed by a breastfed infant, and therefore not harm the baby. However, without evidence to support our suspicion we still must proceed cautiously. An infant with low birth weight or slow growth would have greater risk of exposure. A mother with a family history of breast cancer may have additional benefit from the protective effects of breastfeeding. Each mother-infant dyad is different, and their risk-benefit balance will reflect their individuality.

Healthcare providers are the gatekeepers for prescriptions, and oftentimes overestimate risk to the infant. 

When this recommendation is given flippantly, or in error, by a healthcare provider, it is often left to the woman to be her own advocate to explore treatment options or second opinions. While women place priority on providers with whom they have existing positive relationships, women are frequently dissatisfied with the lack of information provided and seek multiple opinions, leading to conflicting opinions and dissatisfaction with answers.  As a result, women display a divergence in the standard faith in medical professionals’ advice.

With resources like the InfantRisk Center and Hale’s Medications and Mothers’ Milk™ we as providers can take evidence-based steps towards fighting misinformation and protecting breastfeeding mothers and their babies.

Kaytlin Krustch is the co-author of the worldwide gold standard for lactation support professionals, Hale’s Medications & Mothers’ Milk™, now also available online and in the app store as HalesMeds!