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Key pharmacological effects include: Glucose-dependent insulin secretion Enhanced pancreatic beta-cell insulin release only when blood glucose is elevated, reducing hypoglycemia risk Suppression of glucagon secretion Decreased hepatic glucose production from pancreatic alpha cells Delayed gastric emptying Slowed movement of food from the stomach to the small intestine Central appetite regulation Reduced hunger and increased satiety through hypothalamic pathways The delayed gastric emptying effect is particularly significant and represents both a therapeutic mechanism and a potential source of adverse effects

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

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There are also risks that come with substantial weight loss, Legro said