Q&A: Can I Breastfeed on Ozempic?

Question: Can I breastfeed and take Ozempic?

This was asked to me by a close friend, so we were able to discuss her health a bit. We first discussed her risk factors for developing Type 2 Diabetes, including a history of gestational diabetes (diabetes that begins during pregnancy) and previous A1C readings at a prediabetic level (6.1-6.4). For reference, your A1C should be less than or equal to 6, whereas greater than or equal to 6.5 is considered a diagnostic criteria for diabetes.  A1C is most simply understood as an average of your blood sugar activity and levels over the previous 3 months (the lifespan of the red blood cell). A1C is the most accurate way we can diagnose prediabetes and diabetes - taking finger pricks only offer blood sugar from a single moment in time, whereas A1C gives us a story of a 3 month time period. I had never been asked this question, so I took to my resources to find the most reputable source: Ozempic (Novo Nordisk) themselves.

Answer: It's complicated....

For brand name drugs, we often look to the package insert to answer our questions. The package insert is that folded up piece of paper stuck to the top of a manufacturer's bottle. If you can't picture it, it's probably because you've tossed it away without ever knowing how useful it is. Ozempic's package insert states:

 "There are no data on the presence of semaglutide in human milk, the effects on the breastfed infant, or the effects on milk production. Semaglutide was present in the milk of lactating rats, however, due to species-specific differences in lactation physiology, the clinical relevance of these data are not clear (see Data). The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for OZEMPIC® and any potential adverse effects on the breastfed infant from OZEMPIC® or from the underlying maternal condition." (Ozempic PI, Novo Nordisk)

Sounds complicated...but what does it all mean?

In the simplest way: discuss Ozempic with your doctor/OBGYN. Your doctor can analyze your history, blood readings, and risk factors to determine if Ozempic could provide a greater benefit or could be too much of a risk.

For my friend we discussed earlier, I told her no, that I do not believe she is a candidate for Ozempic treatment and I do not believe it is worth the risk. Her A1C was not yet within diabetic range, so at this point we can better manage her weight and blood sugar with less drastic steps, most importantly diet and exercise. Incredibly, lifestyle change is still the first, and arguably the most important, option for weight loss If you are diabetic, please discuss your options with your doctor.

All in all, we should be weary of what we see on social media. Remember: when something sounds too good to be true, it is.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-108

Resources:

1. Ozempic. Package Insert. Novo Nordisk. Updated 10/2023. Available online at https://www.novo-pi.com/ozempic.pdf