Mounjaro and Breastfeeding

[SlightlyWorriedMaybe]

Does anyone know of a private doctor that will prescribe while breastfeeding, please?

Have you tried going through the process? Out of the many questions, I don't remember that one being asked

No one should be, because it isn't known if it's safe. The medication instructions tell you not to breastfeed whilst taking it.

Actually it says,

"Breast-feeding
It is unknown whether tirzepatide passes into breast milk. A risk to newborns/infants cannot be ruled out. If you are breast-feeding or are planning to breast-feed, talk to your doctor before using this medicine. You and your doctor should decide if you should stop breast-feeding or delay using Mounjaro."

The implication is clear that you should either stop breastfeeding or wait until you've finished breastfeeding before starting Mounjaro.

I really hope there isn’t, why on Earth would you risk it?

How old is your child? That will influence things somewhat. Under a year. No way. 3 years old. Then yes maybe.

The molecule size is considered too large to get into breastmilk in any significant quantity. If the benefits outweigh the risks then it might be considered. For example if your bmi is just 30 and your health is good then I'd maybe wait. If your bmi is 50, you're prediabetic and have hypertension then yes maybe worth thinking about.

It has not been tested in breastfeeding women And likely never will be. But there has been some small studies looking at whether it appears in breastmilk (currently it's suggested no it doesnt). Also worth noting the covid vaccine had not been tested in pregnant or breastfeeding women and we all took that.

The breastfeeding network have useful info on drugs in breastmilk and state

Concerns have been raised about adequate nutrient content of breastmilk while taking GLP-1 agonists for weight loss. The evidence for this is poor and expert opinion suggests as long as you have enough weight to lose, that your milk should be unaffected (Hale). You are advised to take a multivitamin with sufficient vitamin D and to ensure you consume enough calories and protein to meet your needs while breastfeeding. This could be a challenge if your appetite is severely affected.

Based on that info make an informed decision for you. Research online. But no provider will prescribe if you declare you're breastfeeding.

To be fair, it is very difficult to prove a medication is safe for breastfeeding infants (especially if the medication can be safely stopped).

It would unethical to study the effect of medication on breastfed babies "just to see if it harms them" by giving medication to breastfeeding mothers in large enough numbers to study the results. For some medications that need to be continued for the mother's health, studies might show no immediate effect, but as for long term consequences it's harder again to study in significant numbers as the baby develops to child, adult, parent etc.

I would suggest that drugs that affect appetite and metabolism wouldn't be a reasonable risk to expose a young baby to such medication, even if in smaller doses through breastmilk...

Thanks all.

To answer a few questions...

Baby is 12 months, not reliably taking fluids from a cup/bottle etc.

I'm 41, BMI of 34

I'm not unfit. I'm struggling with body image, clothes that fit and most importantly very sore joints & fatigue.

I'm desperately wanting to lose weight but constantly hungry, constantly!

You’ll be constantly hungry because you are breastfeeding. I certainly wouldn’t risk taking any medication that’s not been deemed safe whilst breastfeeding and potentially risking the health of my child. If this is the route you want to go down maybe consider stopping breastfeeding?

you might find this helpful to read:

https://breastfeeding-and-medication.co.uk/fact-sheet/semaglutide-and-breastfeeding

I don’t think it’s a complete no based on the research. No studies have been done because they just don’t conduct studies on pregnant and breastfeeding women. There are plenty of women satisfied with how semiglutide breaks down in the body who are taking it, contrary to your responses on here. But these are usually larger bodied women usually with t2 diabetes.

Your BMI is 34. Not 54.

You say you’re constantly hungry, but does that mean you have to overeat? what are you eating? What does a day look like?

It’s normal to be ravenous when breastfeeding. It’s all calorie exertion.

Please ignore if this is not appropriate for you- but if you are finding yourself reaching for snack foods and larger portions - i would be making a conscious effort to not have those things in the house and eating from a smaller plate. 5000 steps a day with the pram.

Yes, it’s not easy and it will be hard- but you really are not far off a sub 30 BMI so I’d be giving that a go before trying any medication that isn’t licensed for breastfeeding.

I doubt you'll get it as pregnant and breastfeeding women aren't to take it.

It's a massive appetite suppressant so you may not be getting enough nutrients while supporting your baby's nutritional needs via your breastmilk too? In a few short months they'll probably be on a bottle or sippy cup and then you can look to a weight loss med?

@casualcrispenjoyer Just to add that Mounjaro isn't semaglutide, it's tirzepatide which is similar but different and has additional actions compared to semaglutide. Wegovy is the brand name of semaglutide for weight loss in the UK.

I stopped breastfeeding in order to start the WLIs, dd was old enough (2!), and the patient information leaflet says not recommended for breastfeeding women. I would either wait until you are comfortable to wean and try then or maybe try something else and keep breastfeeding? To be honest I wouldn't want to do both as I found breastfeeding strangely exhausting. I know a lot of people don't find this, so possibly just me. Good luck!

I will preface this by saying that I am a huge advocate for extended breastfeeding and fed both of my babies well into toddlerhood.

However. Based on what you have said there are a number of things that you should potentially explore before taking the risk of combining a GLP-1 and breastfeeding. It’s possible that your joint paint is being exacerbated by the high levels of relaxin which remain in your system while you are lactating. Have you had bloods to rule out underlying causes of the fatigue, particularly low iron? Does your baby sleep through (no judgement - mine never did) and are you still doing night feeds?

Àlso an advocate of prolonged bf here (for mothers who want). And not a rule follower by nature.

But for your wellbeing and dd’s, you need to finish bf first.

Once you’ve stopped bf, your hormones will settle down and your body shape is likely to change. You’ll also feel less hungry. Then make an assessment of your diet and exercise and try WLIs if you still want to.