Semaglutide

This report examines the transfer of semaglutide into human breast milk in mothers using subcutaneous (injectable) semaglutide. The study found that semaglutide was undetectable in the breast milk of mothers receiving the drug via subcutaneous injection, and breastfed infants whose mothers used this route did not experience adverse effects. The report also highlights an important safety consideration regarding oral formulations of semaglutide (e.g., Rybelsus): these contain the absorption enhancer salcaprozate sodium (SNAC), which may be transferred into breast milk and potentially accumulate in nursing infants, raising concerns about the oral route during lactation. The report concludes that only injectable forms of semaglutide appear to be appropriate for use during breastfeeding based on currently available data. Limitations include the likely small number of mother-infant pairs studied and the observational nature of the data, which precludes definitive causal conclusions. Long-term infant outcomes were not assessed.

Why this grade: While conducted in humans and measuring real-world breast milk drug levels, the study appears to involve a small, uncontrolled observational sample with no long-term follow-up, limiting the strength of its conclusions.