The American College of Obstetricians and Gynecologists (ACOG) advises clinicians to discuss stopping glucagon-like peptide-1 receptor agonists one to two months before conception and recommends against use during pregnancy because outcome data remain limited.
Released Oct. 23, the guidance addresses medication use before, during and after pregnancy. Some patients take these drugs to treat obesity or type 2 diabetes. ACOG says evidence about pregnancy outcomes remains limited.
For semaglutide, the U.S. Food and Drug Administration’s (FDA) February 2026 prescribing information for Wegovy says to stop treatment at least two months before a planned pregnancy, citing the drug’s long half-life.
ACOG says breastfeeding decisions should take into account limited safety information and the needs of both patient and infant. Becker’s Hospital Review reported that the advisory also recommends monitoring an infant’s weight gain if a breastfeeding patient uses a GLP-1 drug, and advises against use while nursing preterm infants or neonates.
A 2024 study tested breast-milk samples from eight women after they received subcutaneous semaglutide. Researchers did not detect the drug in samples collected at 0, 12 and 24 hours. The authors said the study left open questions about long-term effects on infants and possible changes to breast-milk nutrients; its findings do not establish safety for other GLP-1 drugs or long-term use.
A JAMA study of 1,044,171 deliveries among commercially insured U.S. women found that GLP-1 prescription initiation within six months after delivery rose from 0.08% in the first half of 2018 to 1.9% in the first quarter of 2025. Researchers could not determine which patients were breastfeeding, so the figures do not show how many took the medications while nursing.
“This is a fast-moving area of research, so for now we need to proceed with caution and reassess as more data becomes available,” said Dr. D. Yvette LaCoursiere, lead author of the guidance.
