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I receive a lot of questions at ParentData — in your emails, when I meet you in person, and on Instagram. These questions are incredibly varied (nutrition, sleep, poop, very specific issues with your children), but the two I can reliably predict hearing every week are about Botox and GLP-1s during breastfeeding.
For many people, the use of either or both of these was part of their lives pre-baby. Both are likely to have gone by the wayside during pregnancy. Weight loss during pregnancy isn’t recommended, and most providers will not do Botox (even though the actual risk is very low). In the first weeks of your baby’s life, especially if you’re breastfeeding, these may also not have been top of mind.
However, as your baby gets older, breastfeeding is more established, and especially for those who are looking to nurse for a year or more, it’s natural to start to ask whether either or both of these are safe to combine with nursing.
The good news: yes, they both are. Let’s go to the data.
Can I use Botox while breastfeeding?
Evaluating the safety of medications in breastfeeding is quite a bit easier than during pregnancy because we are able to look directly for substances in the milk. In pregnancy, we have a bit of a guessing game about how much of the substance moves through the placenta. With breast milk, we can measure exposure precisely.
In the case of Botox, such measurements show that pass-through is minimal, even in extreme cases. The LactMed database, which covers the safety of medications during breastfeeding, explicitly states that Botox during breastfeeding is fine. As evidence, they draw on a case where a mother got botulism poisoning (she ate some tainted salmon eggs). The concentration of the toxin in her system was extremely high, and yet, it didn’t pass through to her breast milk or the infant.
This is extremely reassuring, especially when you consider that the amount of toxin in cosmetic use is much lower and is localized, so the safety profile is even clearer. Basically, even if you are poisoned with this toxin in your whole system, it is still fine to breastfeed. By extension, if you have a small amount of Botox injected into your facial muscles, it’s even more fine. Enjoy your Botox!
I also feel compelled here to say that you look great already. So if you want to skip the Botox, that is also super.
Can I use GLP-1s while breastfeeding?
GLP-1s — this is the broad name for weight loss drugs like Wegovy and Zepbound — are increasingly common. These medications aren’t for everyone, and many doctors will urge caution around, say, using these to try to lose the last few pounds of baby weight. Having said that, for many people, they are very helpful for losing weight and improving metabolic health overall.
There are two main concerns about breastfeeding on a GLP-1. The first is that the medication might pass through the milk, affecting the baby’s appetite and weight gain. The second is that your milk supply might suffer if you consume fewer calories.
The good news is that we have reliable data on the first issue, suggesting it is not a concern. Although it is a small sample, a detailed 2024 study of eight women using GLP-1 medications showed no evidence of transfer into breast milk. This medication replicates naturally occurring hormones, which is another argument for safety.
The second issue — that you will not consume enough calories to keep up supply — is less easy to evaluate. Individual response to these medications varies, and milk supply reactions will also vary. This concern is more important with a newborn than an older baby, both because milk supply is still getting established and because the baby is not getting calories in other ways. With your 6-month-old, they are starting to get some calories from other sources, and that will be increasingly true.
In the end, there is no significant baby health concern from starting these medications. It is, however, possible that the medication will affect your milk supply, possibly to the point that you need to change the balance of breast milk and formula. This isn’t bad, but it is a risk to be aware of, depending on your breastfeeding goals.
The bottom line
- Standard cosmetic Botox is considered safe (and totally optional because you already look great).
- GLP-1 medications don’t appear to transfer into breast milk, but they may reduce your calorie intake enough to affect milk supply.
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