Breastfeeding and Weight Loss Medications

Introduction to Safety Concerns

Weight loss interventions should generally be deferred during lactation given the lack of urgent medical necessity and the established benefits of breastfeeding, as recommended by the American College of Obstetricians and Gynecologists 1

The American Journal of Obstetrics and Gynecology guidelines state "caution is advised" for bupropion use during breastfeeding due to reports of seizures in breastfed infants exposed to bupropion through breast milk 2, 3
Bupropion is present in human milk and has been detected in infant serum, though typically at very low levels, according to the American Journal of Obstetrics and Gynecology 2, 3
There are no published studies establishing the safety of the naltrexone-bupropion combination during breastfeeding, as noted by the American Journal of Obstetrics and Gynecology 2

Breastfeeding provides short-term protection against infectious morbidity and mortality, and long-term protection against inflammatory bowel disease, obesity, diabetes, and childhood cancers for the infant, as recommended by the World Health Organization 4
For mothers, breastfeeding reduces risks of diabetes, hypertension, and breast, ovarian, endometrial, and thyroid cancer, according to the American College of Obstetricians and Gynecologists 4

The American College of Obstetricians and Gynecologists recommends that weight loss for cosmetic or general health purposes is not urgent and should be deferred until after breastfeeding 1
If obesity-related comorbidities require immediate intervention, consider alternative approaches, such as lifestyle modifications, as recommended by the American Heart Association 1