Overview
- ACOG published the advisory on Oct. 23, 2026, and recommends stopping GLP-1 receptor agonists one to two months before conception and avoiding them during pregnancy because safety in pregnancy is not established.
- For breastfeeding patients the guidance allows case-by-case reinitiation under shared decision-making with coordinated infant weight and health monitoring and advises against use in preterm infants and neonates.
- The advisory warns against oral GLP-1 formulations during lactation because of altered absorption from formulation changes and notes that specific agents such as semaglutide and tirzepatide commonly require an 8–10 week washout before conception.
- Clinicians are urged to individualize plans to prevent weight regain and worsening glycemia by arranging preconception transition strategies, glucose monitoring, nutritional and activity support, and timely switches to pregnancy-compatible therapies when needed.
- ACOG emphasizes that human data are limited, citing small observational studies and one small milk analysis that did not establish safety, and calls for more research to define fetal and infant risks as use of these drugs grows.