Your Friday Five: Restarting GLP-1s Postpartum—What to Expect

This week’s Friday Five tackles a question many women quietly wonder about:
 “What should I expect if I restart Mounjaro after pregnancy and breastfeeding?”

Whether you paused your GLP-1 for pregnancy, breastfeeding, or simply life circumstances, coming back to it after many months brings up a lot of unknowns. In this episode, I break down what typically happens, what we actually know from emerging research, and most importantly—why postpartum women need close, compassionate medical support.

Inside the episode, we explore:

1. What current guidelines say about GLP-1s, pregnancy, and breastfeeding

The traditional recommendation is stopping GLP-1s two months before trying to conceive and waiting until you’re done breastfeeding to restart.
But I also share a recent small study looking at semaglutide and its transfer into breast milk—and what that means (and doesn’t mean) for real-life decisions.

2. Why restarting after long-term use often looks different

If you were previously on Mounjaro for 6–24 months, your body typically:

• tolerates the medication more easily
• can often titrate up more quickly
• experiences fewer early side effects
   Some of this is physiologic, some behavioral—because you’ve already learned hydration, fiber strategies, and the day-after-injection do’s and don’ts.

3. The postpartum period is the “fourth trimester”—and it changes everything

Exhaustion, unpredictable schedules, stress, hormones, sleep deprivation… postpartum is not just a season. It’s a vulnerable season.
This is why you should never “go cowboy alone” when restarting medication.
A skilled clinician helps prevent:

• excessive restriction
• metabolic overwhelm
• worsening mood
• tipping into depression or anxiety
• extreme titration that backfires

4. How ongoing support during pregnancy impacts your restart

I share examples from my own clinic:
 Some women stay with me through pregnancy—not for weight loss, but for structure, nutrition support, and a stable relationship with food.
 Those women often find it much easier to restart postpartum because they never disconnected from caring for their bodies.

5. The good news: most women feel relief when they restart

Once medically cleared and supported, many women say:

• their appetite becomes manageable again
• their mental load decreases
• their urges and cravings quiet down
• they finally feel like they have help

And that’s the whole point: to feel supported, not stressed.

If you’re in this season, I’m rooting for both your health and your baby’s h

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Not Sure Where to Start With the Podcast? I’ve Got You.

Get my free Podcast Roadmap—a simple guide to help you find the episodes that matter most to your journey. Whether you're on GLP-1s, navigating plateaus, or just starting out, there's something here for you.

Transcript

0:29

Welcome back to another, your Friday. Five. I know that this is something that might not apply to everybody, but I got asked a question here. Someone said, what should I expect? I'm about to restart Manjaro after 11 months. After 11 months of being, like post pregnancy being off of it, I'm assuming, or maybe that's the baby plus a month or two after, I don't know. I was pregnant. And when I stopped, I was on, they were saying they were phase two outta three. They were in the phase where they were less volume restricted, but they were not back to the phase where they had a bunch of urges and cravings, problems like that. And they're asking after being on it for almost two years. So what should they expect when they get back on it? Before we even get to that, I wanna say just in general with pregnancy. The traditional recommendation is gonna be holding a GLP one at least two months before you're trying to get pregnant and then to resume it when you're done breastfeeding. Now that being said, there was a publication that came out. They said it was recent, the title was Semaglutide during Breastfeeding. Infant Safety Regarding Drug Transfer Into Human Milk. I'll put the link down below. Now, there's a way in depth episode if you have not checked out yet. The podcast is called Modern Metabolic Health. This was the. Lindsay Ogle, she finally started her podcast and I love it'cause she is really, she goes deep on papers and things like that. She had an episode, it was on November 10th, if you wanna check that out. And she went deep on it. But to give you the cliff notes on this, it was a very small study, here's roughly what they did in the study. They took eight women and they gave them GLP one medication. They were six months postpartum and they measured labs at three weeks so it could build up in their system. And then they took breast milk samples and they looked at, right at the time of the weekly injection. They looked at 12 hours after and 24 hours after injection. And they saw that was semaglutide, none of it was in the breast milk. The conclusion was that likely there's no transfer from the mother to the baby in the milk. Now this is a very small sample size. We can't extrapolate it to Tirzepatide, and I don't know that anyone is gonna say, Hey, get back on your medication when you're breastfeeding. I do know that some women are comfortable with. Thinking through that. It's such a big molecule size, something like Tirzepatide, that they're wanting to start it back before they're done breastfeeding. But this is a conversation that you need to have with your ob gyn doctor. Coming back to the plot here, if you are done breastfeeding, we're gonna assume that. Scenario and then you're getting back on your GLP one. What I typically see is if someone has long-term been on a GLP one before, which I would say that's anything more than six to 12 months. So you were on it two years prior to that. You were on it for two years and then you had a y basically a year off and now you're coming back on it. So you will likely, this isn't everybody again, talk to your medical team, but you will likely have a quicker titration up. To get to the dose that's effective for you. It's very interesting that when you first start the medication, lower doses, you're on it for at least four weeks each dose. And then even then you might not go up. And so this is a very, cautious time and there's all these side effects. And typically, I, I don't know what it is about your body having. Received it at some point in the past, but I find that people can go up quicker to get to a therapeutic dose. And maybe it's that we already know what to expect. Part of what I'm thinking here is that people have learned the do's and don'ts with these medications. They know how to maybe get more fiber. They know how to hydrate. They know right the day after the injection and not overdo it. So maybe they've already learned all that and that's why it's happening. But typically, if you're working with a skilled clinician. I find that the postpartum woman is a very vulnerable woman. It's truly the fourth trimester, and I think that this is. Gosh, if there's a group that's ignored, it's this group. Your life is absolute hell, potentially if you don't have enough help after you have a baby, and depending on the disposition of your baby and everything that's happening. And then on top of that, if we're adding stress of weight loss, not that you don't wanna do it, and not that you might not feel a lot better and all of that, but you need a lot of close guidance. If you hear nothing else that I say. It's that do not go cowboy alone on this. Have the help of someone skilled. We do not need to kick things into overdrive. We don't need to make a postpartum depression happen because you're so calorie restricted that you go ketogenic and now your mind is thinking different things. We don't need these things to occur. I would just make sure that when you're doing this, that you have close oversight. I find that if. The clinician has not worked with enough postpartum women. They do not understand this.'Cause I actually have patients that they do get pregnant and some of them will stick with me during the pregnancy to get that monthly help with nutrition and to really just stay on top of things. And then they find afterward it is so much easier for them to just jump back into things because they never stopped caring about what was happening. And yes, we're not working on weight loss obviously. That was never the goal anyway, and it was always health. And so during pregnancy is a perfect opportunity to really, be in harmony with your body and heal that relationship with food. I will leave it there, but hopefully this is a tool that you're able to get back to. And I typically find that when women get back on the GLP one, they get relief again. They feel like they have some help in this area and that life gets easier. I am hoping for good health, for not only you, but also your baby and that everything goes great for you guys. Alright, if you guys have other questions, let me know. I hope you have an amazing weekend and I'll see you Monday. I.