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Creatine in Pregnancy & Breastfeeding: What the Peer-Reviewed Research Actually Says (and What We Still Don’t Know)
Creatine is one of the most studied supplements in sports nutrition… yet pregnancy and lactation are not the populations driving most of that data. So if you’ve heard “creatine is safe for everyone” and “don’t touch anything while pregnant/breastfeeding,” both of those takes are missing nuance.
What creatine is and why pregnancy/lactation might be a “special” use case:
Creatine is a nitrogen-containing compound stored largely in skeletal muscle (and also used heavily by the brain). It helps buffer and rapidly regenerate ATP via the phosphocreatine system, which is especially relevant when energy demand spikes or oxygen availability is limited.
Pregnancy and early infancy are periods of:
- massive tissue growth,
- high energy needs,
- and (during labor/birth) potential intermittent hypoxia.
That’s why creatine has become a topic of interest beyond performance supplementation.
Creatine + Pregnancy
A foundational scientific review highlights a consistent theme across animal studies: maternal creatine supplementation during pregnancy appears to protect fetal tissues (brain, diaphragm, kidney) from hypoxic insult near term.
Important nuance:
These are controlled experimental models, not human outcome trials.
Still, the protective signal is strong enough that multiple research groups have argued creatine deserves serious clinical investigation in obstetrics.
When it comes to HUMAN pregnancy data:
A 2024 prospective cohort study examined creatine metabolism during pregnancy and found that while maternal plasma creatine is relatively conserved, creatine metabolism appears to adjust throughout pregnancy, suggesting the maternal body actively works to maintain creatine availability.
This matters because it supports the concept of creatine being “important enough” in pregnancy that the body compensates to preserve it.
Recent safety-focused reviews generally describe creatine in pregnancy as a promising but investigational concept. The preclinical support is compelling, yet human efficacy trials are still needed.
Practical guidance: Creatine during pregnancy is not yet “standard” because we lack robust human outcome trials. If someone is considering it anyway, it should be a shared decision with their OB/midwife, especially with kidney disease, preeclampsia/renal involvement, or other high-risk factors.
What about creatine + breastfeeding?
Creatine is naturally present in human breastmilk. LactMed (NIH) notes creatine is a normal component of breastmilk, contributing a meaningful portion of an infant’s daily creatine needs, with concentrations highest in colostrum and decreasing over the first couple of weeks before stabilizing.
The big “we don’t know” for breastfeeding: milk levels AFTER supplementation
I’d say this is the most important limitation: Milk levels of creatine have not been measured after maternal supplementation in humans.
So while creatine is present in milk and is generally well-tolerated in adults, we can’t precisely quantify:
- how much supplemental creatine would raise milk creatine,
- or whether that would have any measurable infant effect (positive, neutral, or negative).
Here’s what we can say based on the totality of evidence:
Creatine has an extensive safety literature in non-pregnant adults (including long-term use in many studies), and major sports nutrition position statements characterize it as safe and effective for indicated uses in those populations.
LactMed does not report documented harms in breastfed infants from maternal creatine, rather, it emphasizes the absence of direct supplementation studies and notes speculation that supplementation might be helpful in some contexts, but remains untested.
For healthy breastfeeding women, creatine appears likely low risk, but evidence is not definitive due to limited lactation-specific supplementation research.
The honest, bottom line
Pregnancy: promising science, but not settled. Creatine during pregnancy is best described as investigational pending more human clinical outcome research.
Breastfeeding: creatine is naturally present in milk, and there are no strong red flags in the literature, but supplementation during lactation still lacks direct milk-level and infant-outcome studies, so we stay conservative and individualized.
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