Diphenhydramine use while Breastfeeding
Drugs containing Diphenhydramine: Benadryl, Tylenol PM, ZzzQuil, Benadryl Allergy, Advil PM, Unisom SleepGels, Q-Dryl, Banophen, Sleep, Dicopanol, Show all 242 »Diphen, Sominex, Aleve PM, Dormin, Motrin PM, Benadryl Children's Allergy, Diphenhist, Nytol, Legatrin PM, Benadryl Children's Allergy And Sinus, Pain Reliever PM, Pain Relief PM Extra Strength, Sominex Maximum Strength Caplet, Nervine, Excedrin PM, Benadryl Allergy Plus Cold, Headache Relief PM, Unisom PM Pain, FIRST Mouthwash BLM, Benadryl-D Children's Allergy & Sinus, Bayer PM, Tranquil Nighttime Sleep Aid, Ivarest, Percogesic Extra Strength, Endal HD, Alka-Seltzer PM, Percogesic Original Strength, DPH, Hydramine, Valu-Dryl, Sleep-Eze-3, Simply Sleep, Diphedryl, Dytan, Siladryl, Sleepinal, Dermarest, Pharbedryl, Ala-Hist D, Calamine with Antihistamine, Airacof, Vicks QlearQuil Nighttime Allergy Relief, Quenalin, Allermax, Sleep Tab II, Theraflu Thin Strips Multi Symptom, Twilite, Duratuss AC 12, Diphenydramine Quick Melt, Tussinate, D-Tann CT, Mucinex Sinus-Max Day & Night (Night), Sudafed PE Nighttime Cold, Equate Allergy & Sinus Headache, D-Tann, Benadryl-D Allergy Plus Sinus, Mucinex Fast-Max Night Time Cold & Flu, Benadryl Allergy Sinus, Robitussin Night Time Cough & Cold, Triaminic Night Time Cold & Cough, Sudafed Sinus Nighttime Plus Pain, Anti-Itch Extra Strength, Headache Formula PM, Aceta-Gesic, Ibuprofen PM, Night Time Pain, Miles Nervine, Scot-Tussin Allergy, Dytuss, Sleepwell 2-nite, Aller-Dryl, Banophen Anti Itch, Benadryl Extra Strength Spray, Benadryl Extra Strength Itch Relief Stick, Valu-Dryl Topical, Complete Allergy Relief, Banophen M-S, Itch Relief, Diphenhist Topical, Histaprin, Compoz Nighttime Sleep Aid, Help I Can't Sleep, Diphendryl, Banaril, Nytol Caplet, Nu-Med, Tusstat, Diphenylin, Hydramine Compound, Pardryl, Aler-Tab, Siladryl Allergy, Ben-Tann, Benadryl Original Strength Itch Stopping Cream, Z-Sleep, Unisom SleepMelts, Nightime Sleepaid, Diphenmax, Sleep-ettes D, Uni-Tann, Q-Dryl A/F, PediaCare Children's Allergy, Respa SA, Delsym Children's Night Time Cough & Cold, Dermarest Plus, Dermamycin, Derma-Pax, Sudafed PE Nighttime Nasal Decongestant, Diphentann-D, Dermarest Anti-Itch, Benadryl Extra Strength Itch Stopping Gel , Sleep-ettes, Hydro-DP, D-Tann HC, HC-Derma-Pax, FIRST Duke's Mouthwash, FIRST BXN Mouthwash, Dytan-HC, Rindal HPD, Gestuss-HC, Doans PM, Uni-Tann D, Aldex-CT, Tavist NightTime Allergy, Actifed Allergy Day/Night, Benylin Multi-Symptom, FIRST Mary's Mouthwash, Tekral, SM Anti-Itch, Di-Delamine, Benaphen Plus, PediaCare Children's Allergy & Cold, Pediatex-CT, Dimetapp Children's Nighttime Cold & Congestion, Triaminic Thin Strips Night Time Cold & Cough, Diphenmax D, Children's Triacting Night Time, Theraflu Thin Strips Nighttime Cold and Cough, Dytan-D, Alahist LQ, Benadryl Extra Strength Itch Stopping Cream, Triaminic Thin Strips Allergy, Robitussin Night Time Cough, Cold & Flu, Robitussin Peak Cold Nighttime Multi-Symptom Cold, Theraflu Nighttime Severe Cold & Cough, Theraflu Warming Relief Flu & Sore Throat, Mucinex Children's Night Time Multi-Symptom Cold, Robitussin Multi-Symptom Cold Night Time, Delsym Cough+ Cold Night Time, Delsym Children’s Cough+ Cold Night Time, Suphedrine PE Severe Cold, CounterAct Night, Benadryl Severe Allergy Plus Sinus Headache, Severe Allergy and Sinus Headache, Benadryl Allergy Plus Sinus Headache, Benadryl Cold, Contac Day and Night Allergy, Tylenol Allergy Complete NightTime, Theraflu Warming Relief Sinus & Cold, Children's Tylenol Plus Cold And Allergy, CVS Allergy & Cold, Tylenol Allergy Multi-Symptom Nighttime, CVS Allergy & Sinus Headache, Theraflu Warming Relief Nighttime Severe Cold & Cough, Sudafed PE Severe Cold, Acetadryl, Genapap PM, Mapap PM, Counteract PM Extra Strength, ConRx PM, Bayer Select Max Strength Night Time Pain, Diabetic Tussin Night Time Formula, Respa C&C, Respa C&C IR, Contac Day and Night Cold and Flu, Midol PM, Wal-Nadol PM Extra Strength, Acetaminophen PM Extra Strength, Tylenol Severe Allergy, Anacin PM Aspirin Free, Tylenol Plus Children's Cold & Allergy, Non-Aspirin PM Extra Strength, Pharbetol PM, Sominex Pain Relief Formula, Coricidin Night Time Cold Relief, Tylenol Sore Throat Nighttime, Benadryl Severe Allergy & Sinus Headache, Actifed Sinus Day and Night, Genahist, Alka-Seltzer Plus Allergy, Aller-G-Time, Sleep Tabs, Diphenadryl, Calm-Aid, Allergia-C, Benahist-10, Benahist-50, Benoject-50, Somnicaps, Nytol QuickCaps, Beldin, Belix, Siladryl DAS, Siladyl SA, Triaminic Thin Strips Cough & Runny Nose, Altaryl, Total Allergy, Trux-adryl, Diphenyl, Aler-Dryl, Diphen Cough, D-Tann CD, Uni-Tann CS, Dytan-CD, Endal CD (old formulation), Dytan-CS, D-Tann AT, Ala-Hist, Invarest, Dytan-AT, Dytan-DM, D-Tann DM, Hydramine Cough Syrup, Bydramine, 40 Winks, Diphen AF, Hyrexin, Buckley's Bedtime, Snooze Fast, Diabetic Tussin Night Time Cold & Flu, ConRx Allergy, Silphen Cough
Diphenhydramine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Small, occasional doses of diphenhydramine would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use may cause effects in the infant or decrease the milk supply, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. Single bedtime doses after the last feeding of the day may be adequate for many women and will minimize any effects of the drug. The nonsedating antihistamines are preferred alternatives.
Maternal Levels. One old study that used a biologic assay system reported that after a 100 mg intramuscular dose of diphenhydramine in four women, drug levels in milk were undetectable in two and 42 and 100 mcg/L in two others at one hour after the dose. Five hours after the dose, milk levels were undetectable in two women and 20 and 100 mcg/L in two others. No studies using modern assay methods have been reported.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
In one telephone follow-up study, mothers reported irritability and colicky symptoms 10% of infants exposed to various antihistamines and drowsiness was reported in 1.6% of infants. None of the reactions required medical attention. In this study, drowsiness was reported in 1 infant of 12 exposed to diphenhydramine in breastmilk.
Effects on Lactation and Breastmilk
Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women. However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers. Whether lower oral doses of antihistamines have the same effect on serum prolactin or whether the effects on prolactin have any consequences on breastfeeding success have not been studied. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs to Consider
1. Rindi V. La eliminazione degli antistaminici di sintesi con il latte e l'azione latto-goga de questi. Riv Ital Ginecol. 1951;34:147-57.
2. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
3. Messinis IE, Souvatzoglou A, Fais N et al. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985;8:143-6. PMID: 3928731
4. Pontiroli AE, De Castro e Silva E, Mazzoleni F et al. The effect of histamine and H1 and H2 receptors on prolactin and luteinizing hormone release in humans: sex differences and the role of stress. J Clin Endocrinol Metab. 1981;52:924-8. PMID: 7228996
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