Benadryl (Diphenhydramine) During Breastfeeding
Benadryl is generally considered safe to use during breastfeeding, though the FDA label advises asking a healthcare professional before use, and you should use the lowest effective dose for the shortest duration while monitoring your infant for drowsiness. 1, 2
Safety Profile
All antihistamines, including diphenhydramine (Benadryl), are considered safe during breastfeeding because minimal amounts are excreted into breast milk and would not be expected to cause adverse effects in a breastfeeding infant 2
First-generation antihistamines like diphenhydramine have been used extensively during lactation with reassuring safety data 2
The FDA drug label for diphenhydramine states "if pregnant or breast-feeding, ask a healthcare professional before use," which is a standard precautionary statement rather than a contraindication 1
Key Monitoring Considerations
Watch your infant carefully for these potential effects:
Marked drowsiness or unusual sleepiness - this is the primary concern with diphenhydramine exposure through breast milk 1
Excitability - paradoxically, some infants may become more excitable rather than drowsy 1
Poor feeding or decreased alertness - these would warrant immediate medical attention 1
Practical Recommendations
To minimize infant exposure while using Benadryl:
Use the lowest effective dose for the shortest time possible - this principle applies to all medications during breastfeeding 3
Avoid using diphenhydramine to make yourself or your child sleepy - this is explicitly contraindicated per the FDA label 1
Time your doses strategically - take the medication immediately after breastfeeding or before your infant's longest sleep period to minimize drug concentration in milk at the next feeding 3
Avoid alcohol, sedatives, and tranquilizers while taking diphenhydramine, as these can increase drowsiness effects that may impair your ability to safely care for your infant 1
Important Safety Caveats
Do not co-sleep with your infant while taking diphenhydramine - sedating medications can inhibit your natural responsiveness to your baby during sleep 4
Be cautious when driving or operating machinery - marked drowsiness may occur, which could compromise your ability to safely care for your infant 1
Do not use with any other product containing diphenhydramine, including topical formulations, as this increases total exposure 1
When to Seek Medical Advice First
Consult your healthcare provider before using Benadryl if you have: 1
- A breathing problem such as chronic bronchitis
- Glaucoma
- Trouble urinating due to enlarged prostate gland
- Are currently taking sedatives or tranquilizers
Context on Medication Safety During Breastfeeding
Most commonly used drugs are relatively safe for breastfed babies, with the dose received via milk generally much smaller than known safe doses given directly to infants 5
Very few drugs are truly contraindicated during breastfeeding - these include anticancer drugs, lithium, oral retinoids, iodine, amiodarone, and gold salts (notably, diphenhydramine is not on this list) 5
Many women are inappropriately advised to stop breastfeeding due to outdated information sources, so ensure you're getting current evidence-based guidance 6