Can I Take Benadryl While Breastfeeding?

Woman sneezing into tissue

Jevtic / iStockphoto

There is nothing worse than allergy season. Coughing and sneezing combined with a stuffy nose and itchy watery eyes can cause allergy sufferers to feel beholden to their allergies, especially if they are breastfeeding and just need a little relief.

In the United States, allergic rhinitis impacts as many as 60 million people a year, according to the Centers for Disease Control and Prevention (CDC). One common remedy for these symptoms is taking an antihistamine like Benadryl. Additionally, Benadryl (along with epinephrine) is often used to treat more significant allergic reactions to foods, bee stings, and other allergens.

Unfortunately, though, Benadryl is usually not the best choice of allergy medication if you are breastfeeding—except in emergency situations. Learn more about what Benadryl is and how it impacts you, your baby, and your breast milk as well as what you can do to address those pesky allergy symptoms that plague you.

What Is Benadryl?

Benadryl is the brand name of an over-the-counter medication designed to relieve itching, burning, redness, and other symptoms caused by an allergic reaction. The active ingredient in Benadryl is diphenhydramine, which is an antihistamine.

Benadryl, which comes in tablets, capsules, liquids, and creams, helps block histamine, a substance that certain cells in your body release during an allergic reaction. Typically, a histamine response will include a runny nose, sneezing, itchiness, and watery eyes. Sometimes people even develop skin rashes in response to an allergen.

The diphenhydramine in Benadryl helps to reduce the body's histamine response and treat the symptoms. What's more, diphenhydramine is a first-generation antihistamine, which means it was one of the first of its kind to be developed. As a result, there are more side effects from these drugs than later generations of antihistamines.

Is it Safe to Take Benadryl While Breastfeeding?

Most healthcare professionals recommend not taking Benadryl while breastfeeding unless absolutely necessary. Not only can the drug impact you personally by making you tired, but it also can be passed to your baby through your milk.

Consequently, this can cause your baby to become drowsy, excitable, or even irritable. In fact, according to LactMed, a U.S. drug and lactation database, breastfeeding mothers who took Benadryl reported that 10% of the infants exposed to diphenhydramine experienced irritability, drowsiness, and colicky symptoms.

Nate Hux, RPH

No one can tell you with absolute certainty that taking Benadryl is safe because there are no real studies on these types of medications as it is unethical to test adverse effects on infants.

— Nate Hux, RPH

"We only have anecdotal evidence, and everything that we can say about the drug is theoretical, based on what we know about how the drug would be expected to act," explains Nate Hux, RPH, a registered pharmacist, and owner of Pickerington Pharmacy in central Ohio. "No one can tell you with absolute certainty that taking Benadryl is safe because there are no real studies on these types of medications as it is unethical to test adverse effects on infants."

Breastfeeding mothers also should reconsider taking Benadryl because of the impact it has on their milk supply. Even just one dose of the drug can reduce the amount of milk a breastfeeding mom produces.

"I tell my clients not to take any antihistamines—if they can avoid them—because they tend to dry up the breastfeeding mother's milk. Although everyone's body is different, just one dose can impact a mom's milk supply," says Lexi Hess, a certified lactation counselor in Ohio. "Benadryl also can cause a mom to get too sleepy, so I would recommend a nasal spray instead."

Every breastfeeding journey is different. Be sure to consult with a healthcare provider about your circumstances if you have any questions about taking Benadryl while breastfeeding.

Risks of Taking Benadryl While Breastfeeding

When it comes to breastfeeding and Benadryl use, the most troubling impact are the side effects. Not only can Benadryl cause you to become drowsy, but it also can create coordination problems. Being sleepy and clumsy is not a good combination when trying to care for your baby—especially a newborn or an infant.

"My concerns with Benadryl are the impact it has on the nursing mother," says Hess. "I am concerned Benadryl would make her too sleepy to care for her baby. She might not hear the baby cry or she might dose off while feeding or holding her baby."

Benadryl gets into the central nervous system, meaning it is not the best option for breastfeeding parents. "Aside from the effects it could have on the mother and the baby, there also is the risk of taking too much Benadryl and having too much in the breast milk," says Hux. "Although Benadryl in small doses is probably not a big deal, I always err on the side of caution and recommend something other than Benadryl for treatment of ongoing allergies."

The only time Benadryl would be recommended to a breastfeeding mother would be during an emergency situation. For instance, Benadryl is commonly used alongside epinephrine when a person has an allergic reaction to a food, bee sting, or other common allergen known to cause anaphylaxis. It is also the most commonly used antihistamine in emergency departments.

If you do you have to take Benadryl, whether because of a severe allergic reaction or other necessity, consult with your healthcare provider on how to best feed your baby, Hux says. You may be able to nurse, but it is important to get advice beforehand.

Hess suggests that you have someone stay with you after taking Benadryl. It is important to have someone there until the medication is out of your system, she says.

"They can supervise while you nurse or they can feed the baby expressed milk from the fridge," she says. "It is also important to pay attention to your milk supply and to make sure you are still pumping if you are feeding the baby expressed milk."

As for what to do with the milk you expressed while the Benadryl is in your system, this is a discussion you need to have with your healthcare provider and your pediatrician, says Hux. In fact, 50 milligrams of Benadryl, which is usually the dose taken for an allergic reaction, is going to stay in your system for about 8 hours or even a little longer.

"I also think it is important that if you have a risk for a severe allergic reaction [from foods or bee stings] to have a backup plan for feeding your baby should you have to take Benadryl in an emergency situation," suggests Hux. "For instance, it is good to begin pumping and storing breast milk as soon as you can or have formula on hand for emergencies."

Breastfeeding Safe Alternatives

Keep in mind that Benadryl is not the only way to address your seasonal allergies. Here are some safe alternatives for treating your allergy symptoms that will have less of an impact on you, your baby, and your breast milk.

Claritin

Claritin, also known as loratadine, is a second-generation medication that is safer to take than Benadryl, which is a first-generation medication. This means it is less likely to make moms feel tired or sedated.

"Almost every drug crosses over into a mother's breast milk and Claritin is no exception," explains Hux. "But it is a safe drug and it is not likely to cause any harm. So, if you have to take something orally for allergies, that would be my recommendation."

Still, both Hux and Hess agree that taking antihistamines on a consistent basis while breastfeeding may not be the best course of action unless absolutely necessary (like when treating a severe allergic reaction.) Talk with your healthcare provider to determine what is right for you.

"Every situation is different," says Hux. "Most of the time when it comes to drugs, you have to weigh the risks and the benefits and then make a decision."

Saline Nasal Sprays

Some healthcare providers and lactation consultants recommend saline nasal sprays as an option for treating allergy symptoms because they are safe and easy for nursing mothers to use. Instead of taking a drug orally, the mother can treat her allergy symptoms topically. What's more, saline nasal sprays can be effective at rinsing pollens from the nose before they can cause allergy symptoms.

"If you get a cold or if your allergies are bothering you, talk to your healthcare provider or call a lactation consultant," suggests Hess. "Overall, you can take Tylenol and use a nasal spray for allergies or a cold. This is a much safer way to treat your allergy symptoms than taking an antihistamine."

Eye Drops

Typically, eye drops that are designed for cold- or allergy-symptom relief, are safe for nursing moms to use as well, says Hess. In fact, eye drops may work better than antihistamines when it comes to allergy-related eye symptoms.

Ultimately, eye drops can help with dryness, redness, itching, and even watering. And, like nasal sprays they allow you to treat your allergy symptoms without taking medication orally.

A Word From Verywell

When it comes to taking Benadryl while nursing, healthcare providers typically recommend that breastfeeding mothers not take Benadryl and instead use other options for addressing their allergies. Some options include Claritin, saline nasal sprays, and eye drops.

That said, in an emergency situation involving a life-threatening allergic reaction, taking Benadryl may be needed. If you do have known allergies to food or insects and have Benadryl on hand for emergencies, it is important to have a plan in place for how you will feed your baby if you have to use Benadryl. Talk to your healthcare provider to make a plan and determine what is right for you.

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Article Sources
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  1. Centers for Disease Control and Prevention. Allergens and pollens. Updated August 21, 2020.

  2. National Library of Medicine, National Institute of Health. Diphenhydramine. Updated October 19, 2020.