Allergy season can leave you reaching for a fast-acting remedy. Taking an antihistamine like Benadryl is a common form of relief, although it’s also used to treat more significant allergic reactions to foods, bee stings, and other allergens. But can you take Benadryl while breastfeeding? It’s not the best choice of allergy medication, except in emergency situations, experts say. An occasional dose of Benadryl while breastfeeding may not cause any problems for you or your baby, but there are safer and more effective medications to take, particularly if your allergy symptoms are chronic. Here’s what breastfeeding parents need to know.
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. It comes in tablets, capsules, liquids, and creams. The active ingredient in Benadryl is diphenhydramine, which is an antihistamine. 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, such as:
- Headache
- Drowsiness
- Constipation
- Heart palpitations
- Impaired coordination
The use of benadryl and breastfeeding raises several questions for parents navigating allergy relief while caring for a newborn or young child. Understanding the potential effects on both the parent and the baby is crucial for making informed decisions about health and wellness.
Risks of Taking Benadryl for the Baby
Most healthcare professionals recommend avoiding regular or high doses of Benadryl while breastfeeding because the active ingredient in the medication can pass through breast milk. “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,” explains Nate Hux, RPh, a registered pharmacist, and owner of Pickerington Pharmacy in central Ohio.
Passing Benadryl to a baby through breast milk can cause them to become drowsy, excitable, or even irritable. “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,” adds Hux. This lack of definitive research underscores the caution advised by medical professionals.
Risks of Taking Benadryl for the Nursing Parent
The risks of taking Benadryl while breastfeeding begins with the central nervous system, as it causes drowsiness and 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 [parent],” says Lexi Hess, a certified lactation counselor in Ohio. “I am concerned Benadryl would make [them] too sleepy to care for the baby. [The parent] might not hear the baby cry or might dose off while feeding or holding the baby.”
Benadryl may also reduce breast milk supply, especially if taken long-term or in very high amounts. “I tell my clients not to take any antihistamines—if they can avoid them—because they tend to dry up the breastfeeding [parent’s] milk. Although everyone’s body is different, just one dose can impact milk supply,” claims Lexi Hess. Hux adds, “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.”
What To Do if You Take Benadryl While Breastfeeding
If you do have to take Benadryl, whether because of a severe allergic reaction or other necessity, here are some tips for what to do next. Talk to a healthcare provider. According to Hux, you may still be able to nurse, but it is important to get advice beforehand. Also, ask how long the medicine will be in your breast milk, so you can plan for future feedings or pumping. Hux says that 50 milligrams of Benadryl, which is usually the dose taken for an allergic reaction, is going to stay in your system for about eight hours or even a little longer.
Line up help in your home. 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. “They can supervise you and the baby,” she says. It’s also wise to avoid activities requiring alertness, such as driving or operating machinery, for the duration the medication is in your system.
How Long Does Benadryl Stay in Breast Milk?
The duration Benadryl remains in breast milk can vary. Several factors influence this, including the mother’s metabolism, the dosage taken, and the infant’s age and weight. While 50 milligrams of Benadryl is generally reported to stay in breast milk for approximately eight hours or longer, this is a general estimate. Some studies suggest that it can linger for up to 24 hours. This extended presence is why healthcare providers often advise caution, particularly with newborns and infants who have immature digestive systems.
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The active metabolite of diphenhydramine, paroxetine, can also be detected in breast milk. While the levels are generally lower than diphenhydramine itself, it contributes to the overall pharmacological effect on the infant. This is another reason why prioritizing alternative allergy treatments when breastfeeding is paramount.
Breastfeeding-Safe Alternatives to Benadryl
Fortunately, several alternative allergy medications are generally considered safer for breastfeeding mothers. These options often include second-generation antihistamines, which are less likely to cause drowsiness than first-generation ones like Benadryl. Claritin, also known as loratadine, is a popular example. Another option is Zyrtec (cetirizine), though some studies suggest it might have a slightly higher risk of drowsiness in some individuals. Allegra (fexofenadine) is another non-drowsy option that is often recommended. Before taking any medication, always consult with your healthcare provider to determine the safest and most effective option for your individual situation.
Beyond medication, non-pharmacological approaches can also help manage allergy symptoms during breastfeeding. These include avoiding known allergens, using saline nasal sprays to relieve congestion, and ensuring adequate hydration. For mild symptoms, these measures can often provide sufficient relief without posing risks to the baby.
Understanding Second-Generation Antihistamines
Second-generation antihistamines, such as loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra), represent a significant advancement in allergy medication. Unlike their first-generation counterparts, second-generation antihistamines are less likely to cross the blood-brain barrier, resulting in significantly reduced drowsiness. This is a crucial consideration for breastfeeding mothers who need to remain alert and attentive to their baby’s needs. While some individuals may still experience mild sedation, the risk is considerably lower than with Benadryl.
The mechanism of action for both first and second-generation antihistamines involves blocking histamine receptors in the body. Histamine is a chemical released by the body during an allergic reaction, causing symptoms like itching, sneezing, and runny nose. First-generation antihistamines bind to histamine receptors throughout the body, including those in the brain, leading to sedation. Second-generation antihistamines are more selective, primarily targeting histamine receptors in the periphery, minimizing their impact on the central nervous system.
When to Seek Immediate Medical Attention
While most allergic reactions can be managed with over-the-counter medications, some require immediate medical attention. Seek emergency medical care if you experience any of the following symptoms while breastfeeding:
- Difficulty breathing
- Swelling of the face, lips, or tongue
- Severe hives
- Dizziness or fainting
- Chest pain
These symptoms indicate a severe allergic reaction, also known as anaphylaxis, which can be life-threatening. Prompt treatment with epinephrine and other medications is essential in such cases. It’s also a good idea to have an emergency plan in place and ensure that your partner or other caregivers know how to recognize and respond to signs of anaphylaxis.
