Is Diphenhydramine compatible with breastfeeding? Do we have alternatives for Diphenhydramine?

Diphenhydramine

December 29, 2014 (Low Risk)

It is a first generation antihistamine drug (Ethanolamine) with a strong sedative effect.

A high protein-binding capacity makes difficult an excretion into breast milk in significant amounts in accordance with old studies that had confirmed it.

The absorption from ingested mother's milk to the infant's plasma is hampered by a low oral bioavailability.

For both, the mother and the infant is safer the use of antihistamine medication with higher safety levels without sedative effect, especially when the child is a premature or younger than 1 month old.

Neither a decrease of milk production nor alteration of Prolactin release have been shown with the use of this drug.

When used while breastfeeding do it with the lower dose as possible and avoid a long-term use.

Check up for feeding difficulty and somnolence in the infant.

Bed-sharing with the infant is not recommended for parents who are on this medication.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • ジフェンヒドラミン
  • Benzhydramine
  • ثنائي فانهيدرامين
  • Δυφαινυδραμίνη
  • Дифенгидрамин
  • 苯海拉明

References

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  2. UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. 2013 Full text (link to original source) Full text (in our servers)
  3. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  4. L.Landa Rivera, M.Díaz-Gómez, A.Gómez Papi, J.M.Paricio Talayero, C.Pallás Alonso, M.T.Hernández Aguilar, J.Aguayo Maldonado, J.M.Arena Ansotegui, S.Ares Segura, A.Jiménez Moya, J.J.Lasarte Velillas, J.Martín Calama, M.D.Romero Escós. El colecho favorece la práctica de la lactancia materna y no aumenta el riesgo de muerte súbita del lactante. Dormir con los padres. Rev Pediatr Aten Primaria. 14:53-60 2012 Full text (link to original source) Full text (in our servers)
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  6. ABM - Comité de protocolos de la Academia médica de lactancia materna (Academy of Breastfeeding Medicine). Protocolo Clínico de la ABM #6: Lineamientos sobre la práctica de dormir al bebé junto con la madre y la lactancia materna Revisión, marzo de 2008. Breastfeeding Medicine 2008 Full text (link to original source) Full text (in our servers)
  7. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008Abstract Full text (link to original source) Full text (in our servers)
  8. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  9. AEMPS. Difenhidramina. Ficha técnica. 2000 Full text (in our servers)
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  11. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993Abstract
  12. Dostal LA, Schwetz BA. Determination of diphenhydramine in rat milk and plasma and its effects on milk composition and mammary gland nucleic acids. J Pharm Sci. 1989Abstract
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  14. Carlson HE, Ippoliti AF. Cimetidine, an H2-antihistamine, stimulates prolactin secretion in man. J Clin Endocrinol Metab. 1977Abstract
  15. 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. 1951