Is Benzhydramine Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Benzhydramine? Is Benzhydramine safe for nursing mother and child? Does Benzhydramine extracts into breast milk? Does Benzhydramine has any long term or short term side effects on infants? Can Benzhydramine influence milk supply or can Benzhydramine decrease milk supply in lactating mothers?

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.

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.

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.[2]

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[3][4] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[3] Whether lower oral doses of diphenhydramine 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. One woman became dependent on dimenhydrinate (which is 55% diphenhydramine) during her first pregnancy and continued to take it in a dose of 150 mg (83 mg diphenhydramine) daily while she breastfed her infant for 3 months. The infant did well except for a febrile seizure at 2 years of age, which was probably unrelated to dimenhydrinate. During her second pregnancy, she took dimenhydrinate 300 mg (165 mg diphenhydramine) daily during the pregnancy and while breastfeeding her infant for 2 years.[5]