Last update: Dec. 29, 2014

Diphenhydramine

Low Risk for breastfeeding


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

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

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Group

Diphenhydramine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Diphenhydramine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 - 60 %
Molecular weight 255 daltons
Protein Binding 98 %
VD 3,3 - 6,8 l/Kg
Tmax 2 - 2,5 hours
T1/2 3 - 5 hours
Theoretical Dose 0,015 mg/Kg/d
Relative Dose 0,45 - 1,2 %
Relat.Ped.Dose 0,3 %

References

  1. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  2. Ball H, Blair PS. (For UNICEF UK). Caring for your baby at night. Health professional´s guide. 2017 Full text (link to original source) Full text (in our servers)
  3. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  4. UNICEF UK. Statement on co-sleeping following publication of new NICE postnatal guidance. Infosheet. 2014 Full text (link to original source) Full text (in our servers)
  5. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  6. 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)
  7. 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)
  8. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  9. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008 Abstract Full text (link to original source) Full text (in our servers)
  10. 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)
  11. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  12. AEMPS. Difenhidramina. Ficha técnica. 2000 Full text (in our servers)
  13. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000 Nov;16(4):319-31. Review. Erratum in: J Hum Lact 2001 Feb;17(1):90. Abstract
  14. 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. 1993 May;168(5):1393-9. Abstract
  15. 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. 1989 Abstract
  16. Paton DM, Webster DR. Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines). Clin Pharmacokinet. 1985 Nov-Dec;10(6):477-97. Review. Abstract
  17. Carlson HE, Ippoliti AF. Cimetidine, an H2-antihistamine, stimulates prolactin secretion in man. J Clin Endocrinol Metab. 1977 Abstract
  18. 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

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