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Can you take diphenhydramine while breastfeeding?

By the pharmaranks editorial teamReviewed against the NIH/NLM Drugs and Lactation Database (LactMed) sourcesUpdated Sep 15, 2025How we research

What LactMed says

The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.

Small (25 mg or less), 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.

Quoted from Diphenhydramine — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised September 15, 2025.

What LactMed would consider instead

LactMed ends this record by naming the drugs it would consider in place of diphenhydramine. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.

How much diphenhydramine gets into breastmilk

Maternal Levels. One old study that used a biologic assay system reported that after a 100 mg intramuscular dose of diphenhydramine in four women, drug levels in milk were undetectable in two and 42 and 100 mcg/L in two others at one hour after the dose. Five hours after the dose, milk levels were undetectable in two women and 20 and 100 mcg/L in two others. No studies using modern assay methods have been reported.

Infant Levels. Relevant published information was not found as of the revision date.

What has been seen in breastfed infants

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.

Effects on milk supply

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women. However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers. 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.

Frequently asked questions

Can you take diphenhydramine while breastfeeding?

Small (25 mg or less), occasional doses of diphenhydramine would not be expected to cause any adverse effects in breastfed infants. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.

What can I take instead of diphenhydramine while breastfeeding?

LactMed lists Cetirizine, Desloratadine, Fexofenadine, Levocetirizine, Loratadine as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.

Does diphenhydramine pass into breastmilk?

LactMed's measured drug levels for diphenhydramine are quoted in full on this page, under "How much gets into breastmilk".

Do I need to pump and dump after taking diphenhydramine?

LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.

More on diphenhydramine

LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.