Benadryl breast milk effects include which of the following?

• A. Increases prolactin and milk production
• B. Has no effect on prolactin or milk production
• C. May decrease prolactin and milk production; infant irritability and drowsiness
• D. Causes permanent suppression of lactation.

Answer: (C)

This question tests how a sedating antihistamine interacts with breastfeeding. Diphenhydramine (Benadryl) can pass into breast milk and affect the nursing infant’s CNS, which can show up as irritability and sleepiness. In the mother, the drug’s anticholinergic and sedating effects can modestly influence lactation—for some people this may mean a reduction in prolactin release or the let-down response, leading to a possible decrease in milk production. Importantly, these effects are not permanent. The infant’s irritability and drowsiness are the main safety concerns with maternal diphenhydramine use during lactation, which is why the option describing a possible decrease in prolactin and milk production alongside infant drowsiness and irritability best fits. If antihistamines are needed, non-sedating options and the lowest effective dose for the shortest duration are preferred during breastfeeding.