I suffer from moderate to severe allergies, including nasal allergy symptoms. My preferred allergy medication is Flonase. However, because Flonase is a category C drug, I opted to refrain from using the medication before and during pregnancy. Despite trying other treatment options, only Benadryl (diphenhydramine) offers me any relief from my allergies.
Benadryl: What Studies Have Shown During Pregnancy
According to the 2012 edition of Medications and Mother’s Milk, diphenhydramine is a category B drug during pregnancy. This means that well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities despite adverse findings in animals, or, in the absence of sufficient human studies, animal studies show no fetal risk. The chance of fetal harm is remote but remains a possibility.
Animal studies on pregnant rabbits indicate that large doses of Benadryl do not increase the risk of problems in offspring. However, the number of adequate, well-controlled human studies on the drug during pregnancy is lacking.
A more recent review of antihistamine safety during pregnancy, published in StatPearls, supports the consensus that diphenhydramine is considered low-risk for use during pregnancy. However, it emphasizes the need for more robust human studies.
CDC Recommendations on Benadryl During Pregnancy
The Centers for Disease Control and Prevention (CDC) provides guidelines on medication use during pregnancy, emphasizing that the benefits of treating a condition should outweigh the potential risks to the fetus.
While the CDC does not explicitly address Benadryl, it notes that antihistamines like diphenhydramine are commonly used during pregnancy and are generally considered safe when used as directed.
However, the CDC also advises pregnant women to consult their healthcare provider before taking any medication, including over-the-counter drugs like Benadryl.
Potential Risks of Benadryl During Pregnancy
While Benadryl is generally considered safe for occasional use during pregnancy, some studies have raised concerns about potential risks. For example, limited evidence suggests that Benadryl may increase the risk of cleft palate, though the data is inconclusive. A 2020 review of antihistamine use during pregnancy found no significant association between diphenhydramine and major birth defects, but it highlighted the need for further research to confirm these findings.
Another concern is the potential link between antihistamine use during the last two weeks of pregnancy and an increased risk of retrolental fibroplasia, a rare eye condition that can cause blindness in premature infants. However, the 1986 study that identified this link had significant limitations, including a small sample size and lack of specificity regarding the type and dosage of antihistamines used. More recent research has not confirmed this association, but the possibility remains a topic of discussion among healthcare providers.
Benadryl Use During Pregnancy: A Case For Using It Sparingly
The lack of large-scale, well-controlled human studies on Benadryl during pregnancy makes it difficult to draw definitive conclusions about its safety. A 2021 article from Verywell Health notes that while diphenhydramine is widely used during pregnancy and is generally considered safe, pregnant women should consult their healthcare provider before using it, especially during the third trimester.
Similarly, a 2022 review published by GoodRx emphasizes that while Benadryl is often recommended for allergy relief during pregnancy, it should be used sparingly and only when necessary. The article also points out that newer antihistamines, such as loratadine and cetirizine, are often preferred due to their lower risk of side effects like drowsiness.
According to Healthline, Benadryl is one of the most commonly used antihistamines during pregnancy. It is often recommended for relieving symptoms like allergies, insomnia, and nausea. However, Healthline also cautions that while Benadryl is generally safe, it can cause side effects such as drowsiness, dizziness, and dry mouth, which may be more pronounced during pregnancy.
Healthline also highlights that while Benadryl is considered safe for short-term use, long-term or excessive use during pregnancy has not been well-studied. Therefore, using the lowest effective dose for the shortest duration is essential.
Additionally, pregnant women should avoid combining Benadryl with other medications or substances that cause drowsiness, as this can increase the risk of accidents or falls.
My Personal Experience with Benadryl During Pregnancy
To treat my nasal allergy symptoms, I took 25 milligrams of diphenhydramine regularly with the approval of my midwife. Based on the evidence, Benadryl during pregnancy appears safe. I weighed the risks and benefits of using the medications against leaving my allergies untreated.
The most significant risk of not taking the drug is that I cannot breathe well and, therefore, do not sleep well because of my allergy symptoms. Exhaustion during pregnancy also poses a significant risk to mother and baby. Thus, I opted to take a low dose of Benadryl once a day to alleviate my allergy symptoms enough to sleep.
However, with the potential association between the use of antihistamines during the last two weeks of pregnancy and an increased risk of blindness, I stopped my nightly use of Benadryl while entering the second half of the third trimester.
With my daughter, I was able to stop taking as much of the medication as the cooler weather of fall appeared. My allergy symptoms ease up considerably once all the plants die or hibernate. For me, I can suffer through a few weeks of sleepless nights due to my nasal allergy symptoms. As my belly gets bigger, I don’t sleep as well anyway! I chose to deal with a little extra fatigue during late pregnancy rather than subject my child to potential blindness — at least until additional studies confirm or disprove the earlier association.
Disclaimer: The information provided in this article is not meant to replace the professional medical advice from a health care professional. Always consult your doctor or midwife before taking any medication during pregnancy.