date: 8/16/2006
Benadryl doesn't improve babies' sleep
Benadryl is not advised for infants, since it doesn't train a baby to sleep and may cause grogginess or even hyperactivity. Consult for advice on good "sleep hygiene" for infants.
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For frustrated parents of babies who won't sleep through the night, the quick remedy of choice has long been a small dose of Benadryl. Benadryl, and several other allergy and cold drugs, contain the antihistamine diphenhydramine, which induces slumber and is actually approved for use as a sleep aid in adults and children 12 years and older. Many doctors have assumed it would also work well in babies.

A 2003 survey of 671 pediatricians found that 49 percent had recommended antihistamines for sleep problems in children under age 2. But according to a study published in the Archives of Pediatrics and Adolescent Medicine in July, that conventional wisdom may not hold true.

In a randomized controlled trial, 44 babies ages 6 months to 15 months were given a placebo or diphenhydramine 30 minutes before bedtime. Diphenhydramine was no more effective than a placebo in reducing nighttime awakenings over the course of six weeks: One of 22 children who received the antihistamine showed improvement vs. 3 of 22 children who received a placebo. In fact, the trial was stopped early because of the lack of effectiveness of diphenhydramine. Some babies treated with the drug did, however, fall asleep faster, which might explain the belief that Benadryl improves infant sleep.

Researchers used doses on the lower end of common recommendations for giving diphenhydramine to babies, which typically range from 1 to 1.5 milligrams per kilogram of body weight. At a higher dose diphenhydramine may have a more sedating effect, but more studies will need to be done to determine that.
A nondrug solution

Either way, many experts caution against using drugs to put your baby to sleep. Though generally safe, Benadryl can cause side effects ranging from next-day grogginess to dry mouth and hyperactivity in children, even when used as directed. At very high doses, Benadryl may cause serious harm. Pfizer, Benadryl's manufacturer, does not promote the drug as a sleep aid for babies.

Furthermore, "drugs don't get to the root of the problem, the reason why the infant isn't sleeping," says Raymond Sturner, M.D., associate professor of pediatrics at the Johns Hopkins University School of Medicine. That's often a sleep association problem, he says, where an infant who naturally awakens wants to resume physical contact with a person or object he or she had contact with before going to sleep, or because some babies have trained their parents to get up and feed them at night.

Behavioral interventions can address those issues. Evidence suggests that treatments such as cultivating calm-sleep routines or training babies to sleep through the night by not immediately answering their cries for attention may reduce night waking.

CR's Take
Benadryl can cause side effects in infants and is no more effective than a placebo in getting babies to sleep through the night. Though it may prompt some infants to fall asleep more quickly, behavioral treatments, such as instituting a calm bedtime routine or learning not to respond to all of your child's calls for attention at night, can and do help--and are safer than drugs.
