Alcohol and Pregnancy: Is It Ever Safe to Drink?

You're likely to hear it more than once during your pregnancy: "Go ahead, have a drink -- one little glass of wine won't hurt the baby." Older friends and relatives will insist that in their day, casual drinking was common during pregnancy. "And look at us," they'll add cheerfully. "We all turned out just fine." Are these well-meaning friends right?

The answer is a resounding no.

It may help you to turn down that drink if you think about it this way: When you drink a glass of wine, the alcohol travels through your blood, passes through the placenta and reaches your baby through the umbilical cord.

In other words, your baby is effectively consuming that drink right along with you.

Ask yourself this: If you poured yourself a glass of wine, would you pour one for your baby as well? It sounds ludicrous, but in effect, that's what you do when you drink during your pregnancy.

How much alcohol is too much?

According to experts, no amount of alcohol consumption during pregnancy has been proven safe. In other words, there is no time during your pregnancy when it is okay to drink. If you are trying to get pregnant or suspect you could be pregnant, you should stop drinking right away.

Did I harm my baby if I had a glass of wine or two before learning I was pregnant?

Probably not, if you're talking about light drinking. But the sooner you stop drinking the better, because many of your baby's vital organs begin to develop during the early weeks of pregnancy. The most important thing you can do to improve your baby's chances for normal development is to stop drinking immediately.

What are the risks of drinking during pregnancy?

Every year, up to 40,000 babies are born with some level of alcohol-related damage, according to the March of Dimes. In recent years, medical experts have identified several distinct categories of alcohol-related fetal damage.

One of the most severe threats to the unborn child is fetal alcohol syndrome (FAS), which causes profound and lasting brain damage. According to the Nemours Foundation, alcohol is the leading cause of preventable mental retardation in the United States.

FAS babies are marked by central nervous system problems and retarded growth. As a result, children with FAS will likely have problems learning, remembering, hearing, and speaking, and generally have short attention spans and impaired judgment. They typically have low birth weight and remain smaller than other children in their age group as they mature.

They also have certain characteristic facial features, including a thin upper lip, small eyes, a short nose, flat cheeks, and a smooth philtrum -- that's the normally grooved area above the lip.

There is no cure for FAS, though early intervention can help them live more comfortably and safely. Some studies show that as they grow older, FAS children are likely to have problems at school, with the law, and with drugs and alcohol.

You may have also heard the term fetal alcohol effects (FAE), which was once used to describe a lesser degree of fetal alcohol syndrome. However, the Institute of Medicine retired the term FAE some years ago.

Instead, alcohol-affected children who develop learning and behavior problems (although not as severe as in FAS) are described as suffering from alcohol-related neurodevelopmental disorder (ARND). The Institute went on to classify physical abnormalities caused by the mother's drinking, such as problems with the heart, kidneys, bone development and hearing, as alcohol-related birth defects (ARBD).

Is light drinking really that bad for my baby?

Heavy drinking is more dangerous to your baby than is light drinking. But unfortunately, even social drinking can have harmful effects on a developing fetus. Alcohol consumption can trigger miscarriage and preterm labor; it can also contribute to low birth weight. Drinking may make it harder to conceive, according to recent studies.

Studies have linked drinking even less than one drink a week during pregnancy to an increased risk of behavioral problems in childhood, including aggressiveness and delinquency. Other research has shown that moderate drinking may increase the risk of attention deficit disorder, hyperactivity, learning disorders, and mood disorders.

In addition, federal guidelines are clear-cut: If you are pregnant, suspect you might be pregnant, or wish to become pregnant, you should stop drinking immediately. Or, in the words of the American Academy of Pediatrics: "Pregnant? Don't Drink. Period."

Are there alternatives to my nightly glass of wine?

If you are a regular drinker, you may have to make a conscious effort to change your habits. If you rely on a glass of wine or a cocktail to help you unwind, you might consider joining a prenatal yoga class or meditation group, or simply making it a practice to take a walk to help you relax. If you and your partner look forward to the cocktail hour at the end of the day, ask him or her to join you in developing some alternatives.

You can also replace that glass of wine with a "virgin" cocktail with no alcohol in it. Many supermarkets and health food stores offer a variety of interesting nonalcoholic beverages. Buy a few, mix and match, and keep your refrigerator stocked with a selection of your favorites.

What should I do if I cannot stop drinking?

If you find that you cannot stop drinking, or if you repeatedly try and fail, consult your physician immediately. You may have a drinking problem, and there is no better time than the present to face it. Your physician can help you find a therapist, treatment center or support group to help you tackle your problem -- before it becomes your child's problem as well.

What about drinking while nursing?

Both the Office of the Surgeon General and the American Academy of Pediatrics (AAP) advise nursing mothers -- along with pregnant women and those trying to conceive -- not to drink at all. According to the AAP, not only does alcohol become concentrated in breast milk, it also inhibits milk production.

References

U.S. Centers for Disease Control and Prevention. Fetal Alcohol Syndrome. Frequently Asked Questions. http://www.cdc.gov/ncbddd/fas/faqs.htm

Nemours Foundation. Fetal Alcohol Syndrome. http://kidshealth.org/parent/medical/brain/fas.html

Sayal, K., et al. Prenatal Alcohol Exposure and Gender Differences in Childhood Mental Health Problems: A Longitudinal Population-Based Study. Pediatrics, volume 119, number 2, pages 426-434.

Streissguth, A.P. et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 25(4):228-38.

American College of Obstetricians and Gynecologists. Pregnancy and Alcohol.

Maryland Department of Health and Mental Hygeine. Alcohol and Pregnancy. http://fha.maryland.gov/mch/alc.cfm

March of Dimes. Drinking Alcohol During Pregnancy. http://www.marchofdimes.com/professionals/19695_1170.asp

Sood B, et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: dose-response effect. Pediatrics;108(2)

American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk. Volume 115, Number 2. http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496

American Academy of Pediatrics. National Alcohol and Other Drug-Related Birth Defects Week. http://www.aap.org/advocacy/releases/natlalcohol-fas.htm

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