Alcohol consumption during pregnancy is a common issue in many countries. Scientists looking at the UK, Ireland, New Zealand and Australia found that up to 80% of women were consuming some alcohol during pregnancy. The effects of alcohol consumption on both maternal health and health of the baby lead to societal, economic, educational and medical consequences.
What are Fetal Alcohol Spectrum Disorders (FASDs)?
The FASD spectrum refers to a group of conditions that can occur in a child whose mother consumed alcohol during pregnancy. They have lifelong implications. Alcohol crosses the placenta with fetal blood alcohol levels approaching maternal levels within 2 hours of maternal intake. Alcohol can impact fetal development, especially in the brain. It can also affect the heart, kidneys, bones and other organs.
What’s the difference between Foetal Alcohol Spectrum Disorder and Foetal Alcohol Syndrome?
Foetal Alcohol Syndrome (FAS) is the most serious end of the FASD spectrum. You can think of it as the most severe form of FASD. Children with FAS might have abnormal facial features, growth problems, nervous system abnormalities, and difficulties with learning, memory, attention span, communication, vision, or hearing. FAS is a lifelong condition that results in disabilities and issues in adulthood including problems at school, social situations as well as substance misuse and mental health problems.
What are the signs and symptoms of FASDs?
There are many symptoms that may develop. Babies with FASD may have small heads, limb and finger deformities, distinctive facial features like small eyes, thin upper lip, and a ridge between the nose and upper lip. The neurological problems include learning disability, coordination and balance issues, hyperactivity and mental health issues.
Is there a cure for FASDs?
There is no cure for FASD and it is an irreversible condition. However, early diagnosis and treatment can improve a child’s development. Although there’s no specific medication that can treat the syndrome, various therapies can help with behaviour and educational problems. Sometimes, specific symptoms like hyperactivity or anxiety can be treated with medications.
Is any amount of alcohol safe during pregnancy?
The truth is, that there’s not enough good quality evidence to answer this question accurately (as concluded by a meta analysis done in 2017. The current NHS consensus is that the risk is higher the more you drink, although there’s no proven “safe” level of alcohol in pregnancy. Because the condition can be completely prevented by abstaining, most doctors and experts recommend not drinking at all. Based on a literature review commissioned by the NHS to update the guidelines, of reviews, an Expert Group proposed that women should abstain from alcohol when pregnant and/or trying to conceive based on the precautionary principle (ie, ‘better safe than sorry), in the absence of robust evidence that a small amount of alcohol won’t cause any issues.
Should you reduce your alcohol conception ahead of conceiving?
Short answer? Yes.
A big issue in terms of alcohol consumption and pregnancy is that the first trimester of pregnancy is crucial for fetal development. Often, women may not realise they are pregnant in these first weeks. That’s why it’s really important to be proactive!
Scientists found that alcohol consumption 2 weeks before pregnancy can result in abnormal fetal development as well as other adverse outcomes like fetal death, growth retardation and miscarriage. In early stages of pregnancy, women’s bodies undergo significant changes and adjustments to facilitate embryo development. Scientists think that alcohol can interrupt these processes due to its effects on mother’s metabolism.
However, it’s difficult to quantify the actual effects and understand the underlying mechanisms. Some scientists managed to estimate that maternal alcohol consumption of up to 32 g/week was associated with an 10% increased risk of preterm birth. In comparison, light to moderate smoking (<20 cigarettes per day) is associated with a 22% increased risk of preterm birth.
Alcohol and breastfeeding
There is limited data on the impact of maternal alcohol consumption while breastfeeding. It has been reported that the concentration of alcohol in breast milk is similar to that of maternal blood concentration. Alcohol goes freely through a lactating mother’s milk and thus if you continue to drink and breastfeed, it’s advised that you wait at least 3-4hours after a moderate/high alcohol consumption. At moderate doses of alcohol (1 to 2 drinks), there are negligible amounts of alcohol present within a lactating mother’s milk thus making it less harmful for a mother to breastfeed their baby.
Alcohol and Your Health
Remember when we used to say “a glass of red wine is good for you”? Well, we may need to rethink that. Recent studies looking into alcohol’s effects on the brain concluded that there’s NO safe amount of alcohol consumption for the brain. Even “moderate” drinking adversely affects our brains. The study found no evidence to suggest alcoholic beverage type conferred differences in risks to the brain.
There are many well known negative effects of alcohol on health (picture below). However, you may not know that women have greater absorption and slower metabolism than men and thus, upon drinking equal amounts, women will have higher blood alcohol levels than men. In addition, women will more likely have long-term health problems from drinking than men such as liver disease, memory loss, decreased brain volume, heart problems, and cancer! Women who engage in heavy drinking or chronic alcohol abuse have also been shown to have reduced fertility and a higher rate of menstrual disorders.
Tips on how to reduce your alcohol consumption
If you think you have a problem with alcohol, get help before you get pregnant. Tell your doctor and they will be happy to connect you with professionals who specialize in helping people reduce their alcohol consumption.
You can start by trying ordering mocktails instead, deciding which days are drink-free days, and telling your closed ones so that they can support you! Not everything works for everyone so try to commit to something achievable for you. Remember that you are doing this for your own health but also for your baby’s development. Just like with your other well-being habits (healthy diet, exercise) discipline is key!
There are also confidential helplines available in the UK:
- Drinkline – the national alcohol helpline; if you’re worried about your own or someone else’s drinking, call this free helpline on 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm)
- We Are With You – a UK-wide treatment agency that helps individuals, families and communities manage the effects of alcohol and drug misuse
- Alcoholics Anonymous (AA) – a free self-help group; its “12-step” programme involves getting sober with the help of regular support groups
NOFAS-UK helpline on 020 8458 5951
