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Alcohol and pregnancyPublished by Bupa's health information team, healthinfo@bupa.com, April 2008 The jury is still out on exactly how much alcohol is safe to drink during pregnancy. In the meantime, experts agree that it's best to be on the safe side while you are expecting, either abstain completely or keep alcoholic drinks to a minimum. Can I enjoy a drink in early pregnancy?Many women find they cannot drink alcohol in early pregnancy and even the smell makes them feel sick. This may be a natural defence mechanism. Most women in the UK drink very little while they are pregnant. One survey showed that 45 percent of women did not drink at all during pregnancy, 44 percent drank less than one unit of alcohol a week and 10 percent drank less than one unit a day. Just one percent said they drank more than one unit a day. Although experts agree that the amount of alcohol you drink should be kept to an absolute minimum during pregnancy, advice does vary. The Department of Health recommends that pregnant women have no more than one or two units, once or twice a week. The National Institute for Health and Clinical Excellence (NICE), meanwhile, recommends women drink no more than one unit per day. The reason for this variation is that research about how low levels of alcohol affect unborn babies is inconclusive. An unborn baby is particularly vulnerable to heavy drinking during the first three months of pregnancy, when the organs and nervous system are developing. Because of this, some doctors and midwives recommend not drinking at all during this period. In the US, the government advises women not to drink at all if they are trying for a baby or are already pregnant, and alcoholic drinks carry warnings to that effect. However, the evidence for a blanket ban is weak. What the experts do agree on is that drinking to excess and binge drinking can be very harmful during pregnancy. There's evidence that women who drink more than five units a week during early pregnancy are more likely to miscarry. Another study showed that, during early pregnancy, even occasional binge drinking - that's five or more units on a single occasion - can lead to your offspring having learning and behavioral problems in childhood. What about later on in pregnancy?Although your baby is most vulnerable during the first three months of pregnancy, moderate to heavy drinking after this time can still cause problems. Firstly, it can affect your baby's growth. One study found that women who drank three to five units of alcohol a day during the second half of pregnancy were nearly twice as likely to have a low birth-weight baby as women who drank nothing at all. What is fetal alcohol syndrome?Fetal alcohol syndrome (FAS) is the name given to a group of physical, mental and behavioural problems seen in babies whose mothers drink particularly heavily during pregnancy. These can include facial disfigurements, brain abnormalities, slow growth, learning difficulties and behavioural problems. Not all women who drink heavily in pregnancy have a baby with FAS but the more you drink, the greater the risk becomes. Thankfully, FAS is rare. But doctors have also identified something called fetal alcohol spectrum disorders (FASD), which affects babies at lower levels of drinking. Babies with FASD show some, but not all, of the signs of full-blown FAS. FASD is not seen in babies whose mothers drink within the recommended safe limits for pregnancy. How do I know how many units of alcohol I am drinking?One unit of alcohol is equivalent to:
However, it's important to note that in recent years the alcohol content in some drinks has increased, for example in wine, and new types of alcoholic drinks have become available. The safe upper limit for drinking in non-pregnant women is no more than two or three units on any one day. In pregnancy, this level of drinking poses small but definite risks to your baby. So it's important to stay within the limits recommended for pregnant women of one unit a day, or one to two units once or twice a week. If you are not sure how many units you are drinking, try our alcohol calculator. Is drinking beer or wine safer than drinking spirits?It doesn't make any difference what kind of alcoholic drink you have - it's the number of units of alcohol drunk that counts. So, if you drink only one measure of gin (one unit), this is safer than drinking one pint of normal strength lager (two units). Don't be tempted to drink more if you are eating as well - it's still the number of units you have that counts. Can I have a drink while I'm breastfeeding?The occasional drink is unlikely to harm your baby; less than two percent of alcohol consumed by the mother gets through to the breast milk. Follow-up studies show no difference in motor and mental development between the babies of mothers who drank less than one drink a day and those that did not drink. It takes around two hours for a unit of alcohol to leave your breast milk. Pumping and discarding milk is not necessary, as it is the amount of alcohol in the mother's bloodstream that determines how much gets through in the breast milk. If you do have a drink, avoid breastfeeding for two to three hours afterwards. The Department of Health recommends that breastfeeding mothers stick to the normal safe limit of alcohol for women - in other words, no more than two or three units a day. Don't be tempted to save your units up for a binge. If you drink to excess:
Together these changes may mean that your baby's feeding patterns are altered. Further information
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