not even a drop
Dr. Susan D. Rich, MD, MPH
National Organization on Fetal Alcohol Syndrome
"No amount of alcohol at any point
during pregnancy is safe. Once you find out you’re pregnant, you should
stop drinking immediately. If you find you’re pregnant and have already
had a couple of drinks, stop now.
Even from OBs, there’s a lot of inaccurate
information on this subject. OBs still tell women, and you can still
read it in less credible books and lay news articles, that it’s okay
to drink a little bit of alcohol during pregnancy. But we don’t know
that. There are no scientific studies because we can’t do clinical
trials on this sort of thing. And there’s no way we’ll ever know
if there is a small amount you ‘could’ drink. For doctors
to say any alcohol is okay is simply inaccurate.
It’s the first eight weeks after conception
that the embryo is the most vulnerable to physical birth defects caused
by alcohol, and a lot of times that’s when a mom may be having a binge
episode of four or five drinks at a time. Research has shown that having
four or five drinks during one sitting at three to four weeks post-conception
is enough to cause full blown fetal alcohol syndrome. (Research on
this topic dates a fetus based on weeks past conception. An OB would
call this week six or seven of pregnancy because they date based on
the last menstrual period.)
But many of the other problems associated
with alcohol are brain problems -- neurological and psychiatric disorders.
It can cause behavioral issues that don’t show up at birth. Fetal
alcohol syndrome can show up at birth, but the subtle brain changes
caused by a little alcohol throughout pregnancy may not be identified
until school age. These are what we consider functional defects --
brain and nervous system problems (things like attention problems, occupational
issues, and sensory integration issues), which you can’t actually
see until a child is a little older. And a lot of OBs aren’t following
the mom by that point, so they don’t know about this outcome, and
the child’s pediatrician doesn’t have the mom’s OB
record (though a lot of OBs don’t even ask about drinking). There’s
evidence from the CDC that as little as one drink a day throughout pregnancy
(or seven a week on average) is enough to cause attention deficits in
children. To say one drink will cause these problems would be false
because we just don’t know the lower limit. And every woman is genetically
different, so certain people and their babies are more at risk.
No safe time
I’ve heard people say, ‘I’m in
the third trimester; now I’m going to have a few drinks.’ But there
can absolutely be damage to the baby in the third trimester. A baby’s
brain is very susceptible to alcohol at all
points in the pregnancy. In the last trimester the areas that help
with the vestibular system and other sensitive parts of the brain are developing, and can definitely be affected. Alcohol
is fat soluble, so it can permeate the brain and damage it at any point
Unfortunately, women will often go to
parties and drink before finding out they’re pregnant. If you’re
planning a pregnancy, you can simply avoid drinking while you’re trying
to conceive. But a lot of women aren’t planning the baby, so they
don’t know they’re pregnant in those early stages. They’ve just
barely missed a period, or if they aren’t regular, they wouldn’t
even know they’ve missed it. This is the dilemma of our society --
we have this freely available and non-regulated drug that causes serious
problems for babies out there on the shelves. Women can use it and
unintentionally cause their babies difficulties. So, if you’re having
unprotected sex, you shouldn’t be drinking.
I’d like alcohol labels
to say, 'Sexually active consumers of childbearing
age should use contraception to prevent unintentional birth defects
in children.' It is my dream for all babies to be
Dr. Susan D. Rich, MD, MPH is on the board of the National
Organization on Fetal Alcohol Syndrome, and is a child, adolescent and
sure, take a sip
Dr. Mary Jane Minkin, MD
Department of OB/GYN at Yale University
"Part of this is a lack of data. We
know women who have as little as two drinks a day on a regular basis
can have babies with fetal alcohol syndrome. But the problem is there’s
no data that says even one drink a day does this. Is it possible?
Sure. But we just don’t know.
From a rational point of view, an occasional
glass of alcohol is fine. If you’re at your sister’s wedding and
it comes time to toast with a glass of champagne, it’s perfectly okay.
People can get carried away and think crazy things, like it’s not
even okay to have a glass of wine touch their lips. If it’s your anniversary
and you want to have a glass of wine at your last quiet dinner before
the baby comes, go ahead. The European countries -- France, Italy,
Germany -- have produced pretty good thought leaders over the year.
Albert Einstein was a German fellow, and it’s hard to imagine his
mom didn’t have a drink while she was pregnant with him.
I’m not saying six glasses of wine
in one sitting is okay -- a high level on even one occasion could be
very dangerous. But as long as you keep it sporadic -- once or twice
a week, say, -- you’re probably okay. I trust my patients, and I let
them know that an occasional glass of wine doesn’t mean one every
day. Absolutely not. But some of my colleagues think I’m awful for
even saying that a little is fine -- they’re concerned that pregnant
women will go crazy.
The March of Dimes says pregnant women
should not have any alcohol, and I understand why they’re hesitant
to say on a large-scale basis that it’s okay to have an occasional
drink. They’re concerned that if you give women an inch, they’ll
take a mile and decide that if one drink is okay, five or six is fine
too. They’re also concerned that there’s no data that outright says
you can have one glass a day throughout your pregnancy and have
a healthy baby.
Keep it occasional
But the way I see it, there’s just
no data to say it’s not okay. As long as you take the advice
seriously and keep it to an occasional drink, it really is okay."
Dr. Mary Jane Minkin, MD is a clinical professor of obstetrics and gynecology at the Yale University School of Medicine