Strollerderby : drinking while pregnant

Drinking While Pregnant: Is Any Amount Okay?

Kate Tuttle — Fri, 20 Mar 2009 17:01:00 GMT

As Miriam posted about earlier this week, a few new studies have come out that some are using to argue, again, that ANY amount of alcohol during pregnancy is dangerous for the unborn -- even though the studies themselves say no such thing. Now Amy Graff at SFGate's Mommy Files reports on the ongoing controversy, quoting doctors and mothers who differ with the most stringent "no drinking" line, and exploring what the studies really say.

My favorite quote quote is from the doctor who says:

"If you're at a dinner party and someone pours a 1978 Bordeaux, I say go ahead and try it. Most healthy pregnant women lose their taste for alcohol, especially in early pregnancy when alcohol is known to exert its greatest effects, so they're only going to be having a sip here and there anyway."

The problem, as so many have pointed out, is that the vast majority of the research data focus on women who drink heavily during pregnancy, or binge drink. It's no surprise that their babies are at high risk for Fetal Alcohol Syndrome, nor is it really any surprise that the public health message -- aided by an often hysterical media -- compresses all alcohol use into this baby-damaging paradigm. But is there any science out there that tells us what really happens when a pregnant woman drinks very occasionally? And how do we square the dangers of FAS with the example of all those gorgeous French children whose mothers drank a moderate amount of (excellent) wine while gestating?

The SFGate piece links to three studies, all of which seem to provide some evidence of some effect -- whether on size or behavior -- of the children of women who drank lightly in pregnancy. Public health folks continue to deliver the message that there is no known safe amount, although most doctors will contradict that (mine advised me to have a glass or two of wine following the amnio, and then said, when I visited France in my six month, that he certainly hoped I would have some wine). With one woman in twelve reporting that she drank at least a little alcohol during pregnancy, the confusion will likely continue, leaving individual mothers to asses their own risk level.

So how about it? Did you lift a glass while pregnant? Did you feel guilty or worried, or do you think the health message is overstated?

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They [Didn't] Say: Not Even a Drop of Alcohol

Miriam Axel-Lute — Mon, 16 Mar 2009 14:30:00 GMT

Oh the pull of the easy, dramatic headline.

Lauredhel, over at Hoyden About Town, has two interesting, detailed posts up recently about the, shall we say, divergance between what a scientific study and a set set of agency guidelines, respectively, actually say, and what's been been reported about them. It's all Aussie, but I know the same things happen here (and presumably booze and pregnancy aren't that different down under, physically).

In the first, she takes apart a study that finds an increased risk of pre-term birth for binge drinkers (shocking, I know) and, with very slim margins of confidence, women who drink heavily in the first trimester and then stop (but not, interesting, those who keep going. It would be interesting to come up with a mechanism for why that would be). It does not find an increased risk for light drinking. Also, much of its data appears to be pretty tentative.

But the coverage of it says the report states that "abstinence is still the safest option" (It might be. I did. But the report says no such thing) and also gets the data about the trimesters wrong. Laurdehel takes both the original study and the coverage apart in minute detail.

In the second, quite similarly, she notes some health guidelines that, based on no new evidence, reverse their previous stance that a light amount of drinking is OK while breastfeeding and start suggesting abstinence, though retaining a level-headed description of what would constitute a cautious approach to alcohol and lactation. The coverage (1) implied that there was some new evidence that it's more dangerous than previously believed and (2) never even mentioned the existence of the more nuanced guidelines.

It's easy to pick on journalists, sometimes too easy, but it's also necessary sometimes, because they have all the same cultural biases and habits (like infantilizing women and being alarmist about pregnancy) as everyone else.

Photo by timomcd.

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They Say: Alcohol Tastes Better If You Get It First in the Womb

Miriam Axel-Lute — Tue, 10 Mar 2009 20:30:00 GMT

Perhaps I can blame the fact that I can't take the bitterness of beer on my mother. It seems that on top of all the known hazards of drinking while pregnant, it also just might give your kid a taste for booze.

Emphasis on the might. This is one of those studies that should be taken with a grain of salt, as it was done on rats and the pregnant rat moms were basically kept drunk much of the time, not just allowed to sneak a glass of wine now and then. (While I'm all about not being alarmist, I hope there's no one out there who thinks a constant BAC of .15 during pregnancy is acceptable.)

With those caveats in mind, the results: baby rats born to alcohol-soaked mothers were distinctly more interested in licking alcohol-covered feeding tubes than the controls. Shocking, no? They were also more willing to lick a non-alcohol bitter substance, making the researchers figure the efect of fetal alcohol exposure on taste in particular is to reduce the resistance to bitter flavors.

I have to say, I think it's a stretch to go from here to surmising that this is why fetal alcohol exposure is linked to higher rates of alcohol abuse at 21. Is "it's an acquired taste" really that much of a barrier if the other conditions for abuse are in place? Wouldn't it just drive you to sugary, non-bitter drink and worse hangovers? (Or conversely, if other risk factors for abuse aren't present, is liking the taste enough to make you abuse it?)

Photo by Chris Owens.

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They Say: Crack Babies? Not Such a Big Deal

Madeline Holler — Tue, 27 Jan 2009 21:23:00 GMT

One of the big news stories in the 80s and 90s was about crack babies -- kids whose addict moms continued using during pregnancy and after. The babies -- crack babies -- were born with varying amounts of the drugs in their systems. Much hand-wringing (and social-servicing, and child removal) ensued.

Researchers have been following a significant number of these babies-now-tweens. What's the one thing these researchers have found in the crack babies that truly surprised them?

Nothing. That is, the hugely harmful outcomes for these children that everybody feared were never borne out. That's good news!

From the NY Times:

So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”

Of course, cocaine is bad for the fetus. But get this: alcohol and cigarettes have been found to be worse. But that's still no reason to re-establish contact with your hook-up.

Again, the Times:

“The argument is not that it’s O.K. to use cocaine in pregnancy, any more than it’s O.K. to smoke cigarettes in pregnancy,” said Dr. Deborah A. Frank, a pediatrician at Boston University. “Neither drug is good for anybody.”

The study showed no significant difference in language development or IQ scores between crack babies and those born to mothers who stayed clean during pregnancy. However, there were notable differences in visual attention and “executive function” — the brain’s ability to set priorities and pay selective attention, enabling the child to focus on the task at hand. Cocaine exposure may also increase the frequency of defiant behavior and poor conduct. Boys may also be more prone to the behavior disorder effects than girls.

This study has interesting implications, especially in light of the fact that crack babies' mothers were often punished more severely than other abusers and more vulnerable to have their children taken out of the home.

Breaking News: Drinking while Pregnant May Make Your Baby Smarter

Shannon LC Cate — Sat, 01 Nov 2008 12:15:00 GMT

According to the Guardian, a new study out from the University of London, found that not only did moderate drinking (defined as one to two units of alcohol per week) have no noticeable ill effects on three-year olds, but that:

"Boys born to mothers who drank lightly were 40% less likely to have conduct problems and 30% less likely to be hyperactive, even when the differences between social and economic circumstances were taken into account. They also scored more highly in vocabulary tests and were better able to identify shapes, colours, letters and numbers."

These results stuck even when corrected for social circumstances like having parents of a higher socio-economic class and better education. Better outcomes were also reported for girls born to the light drinkers, but these were not as clearly independent from other social factors in those families.

The study adds to the controversy about drinking during pregnancy, as the Guardian notes:

"Although it has always been clear that heavy drinking can seriously damage babies, scientists have not had good evidence either to prove or disprove that light drinking does any harm. Doctors and other health experts have swung uneasily between condoning a drink or two each week and urging women to abstain."

Everyone is clear that abstaining from all alcohol is best in the first trimester of a pregnancy. But whether or not to drink thereafter may best be left up to personal choice, as advice sways back and forth from The Powers That Be.

To drink or not to drink? What do you think? What did you/do you/will you do?

Image: photorepetto.com

Scottish Health Board Says Drink Up, Pregnant Ladies

Jen Chaney — Sun, 12 Oct 2008 18:02:00 GMT

Okay, they didn't exactly say "drink up." But the NHS Lothian, Scotland's national health organization, has urged the government to abandon advice that tells women they should abstain entirely from alcohol while pregnant or trying to conceive.

As reported on scotsman.com, the NHS Lothian told the Scottish government that suggesting pregnant women cannot have even one drink "stigmatises any of them choosing to have a single glass of wine" and also "causes unnecessary anxiety." The NHS Lothian acknowledges that excessive drinking clearly should be avoided but notes that there is no evidence that having one or two units -- aka servings -- of wine a couple of times a week will harm the child.

Look, no one wants to endanger their unborn kid's life by taking a few swigs of sauvignon blanc. But I appreciate hearing this from our neighbors in Scotland because I've always been a little irked by the "abstension is the only way to go" approach. I think there are two reasons health agencies usually give that advice. First, there is no concrete evidence that small amounts of alcohol can harm a fetus. But there is also no definitive evidence that small amounts of alcohol can't, under any circumstances, harm a fetus. If doctors cannot rule out something 100-percent, they tend to err on the side of caution. Which is understandable, albeit a little extreme.

Secondly, pushing the tee totaling approach is the easiest, most concise advice that can be given to potential moms. If health experts say, "Well, a glass of wine is okay but otherwise, abstain" that sounds wishy-washy and potentially confusing. And -- let's be honest -- it leaves doctors and other organizations open to potential lawsuits if their guidelines aren't absolutely clear.

Unfortunately, that advice also insults women's intelligence. Most of us realize that guzzling a six-pack in one evening is not a hot idea when you're pregnant. But we've also seen enough anecdotal evidence to know that a glass or half-glass of something bubbly with our Thanksgiving meal isn't going to be a deciding factor in our baby's well-being. I understand why health agencies feel they can't say that officially. But I also think it's a shame, too.

I wish that, collectively, we were all a little smarter than that. Apparently the higher-up health experts in Scotland trust their female population enough to tell the truth. That's right: The nation that gave us Groundskeeper Willie may be ahead of the curve when it comes to giving honest maternity advice.

Image: Top News Health

Pregnant Binge Drinker Faces No Criminal Charges

Hannah Tennant-Moore — Tue, 08 Jul 2008 21:45:00 GMT

If there’s anything sadder than domestic violence, it’s domestic violence involving a pregnant woman and an insane quantity of booze. Last week, New Zealand police, responding to a 4 a.m. domestic violence complaint, found a heavily intoxicated woman whose partner had hit her over the head with a bottle. She was nine months pregnant, and had been drinking with her partner for eight hours straight.

The man was imprisoned on assault charges, but police were uncertain about how to deal with the mother-to-be. They considered bringing charges against her for endangering her child by binge drinking, but ultimately decided to refer the case to Child, Youth, and Family—largely because maternal substance abuse is not explicitly outlawed. In some rare cases, pregnant drinkers have been charged with attempted fetal homicide, but New Zealand, like the United States, does not criminalize the simple act of drinking while pregnant.

This recent case has New Zealand police hoping to change that. Detectives involved in the case have called for legislation banning maternal substance abuse, believing that's the best way to stop addicted mothers-to-be from endangering their fetuses. But others feel that throwing pregnant women in jail is not the answer. Furthermore, legislating pregnant women's behavior could be a slippery slope. While many pregnant women feel comfortable having a daily drink, others would never consider consuming even a drop of wine.

What do you think? Should drinking while pregnant be against the law?

Photo: The Daily Mail

Pregnancy and Booze: A Match Made in France

Hannah Tennant-Moore — Tue, 06 May 2008 16:30:00 GMT

Back pain and swollen feet bringing you down? That bloated feeling making you want to jump out of your skin? Make like the French, and have a vodka tonic, or even a couple of sérieux (roughly translated as, “one serious beer.”) According to a new study, 52 percent of French women consistently hit the bottle while pregnant. I knew I was a French major for a reason!

I know what you’re thinking: those French and their hedonistic ways. Well, in this case, the majority of tipsy pregnant mademoiselles simply didn’t know that drinking alcohol presents a health risk to their babies. And we’re not just talking an aperitif before dinner.

Here it gets a bit disturbing: Of the 837 pregnant women interviewed, 13.7 percent had at least one binge drinking episode, consuming five or more drinks, during their pregnancy. (Compare this to American women, of whom only 12 percent consume the medically approved daily drink while pregnant.) Tragically, two of the women in the study gave birth to babies with fetal alcohol syndrome. Let’s hope this study serves as a wakeup call to the French that at least one American dietary obsession just makes sense.

Photo: hoverdontsit.typepad.com

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UK Preggos Can Drink, But Aussies Can't? WTF?

Karen Murphy — Sun, 14 Oct 2007 12:53:00 GMT

All right, people, I have one request. Will you (and by "you" I mean those who make dire pronouncements about what is good and not good for pregnant women and then change their minds) PLEASE MAKE UP YOUR MINDS?

Please. Because first you tell us to stay away from alcohol. And then you say, well, a little is okay. And then you've got to break it down by country (OK in the U.K.!), so now we're left wondering who to believe.

So even though Australia has said previously that it's totally okay to drink during pregnancy, in fact even up to seven drinks a week (could that be all in one day?), they've reversed course and said that zero drinks per week is now the maximum. Because it's bad for you and stuff. In fact, now they're thinking that early exposure to alcohol, like any time under age 25, leads to all kinds of problems down the road.

And this is a country that thinks SIX DRINKS A DAY is okay for the non-pregnant. Four if you're a woman. I know what six drinks a day would do to me, or even four. That's a LOT of alcohol sloshing around in there. Which is maybe why Australia is rethinking things and considering that even two drinks a day makes one's risk of death due to accident or disease, related to the alcohol, goes to one in a hundred.

Them's not good odds.

Which seems to be why they're counseling pregnant moms not to drink at all, to reduce alcohol exposure even in the very very young.

Britain Joins U.S. (and France?) in Saying No Alcohol During Pregnancy

Rachael Brownell (Redsy) — Tue, 20 Mar 2007 16:23:00 GMT

Ahhh the Brits. The nice people often accused of bad food, excellent architecture and poor taste in allies have finally ruled against moderate alcohol consumption during pregnancy. Rachel Weisz
better watch where she quaffs that next brew. Unlike the Aussies, who lately have determined that drinking in moderation is still acceptable, the British government has decided to rule against even occasional consumption during pregnancy or when trying to conceive a child. Warning labels to this effect will be added to wine, beer, and spirits. Shockingly France, the poster country of wine with everything, is apparently also considering warning labels.

Not surprisingly, wine growers and others representing alcohol interests, argue that the pregnancy warnings are overkill and point out, rightly, the new warnings contradict existing Department of Health guidelines, which allow occasional usage as not damaging to the fetus.

Despite the terrible outcomes associated with drinking heavily while pregnant (fetal alcohol syndrome), most women admit to consuming alcohol at some point during pregnancy. So total abstinence may be the absolute safest course of action, but I'm with Rachel Weisz on this one. I think it's better to have an occasional glass of wine after the first trimester than try and follow a rigid regimen of total abstinence. And now apparently we'll both be "pilloried" in England and the States.